THE

Clinical CO Biochemist I NEWSLETTER

REGISTERED BY AUSTRALIA POST PUBLICATION NO NBP 2747 NUMBER 71, DECEMBER 1983

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PUBLISHED FOR THE AUSTRALIAN ASSOCIATION OF CLINICAL BIOCHEMISTS THE Clinical iochemist NLWSLLTTtK

The Clinical Biochemist — Newsletter is AUSTRALIAN ASSOCIATION OF CLINICAL BIOCHEMISTS published four times a year by the Australian Incorporated under the Associations Incorporation Association of Clinical Biochemists, in March, Act (SA) June, September and December. Suitable con• tributions would be welcomed by the Editor,

Council 1983-1984 Nancy E. Dale, MSc, FAACB, President: Department of Clinical Biochemistry, Peter M. Dennis, MB, ChB, FRCPath, FRACP, Royal Prince Alfred Hospital, FRCPA, FAACB. Camperdown, NSW, 2050. Telephone (02) 516-8832 or 516-8816 Vice-President: and must be received by 24 January, April, William J. Riley, BSc, PhD, FAACB. July or October.

Honorary Secretary: Ronald C. Bowyer, BSc, PhD, FAACB, Bio• Other AACB Publications include: chemistry Dept., Royal Perth Hospital, Perth, WA, 6000. The Clinical Biochemist — Reviews, con• Honorary Treasurer: sisting of Educational Reviews and Tech• Peter Greenacre, BSc (Hons), FAIMLS, nical Reports from the Education and Scien• MAACB, Endocrine Department Royal Alex• tific & Technical Committees of the AACB. andra Hospital for Children, Camperdown, NSW, 2050. The Clinical Biochemist — Proceedings, con• taining abstracts of papers presented at the Chairman of the Board of Examiners: Annual Conference of the Australian Associa• William J. Riley, BSc, PhD, FAACB. tion of Clinical Biochemists.

National Representative to the I FCC: Statements of opinion are those of the John F. Connelly, MD, MAACB. contributors and do not necessarily represent official policies of the Association. Branch Representatives: Anthony Little, BSc, MAACB (New South Printed by: Wales); Anne E. Barr, BSc (Hons), MSc Publicity Press (NSW), 66 O'Riordan Street, (Queensland); John B. Edwards, BSc, PhD, Alexandria, NSW, 2015. FAACB (South Australia); Stephen J. Cook, BAppSc, MAACB (Tasmania); Stephen Slater, Published for the AACB by Associated Bus• FIMLS, FRSH, MAACB (Victoria); Andrew iness Publications Pty. Ltd., 104/3 Smail St. John, BSc (Hons), MAACB (Western Street, Ultimo, NSW, 2007. Postal address: Australia). PO Box 440, Broadway, 2007.

CHAIRMEN OF COMMITTEES All advertising enquiries to Mr. Ian Collins, Education: 212-2780, 212-3780.

Jean E. Robinson, BSc, MSc, FAACB. Copyright © 1983. The Australian Association of Clinical Biochemists Inc. Publications: ISSN 0159-8090. Graham H. White, BSc, PhD, MAACB. Scientific & Technical: DEADLINE FOR MARCH ISSUE IS T. Des Geary, BSc, MAACB. TUESDAY, 24 JANUARY 1983

2 The Clinical Biochemist, Newsletter, December 1983 The first complete kit for urinary VMA by HPLC

What's been needed for VMA analysis is a method that is specific for VMA and highly dependable. That's precisely what the new Bio-Rad VMA by HPLC assay kit provides... a specific, 15-minute assay suitable for any existing HPLC system with UV detection. This highly accurate HPLC technique eliminates compli• cated protocols and dietary restrictions. It may be used with available electrochemical detectors without modifications. 6 8 Minutes What's included in the basic Chromatogram of pheochromocytoma patient's urine prepared according to Bio-rad VMA by HPLC protocal chromatography kit really tells (concentration of VMA: 25.0mg/l) the story! • 100 disposable resin • Simple, comprehensive, step- columns for maximum clean-up by-step protocol. of urine samples. For labs without HPLC, complete • Reverse phase HPLC column systems are also available. optimized for VMA analysis, For details on the first of a series along with a guard column of advanced HPLC assays from system. Bio-Rad, contact our office. • Internal standard to monitor the recovery and assure high precision and reproducibility. BIO-RAD • Urine standard and optional Bio-Rad assayed urine controls. Laboratories P.O. Box 406, Epping, N.S.W. 2121, Australia Telephone (02) 84 5077 Telex: AA 70166

The Clinical Biochemist, Newsletter, December 1983 3 ASTRA-a

HJEXimUTY:

The ASTRA from Beckman. The most single keyboard, make an flexible automated Stat/Routine clinical ASTRA IDEAL system. Which chemistry analyzer, which makes build• may be ideal for you... handling ing your ASTRA test panel as easy as all the chemistries available to• stacking building blocks. The key is day. Acquire ASTRA through one the unique chemistry module concept. of the financial programmes Each performs one or more chemistries. we've developed for these diffi• There are twenty chemistries available cult times. And start building for now - more to come - giving over 120 an easier, more economical fu• different configurations. Use ASTRA as a ture. Write now for literature and 70 second STAT system. Or use it for multi• comparative running costs infor• channel routine analysis - switch from one mation. Contact your local sales to the other without losing count. Real flexi• office or direct: Beckman Instruments bility! ASTRA gives low cost-per-test. You (Australia) Pty. Ltd., Analytical Sales and don't have to keep changing tubes and Service Operation, 24 College Street, membranes or use expensive dispos• Gladesville, N.S.W 2111 or telephone: ables like reaction trays and rotors. Save Sydney (02) 896-2288, Melbourne (03) 544- still more on running costs... ASTRA is 3144, Adelaide (08) 268-4828, Bnsbane (07) test-selective. Use reagents only on the 369-9896, toll free in Watts (008) 226-423. channels in use. Every time you use ASTRA you save in time, trouble and reagent. ASTRA can be built as big as your problem. Two ASTRAS, linked and controlled by a BECKMAN

4 The Clinical Biochemist, Newsletter, December 1983 THE Clinical

NEWSLETTER NUMBER 71, DECEMBER 1983 Published for the Australian Association of Clinical Biochemists

Contents

EDITORIAL 6 "Education — Can we make it in Tasmania?" Michael Staley

NOTICE BOARD 7 Meeting — Colloids and Surface in Biological Systems 7 Reminder — Annual Postgraduate Course in Chemical Pathology, Adelaide, 1984 9 Nominations for the Executive of the Association 9 Impact 1984 - Meeting of the ACB in England 10 Overseas Meeti ngs - 1984 10 Graduate Diploma in Clinical Biochemistry 10 Dr. Alan Williams — Farewell Scientific Meeting 10 Treasurer's Report for the Financial Year 1982-1983 11 Information on Examinations for Membership and Fellowship — 1984

NEWS OF MEMBERS 12 New Associate Members 12 Congratulations to (i) Dr. Graham White (ii) Veronica Wiley 12 Letter from Dr. Callum Fraser

ARTICLES 13 "Hospital Ward Laboratories" - M.L. Wellby 13 "Matters of Concern to Clinical Biochemists" Introduction by Peter Dennis Letter to Council by Ian Farrance 15 "Victorian Survey of Plasma Creatinine Units" Peter Boyne

REPORTS 16 From the Education Committee (a) Report to Council - 1983 (b) Wilson's Disease (c) Education in the State Branches - 1982-1983 26 From the Scientific and Technical Committee Report to Council — 1 983

REGULAR FEATURES 12 Publications by AACB Members 22 Book Review 22 Laboratory Laughter 24 Chemical Crossword 31 New Products and Developments 34 Forthcoming Meetings

BRANCH NEWS 30 Queensland, Tasmania, Victoria and Western Australia

Front Cover

The front cover shows two old items of laboratory equipment for measuring urea in Urine — Figure 7: Maclean's Ureometer. Blood — Figure 2: Maclean and de Wesselow's modified apparatus. For details of the methods used see page 7.

The Clinical Biochemist, Newsletter, December J 983 5 Guest Editorial -V- 1 Jy^y

7*v Education — Can We ***** : Make it in Tasmania?

Michael Staley

Over the last four years, the Education Committee of Michael Staley the AACB has provided a considerable number of innova• tive educational activities that are available to most mem• bers of our Association. However, it is still sobering to look Michael Staley left the UK in 1976 after working at the number that use these educational facilities; I think at four large hospitals in the Midlands. He was that most Branch Committees would consider themselves initially employed for three years at Flinders Medical very fortunate if 50% of their membership attended lec• Centre during which time he gained a MAACB and tures or other special educational activities throughout the MSc to add to his Fellowship of the Institute of year. Medical Sciences (UK). He is presently employed as There are several forms of education that are available Scientific Officer-in-Charge of the Department of to our membership and it is a matter for each individual Clinical Chemistry at the Royal Hobart Hospital, a to decide which, if any, method he would like to under• position that he has held for four years. He was take. The choice may be very simple as he/she may decide Branch Education Representative for three years and that there is no point in taking any form of postgraduate is also Editor of Bibliographies for the Clinical study or for that matter attending any further-educational Biochemist — Reviews. lectures, as to so do would usurp their valuable free time and 'anyhow there is no professional or financial advan• ensure that his staff are adequately prepared. This approach tage in so doing'. There is no doubt that the Clinical may well seem idealistic to the department where staff time Biochemists employed within, or in close proximity to is at a premium, but it has been my experience that depart• tertiary institutions may find it more desirable to under• ments gain in flexibility if the majority of staff can perform take an academic form of postgraduate education, but even most tasks within the department. In addition the 'much here there may be problems with respect to the nature of travelled' biochemist will view the tasks performed in his the study undertaken. There are universities that offer own department in a different perspective. To second staff part-time MSc courses in Clinical Chemistry with a 50% to other institutions on an exchange basis has many advan• coursework/50% thesis content, but they usually require a tages and contributes to the knowledge of the staff mem• significant amount of time spent away from one's place bers who are exchanged as well as to the institutions where of employment which in the current financial and staffing they are transferred. In Australia, most large metropolitan situation is difficult to arrange. A MSc by thesis alone is hospitals provide specialist services for certain aspects of another alternative, but this poses several problems such as health care but there are very few institutions that are res• the need for a suitable topic, qualified and enthusiastic ponsible for" all specialties such as paediatrics, gynaecology, supervisors, a suitably equipped laboratory and a great deal infertility etc. All of these topics have their own 'special of personal effort. The vast majority of our membership Clinical Chemistry' and the MAACB candidate is expected does not have the opportunity to attend such castles of to have a certain level of knowledge in most disciplines. In education and it is here that the AACB has the potential to most large cities, there are hospitals that collectively cover provide a suitable modus operandi for personal professional all aspects, so an exchange programme for staff who intend fulfilment. to take postgraduate qualifications may be a simple means Undoubtedly, each individual must have the personal by which hands-on experience may be obtained. This idea motivation to embark on any further educational activity could easily be extended to the smaller hospitals through• but there can be several important factors that may out Australia where a two-way exchange could have major influence the decision to attend further educational benefits to all concerned. The experienced Clinical Chemist activities or to attempt postgraduate study. from the larger institution may well welcome the oppor• tunity of using his knowledge and talents in the smaller The senior members of the staff of each employing department and his 'country-cousin' will gain invaluable institution can provide a major stimulus to further educa• experience in the larger hospital. tion. It is extremely difficult for anyone to successfully embark on a course of study if, for instance, they are asked The local branch of the AACB also has a major role to to perform the same task day after day without being given play in the motivation of members in further-educational the opportunity to work in other sections of the depart• matters. Each State gets the Branch Committee that it ment. Indeed a caring Director may well consider the deserves, so it is up to each member of our Association to possibility of exchanging staff with other institutions to ensure that suitable candidates are proposed for each

6 The Clinical Biochemist, Newsletter, December 1983 Committee position. Obviously I believe that the role of Branch Education Representative is one of the most impor• Colloids and Surfaces tant positions for encouraging participation in continuing in Biological Systems education so it is essential that the right candidate is chosen. My preference is for a graduate who has recently gained the MAACB by taking all parts of the examination. This is a joint meeting of the Australian Biochemical It is here that the local graduates can have a major influence Society and the Colloid and Surface Division of the Royal on their own educational future because if sufficient Australian Chemical Institute and will be held at the younger members are interested enough to pursue further University of Sydney from 12-14 May 1984 immediately education, then it is quite likely that they could muster preceding the Annual Meeting of the Australian Biochemi• suitable numbers to elect the representatives that they cal Society. desire. The meeting aims to bring together biologists and A factor associated with the degree of interest shown in physical scientists with a common interest in biological professional matters by the newer members of our Asso• colloids and surfaces. Topics include colloid and surface ciation is one of enthusiasm — not necessarily theirs', but phenomena in immunology, cell recognition and that shown by their senior members of staff and the office adhesion, fertilisation, fat emulsification in the gut, blood bearers of the AACB. I am convinced that.the interest rheology, forces between living membranes, lung surfac• shown in our Association by our members is a reflection of tants and bacterial adhesion. Review papers on the any of that shown by senior members of staff in our institutions the above topics are welcome. There will also be a poster and by those people who choose to serve the AACB as office display. bearers. It is very easy for senior members of staff to Further details from Dr. L. Fisher, CSIRO Division of pretend that it is up to their staff to show all the enthus• Food Research, PO Box 52, North Ryde, NSW 2113. iasm and motivation, their own role merely being to provide instruction when requested to do so. This obviously leads to many problems and can soon develop into a vicious REMINDER circle where Clinical Chemists do not show the appropriate The Annual Postgraduate Course in Chemical interest because of lack of suitable stimulation from above Pathology will be held in Adelaide from 20-24 while senior members label their charges as professionally February 1984. Further information from the disinterested, not worthy of any special effort. Secretariat, Chemical Pathology Course, c/- Ms. B. The upsurge of interest in AACB matters in Tasmania Dilena, Department of Clinical Biochemistry, Flinders has most probably been due to the denouement of several Medical Centre, Bedford Park, SA, 5042. of these factors. Four years ago this State was not included on the itinerary of post-graduate activities organised by the AACB such as the Current Concepts Seminar and it was THIS MONTH'S COVER only occasionally blessed with a visit from the Roman UREA METHODS Lecturer. This apparent lack of support by the Federal body of the AACB did not encourage interest in Clinical Figure 1: This apparatus estimated the urea con• Chemistry amongst members in the State and did nothing tent of urine by the action of alkaline hypobromite on to encourage anybody to join the AACB. After strong rep• urea to liberate nitrogen. The nitrogen was collected resentations were made, the situation was rectified and the over water and its volume measured at atmospheric effect has been most dramatic. Conferences are very well pressure. Freshly prepared hypobromite solution was attended and I am sure visiting lecturers will testify that the placed in the jar and a small tube containing a meas• level of interest shown by registrants at our Current Con• ured amount of urine was placed obliquely inside it. cepts meeting is equal to that shown on 'the North island'. After setting the water level at zero with the aid of the In addition to the high percentage of membership that bulb the urine was tipped into the hypobromite and attend these ventures, we have been fortunate in attracting the liberated nitrogen measured in the burette. This a significant number of registrants from other professions in method was not particularly accurate and the hypo• the health care field, which has enabled us to use this forum bromite was unpleasant to prepare involving the to increase our knowledge of related fields. It is my belief addition of bromine to 40% caustic soda solution! that most laboratory workers enjoy being exposed to the Figure 2: This method was based on the ability of other half of the coin and there is considerable interest the enzyme urease to convert urea to ammonium car• shown in the role of other hospital departments in total bonate. Accordingly blood in phosphate buffer patient care. This new-found interest in AACB matters has was incubated with urease (soy bean meal) in tube B. led to an explosion in our Tasmanian membership, which Tube A contained acid to remove atmospheric ammo• in three years has risen from five to thirty. nia and tube C contained standard acid and indicator. We have been fortunate in attracting several enthusiastic Following the incubation step potassium carbonate was science graduates to this State over the last few years, some added to tube B to liberate the ammonia and the aera• of whom had recently obtained the MAACB. This has tion train was set up and connected to a pump. Air was meant that the local graduates have had the opportunity to driven through tube A to tube B from whence it carried avail themselves of knowledge that was backed-up by a the ammonia into the acid in tube C; the contents of great deal of enthusiasm. This has resulted in seven which were then titrated against standard alkali and the attempts at the MAACB examination in the last three years amount of ammonia which had already reacted with with five successes. We are now in a situation where we can the acid was calculated. Although several tubes could call upon the expertise of our home-grown produce to be set up at once it was very time-consuming and disas• assist in the education of further potentially successful ters could occur from malfunctioning pumps or by candidates. The expertise of the recently qualified MAACB human error in connecting tubes the wrong way so that is one of the greatest attributes that a State can possess in the contents of one tube could run over into another! respect to further successes in the examination.

The Clinical Biochemist, Newsletter, December 1983 7 THE COMPLETE ANALYSER

— SELECTIVE

— DISCRETE L

— PROVEN I.S.E. CAPABILITY

— STAT CAPABILITY

— BUILT IN REAGENT STORAGE

— UP TO 19 TESTS PER SAMPLE

HITPCHI 705

c boehrinqer BOEHRINGER MANNHEIM AUSTRALIA PTY. LTD. [W 8 The Clinical Biochemist, Newsletter, December 1983 NOTrCUOAMO AACB NOTICE BOARD E3

NOMINATIONS FOR THE ASSOCIATION IMPACT 1984 EXECUTIVE - 1984-1985 A THREE DAY MEETING FOR CLINICAL CHEMISTS Members are reminded that nominations for Officers of 21-23 MAY 1984 the Association should be lodged with the Secretary not Visit England during its most beautiful month of the later than 31 March, 1984. year and join members of the Association of Clinical Bio• Nominations must be made in writing by two members chemists at one of England's most attractive spa towns - (not Sustaining Members) of the Association and should be Buxton in Derbyshire — for their national meeting. The reg• accompanied by the nominee's written acceptance. The istration fee and hotel accommodation charges have been present executive comprises: kept at exceptionally low levels and travel within the UK to President: Dr. P.M. Dennis. the Congress is also available at specially reduced prices. Vice-President: Dr. W.J. Riley. 1984 sees the introduction of the new philosophy of the Treasurer: Mr. P.Greenacre. Association's National Meeting — one major meeting per Secretary: Dr. R.C. Bowyer. year held at a top conference centre. It is hoped that Drs. Dennis and Riley and Mr. Greenacre are eligible for Buxton will be a 'first' in another way attracting those re-election to their present posts. Dr. Bowyer has indicated members seen rarely, or not at all, at these events, and that he is unavailable for re-nomination. especially in attracting clinical chemists from overseas. R.C. Bowyer, You are invited to enjoy three days of high life style in Secretary a first class hotel with a wide range of facilities and hear something of the new ideas affecting our specialty and of the efforts of our colleagues in commerce to develop and AUSTRALIAN ASSOCIATION OF implement these ideas. In addition we invite industrial CLINICAL BIOCHEMISTS seminars and poster presentations. Nomination Form Cost: Accommodation £60 for three days (or £25 per day). This includes English breakfast and table d'hote lunch and and dinner and shared twin bedded room. (Print Title, Initials and Surname) Registration Fee: £25 (or £12 per day).

being Scientific Programme (Print Title, Initials and Surname) Plenary lectures — genetic engineering; cellular biochem• istry; NMR and the diagnosis of metabolic disease. members of the Australian Association of Clinical Symposia - Biosensors; enzymes — mass or activity; Biochemists (Inc) hereby nominate neonatal biochemistry; management in the laboratory; reshaping service in clinical chemistry. as Roundtables — Among the topics to be included are: (Print Title, Initials and Surname) Prostaglandins; PATHTEL; flow injection analysis; thyroid function testing; steroid analysis - new methodologies; of the Association for diagnosis of pituitary tumours etc. (Print Office to which nominated) Poster sessions and Commercial Seminars. for 1984/85 year. Welcome, Vickers and Kone Award Lectures. Ames Medal Competition. The Annual General Meetings of the Association and Signature of first nominator Regulating Committee. Further details from: Dr. C. Toothill, Signature of second nominator. Department of Chemical Pathology, University of Leeds, Leeds LS2 9JT, England. Acceptance Form WANTED accept nomination (Print Title, Initials and Surname) Preferably alive and active as of the Association A NEW FEDERAL SECRETARY (Office) Nominations from all able-bodied members for 1984/85. welcome. Please forward to current Secretary, Dr. R.C. Bowyer by 31 March 1984. (Use the nomination form on this page.) Signature of nominee

The Clinical Biochemist, Newsletter, December 1983 9 OVERSEAS MEETINGS - 1984 AUSTRALIAN ASSOCIATION Members are reminded of the 12th International Con• gress of Clinical Chemistry which is being held in Rio de OF CLINICAL BIOCHEMISTS Janeiro, Brazil from 29 April to 4 May 1984. It is hoped TREASURER'S REPORT that as many AACB members as possible will attend the meeting to support the Victorian Branch in their bid to 1982-83 FINANCIAL YEAR hold the 1990 meeting of the Congress in Melbourne. World Travel Headquarters have put together an attrac• The Association recorded a surplus for the 1982-83 tive package to South America which includes the seven financial year of $25,581 after bringing to account all days in Rio for the Conference with subsequent visits to known receipts ($87,471) and payments ($61,890). Iguassu, La Paz, Puno featuring Lake Titicaca, Cuzco/ Accumulated funds were increased from $42,195 to Machu Picchu and Lima. $67,174. An amount of $6,495 still held in reserve for The second meeting is the Second International Congress South-East Asian and Pacific Regional activities would re• on Automation and New Technology in the Clinical duce this amount of $60,679. Laboratory which is being held in Barcelona, Spain from The recommendation by our previous Auditor that re• 15 to 18 October 1984 and for which members have serves should be increased to approximate one year's ex• already received registration forms. World Travel Head• penditure has therefore been achieved. quarters would be interested to hear from anyone thinking Surplus for the year may appear excessive when less of attending this meeting with a view to arranging some sort than $5,000 was planned after inflation. Several factors of group travel. influenced the variation and made significant contribu• Please contact Miss Jennifer Jones (02) 237-0492 in tions to the funds: connection with the Rio meeting and Marie Bennett (02) 237-0489 in connection with the Barcelona meeting. The — effects of inflation offset by the endeavours of officers address of both is World Travel Headquarters, 33 Bligh to keep within budget; Street, Sydney NSW 2000. — failure of the Asian and Pacific Federation to claim money held in trust; — Annual Conference profit. — high rate of interest prevailing in the money market GRADUATE DIPLOMA IN throughout the year. CLINICAL BIOCHEMISTRY — favourable rate of exchange for Annals of Clinical Bio• The New South Wales Institute of Technology School of chemistry. Life Sciences, Gore Hill has a part-time course made up of formal studies in: Publishing and administration expenses continued to Introductory Clinical Biochemistry account for a major part of the annual expenditure of the Advanced Clinical Biochemistry Association. Analytical Biochemistry The role of our Sustaining Membership in supporting Biomedical Statistics publications and scientific meetings must be recognised as a Biomedical Computing vital contribution to the development of the AACB. Laboratory Management Subscriptions to the 1983 Annals of Clinical Biochem• plus a supervised research project in clinical biochemistry. istry totalled 237. The exchange rate at time of transfer For further information about this two-year course favoured the Australian dollar. It is hoped that the mem• contact Dr. A.G. Dawson, Head of the Department of bership appreciate the difficulty in predicting currency Biochemistry (telephone 436-9283) or apply in writing fluctuations more than seven months in advance. to the Registrar, The New South Wales Institute of The Association's computer continued to maintain Technology, PO Box 123, Broadway, NSW 2007. membership records. During the year a fast printer was pur• Application forms are available from the Student Enquiry chased to more efficiently produce address labels for state Centre (telephone 20930). and federal mailings and updated membership lists as required. The problem of non-financial members remained a bur• den on both the Association's finances and the Treasurer's DR. ALAN WILLIAMS time. Attempts to collect outstanding debts met with little Dr. Alan Williams retires from his post as Director of success despite three invoices and a final letter. Pathology at The Royal Children's Hospital on 11 May The Association's finances are currently in favourable 1984. balance. As retiring Treasurer I feel it my duty to warn To mark this occasion a Scientific Meeting is being against complacency. Surplus can all too quickly turn to organised for Friday, 13 April 1984 in the Lady Latham deficit as witnessed in the 1980-81 financial year. Theatre at The Royal Children's Hospital, Flemington Future Annual Meetings planned for West Australia, Road, Parkville, 3052 Victoria. The meeting will com• Queensland and Tasmania, overseas guest speakers and pos• mence at 0930 and finish at 1700. Lunch will be provided sible hosting of international meetings could place consider• and will be covered by the registration fee. able financial strains on our Association and would require This is a preliminary notice to bring the meeting to the further consolidation of assets. attention of former members of the department, colleagues I trust that we will continue to strike a good balance and friends of Dr. Williams who might wish to attend the between development and stability. Scientific Meeting. Enquiries should be directed to Dr. Peter Campbell, Jan Pickering, Department of Anatomical Pathology, The Royal Chil• Treasurer 1982-83 dren's Hospital, Parkville, 3052. 30 September 1983

10 The Clinical Biochemist, Newsletter, December 1983 Information on Examinations for Membership and Fellowship — 1984

Written examinations for Membership and Fellowship of the Australian Association of Clinical Bio• chemists will be held in State Capitals (and other centres if appropriate) in June 1984. Successful candi• dates will be required to attend a viva examination which will be held in Perth before the Annual Scien• tific Meeting in October 1984. It is anticipated that appointments for viva examinations will be made known to individual candidates in early September. Please note that the viva voce examinations must be taken in the same year as the papers.

APPLICATIONS of Examiners, on application, may grant permission for the Application forms are available from the Federal and submission of an original thesis in lieu of the usual written Branch Secretaries and should be submitted, in duplicate, examinations. Prospective candidates in this category to the Registrar before 30 April 1984. An examination fee should submit an outline of the proposed thesis to the ($120 for Membership and $220 for Fellowship) should Chairman of the Board early in 1984. The closing date for accompany the application and is not refundable irres• submission of a thesis is 2 )uly 1984. pective of the outcome of the examination. Unsuccessful candidates are liable for a further examination fee at any 3. Candidates working in specialised areas future attempt. Successful candidates will also be required Candidates working in specialised areas of Clinical Bio• to pay an admission fee on formal admission to Member• chemistry, but with a lesser quantum of original research ship or Fellowship. than is required under (2), may proceed to Fellowship by presenting a dissertation as well as being examined by one MEMBERSHIP EXAMINATION (25 and 27 June 1984) or two written papers. Nominated field of study and an Intending candidates must have spent a minimum of outline of the proposed dissertation must be submitted to two years in the practice of Clinical Biochemistry at the the Chairman of the Board of Examiners by 31 January date of the official commencement of examinations. Note, 1984. however, that successful candidates will not be formally Successful candidates under any of the three categories admitted to Membership until they have attained a total of will be required to attend a viva voce examination. three years experience in Clinical Biochemistry. The written examination will consist of two 3-hour EXEMPTION FROM WRITTEN EXAMINATIONS papers, one on Clinical Biochemistry and Interpretation and Holders of certain postgraduate qualifications in Clinical the other on Analytical Procedures and Instrumentation. Biochemistry and with the required experience may be The Board expects a basic knowledge on analytical instru• exempted from some or all of the written examinations for mentation, technique and methods as well as basic bio• Membership or Fellowship. Candidates who feel that they chemistry, physiology and the interpretation of results. It is have a case for exemption must apply for this sufficiently emphasised however, that candidates are expected to be early for the application to be considered before the closing able to apply the information gained from text books and date. Such applications should be submitted to the other sources and to have developed some critical faculty. Registrar. This is so even where, at the time of joining the They should also be aware of new developments in Clinical Association, an indication has been made that favourable Biochemistry. consideration would be given to such a request for exemp• Candidates reaching a satisfactory standard will be re• tion. quired to attend a viva voce examination. It must be pointed out that candidates who are granted exemptions are not eligible for the Wellcome prize. Further• FELLOWSHIP EXAMINATION (25, 27 and 29 June 1984) more, candidates who have been granted exemptions and Intending candidates must have spent a minimum of who fail at examination will not be considered for exemp• nine years in the practice of Clinical Biochemistry at the tions at a subsequent attempt. date of the official commencement of the examination. In this respect, the decision of the Board is final and the Note, however, that successful candidates will not be for• Board is not required to give reasons for its decision. mally admitted to Fellowship until they have attained a total of ten years experience in Clinical Biochemistry. GENERAL INFORMATION Fellowship may be obtained in the following ways: Copies of previous examination papers may be obtained from the State Branch Education Representative or the 1. General Examination Registrar, to whom all enquiries for further information The examination will consist of three 3-hour papers. relating to the examinations should be addressed. Candidates are expected to be proficient in all aspects of Clinical Biochemistry including methodology, instrumen• ADDRESSES tation, interpretation of test results and laboratory manage• Chairman, Registrar, ment. Dr. W.J. Riley, Dr. P.R. Pannall, Biochemistry Department, Department of Clinical 2. Thesis Royal Perth Hospital, Chemistry, In certain circumstances, such as for Clinical Biochem• Perth, WA 6000 The Queen Elizabeth Hospital, ists working in specialised but relevant fields, the Board Woodville, SA5011

The Clinical Biochemist, Newsletter, December 1983 11 News of Members

NEW ASSOCIATE MEMBERS I hope that you, as President of the Association, will To end of August 1983 pass my sincere thanks to Council for the opportunities they have given me and I look forward to meeting you and, New South Wales I hope, many members of the Association in the future, whether in Dundee (there would be a warm welcome in the Dr. R.L. Orwell, Mr. J.W. Sargent, Dr. J.D. Tomlinson. Highlands) or at a congress or scientific meeting. Queensland Callum G. Fraser, Department of Clinical Biochemistry, Mr. N. Avsenev, Mrs. Oi Hung Chang, Ms. Robynann Flinders Medical Centre, Henry. Bedford Park, SA, 5042 South Australia Miss Lesley Blight, Miss Rosy Bruno, Mrs. Beryl Mazzachi. Publications Tasmania by AACB Dr. V. Parameswaran. Members Victoria Miss Mary-Anne Ganey, Mr. A.N. Pentland. From the Department of Clinical Chemistry, The Queen Western Australia Elizabeth Hospital, Woodville, South Australia.

Mr. C.D.S. Mamotte, Ms. Deborah Norman. C.R. Milner, J.E. Buttery and B.R. Chamberlain, "The Measurement of Erythrocyte Transketolase Activity on a Discrete Analyser", /. Automatic Chem. 1982, 4,183-185. CONGRATULATIONS J.E. Buttery, C.R. Milner and B.R. Chamberlain, "The To Dr. Graham White who has been appointed to the NADH-dependent Transketolase Assay: A Note of position of Chief Clinical Chemist in the Department of Caution", Clin. Chem. 1982,28,2184-2185. Clinical Biochemistry in the Flinders Medical Centre, Bed• J.E. Buttery, N. Ludvigsen, E. Braiotta and P.R. Pannall. ford Park, South Australia. This is the position which was "Determination of Urinary Oxalate with Commercially recently vacated by Dr. Callum Fraser. Dr. White retains his Available Oxalate Oxidase", Clin. Chem. 1983, 20, 700- position of Senior Lecturer in Clinical Biochemistry at 702. Flinders University. He is also Chairman of the Publications Committee of the AACB. R.N. Ratnaike, J.E. Buttery, T. Maiden, B.R. Chamber• lain and M. O'Halloran, "Erythrocyte Ammonia in Liver To Veronica Wiley, Secretary of the NSW Branch on Disease", Scand. J. Gastro., 1983, 18,103-106. the birth of her son, Christopher, in September last. As well B.J. Potter, M.T. Mano, G.B. Belling, G.H. Mcintosh, C. Veronica was Conference Secretary for the 21st Annual Hua, B.G. Cragg, J. Marshall, M.L. Wellby and B.S. Hetzel. Conference of the AACB held in Sydney in November. "Retarded Fetal Brain Development resulting from severe Does this constitute a record? dietary iodine deficiency in sheep", Neuropathology and Applied Neurobiology, 1982, 8, 303-313. M.L. Wellby, "Biochemists: Brush up your Bedside The following is an extract from a letter written to our Manner", Clin. Biochem. Revs., Vol. 4, May 1983. President, Dr. Peter Dennis, who thought it would be of interest to readers. I thank him for permission to publish it. E.A. Braiotta and J.E. Buttery, "Experience with a Kit and a Manual Colorimetric Method for Plasma Paraceta• I am leaving Australia with many regrets and one of the mol", Aust. J. Med. Set., 1982, 3, 109-113. main things that I shall miss will be participation in the activities of the Australian Association of Clinical Bio• J.E. Buttery, R.N. Ratnaike and B.R. Chamberlain, chemists. I have greatly enjoyed the opportunity to work "The Measurement of Erythrocyte Ammonia Using the for the Association and have made many friends through Hyland Ammonia Kit", J. Clin. Chem. Clin. Biochem., the Association. It is my firm belief that, particularly be• 1982,20, 447-450. cause many clinical biochemists work in hospitals where there are few opportunities and time for research and From the Pathology Department, Cancer Institute, development, participation in the activities of a strong Melbourne, Victoria. professional body is vital to the wellbeing and future "Liquid-Chromatographic Determination of Aminoglu- success of the marvellous profession we have all chosen to tethimide," B.A. Robinson and F.N. Cornell, Clin. Chem. follow. 29, 1104 (1983).

12 The Clinical Biochemist, Newsletter, December 1983 Hospital Ward Laboratories Council remains considerably concerned at the develop• cal biochemistry ward laboratories; ment of clinical biochemistry tests away from the main — to indicate the changes which are occurring in instru• clinical biochemistry laboratories, for example at the bed• mentation available to provide such services; side and in medical practitioners' surgeries. It sees the pos• - to review existing ward laboratories and rationalise sible risks of such tests being removed from the rigid stan• the performance of all clinical biochemistry analyses, dardisation procedures that normally apply to main labor• current and projected. atories in the areas of quality control, instrument standard• 2. That each clinical biochemistry ward laboratory be isation and maintenance schedules as well as implications established as an extramural activity of the clinical bio• for employment of hospital scientists. chemistry department and be under the direction of the Further development of hospital ward laboratories and executive of that department. surgery tests are anticipated as manufacturers further 3. That staff in the clinical biochemistry ward laboratory develop equipment for these purposes. remain in or become part of the establishment of the Therefore Council has developed a POSITION STATE• clinical biochemistry department. MENT incorporating the RECOMMENDATIONS listed 4. That equipment in the clinical biochemistry ward lab• below and have asked me to bring these to the notice of oratory be selected by and be part of the allocation to members, Des Geary and I having initiated the draft the clinical biochemistry department. statement for Council. 5. That, where appropriate, the internal and external qual• It is Council's intent to use the recommendations as a ity control procedures of the clinical biochemistry basis for discussion with Colleges and other professional department should be applied to the clinical biochem• bodies and with government organisations wherever appro• istry ward laboratory. priate. 6. That the maintenance and the preventive maintenance "Bedside biochemistry" has been the subject of the programmes for the equipment be organised and moni• following papers in which some of the inherent potential tored by the clinical biochemistry department. problems have been analysed. 7. That the Association actively encourages both discus• "Analytical investigations closer to the patient". Watson, sions on equipment design with manufacturers and eval• D. Br. Med. j. 1980, 281, 31-35. uations of existing equipment with particular reference "Guidelines on the performance of chemical pathology to the use of such equipment in clinical biochemistry assays outside the laboratory". Anderson, J.R., Linsell, ward laboratories. W.D., Mitchell, F.M. Br. Med. J. 1981, i, 743. The suggested mechanism is that the Scientific and "Guidelines for the performance of Clinical Biochemis• Technical Committee of the Association initiate the proto• try tests outside laboratories". Fraser, C.G. and Geary, T.D. cols for equipment evaluation and other formal approaches Clin. Biochem. Revs. 2/1, May 1981, p. 24. to manufacturers, these protocols first being approved by "Biochemists: Brush up your bedside manner. Wellby, an Ethics Committee of the Association. M.L. Clin. Biochem. Revs. 4/1, May 1983, p. 21.

RECOMMENDATIONS Council would be happy to receive helpful comments on 1. That clinical biochemistry managerial staff initiate dis• this topic. Please address these to the Honorary Secretary. cussions with Hospital administration staff and represen• M.L. Wellby, tatives of medical staff societies: On behalf of the Council — to discuss the need or otherwise of establishing clini- Matters of Concern to Clinical Biochemists In a letter to Council published in this Newsletter, Ian Farrance, Head, Division of Chemical Pathology at the Geelong Hos• pital has highlighted some recent trends which are of major concern to our profession. He notes that rising costs of reagents, budgetary restrictions, the freezing of staff levels and the dependence which clinical biochemists in this country have on imported reagents, are having serious effects now, with probably worse to come. THE CASH CRISIS with good medicine, but when insufficient resources are Across the country clinical biochemists are being asked available to provide the generally accepted levels of service, to do the same or even more work, but with fewer resour• the clinical biochemist is placed in the invidious position of ces. This decline in resources has its origins both in redu• having to say "No". This hardly cements the important ced hospital funding and in inflation which raises the cost relationships between the clinician and the medical bio• of consumables. chemist. More seriously, patient management may be affec• The need for some restraint and new directions in the ted deleteriously. Health Services of Australia are well recognised and accep• A second effect of the cash crisis is its effect on the pro• ted by many. Most clinicians in our community have fessional work of the clinical biochemist. With restrictions become accustomed to laboratory staff accepting almost in funding far staff, consumables and equipment, our mem• every request for a test without question. Undoubtedly bers have less time to discuss diagnostic problems with there is a major place for continuing and critical review on clinicians. As a result the educational role of the clinical the clinical value of many laboratory investigations. Selec• biochemist, especially in advising interns or training junior tive and systemative use of laboratory tests is consistent hospital scientists, will be diminished.

The Clinical Biochemist, Newsletter, December 1983 13 A profound and far-reaching effect of severe cuts in the tory. Educational campaigns to modify ordering patterns wages bill is that with fewer career prospects in this field, of medical practitioners bring only temporary relief, and well qualified graduates who have contributed so much to the considerable time involvement by senior laboratory the high standards of our profession in Australia in recent staff can not always be justified for the real "benefits" years, will be discouraged from taking up clinical biochem• obtained by the laboratory. istry as a career. 3. Staff levels within Victorian Hospitals have been frozen since 1979. In addition, the employment of temporary clerical staff on a casual basis to relieve during annual THE CARGO CULT and other leave, has been greatly reduced or stopped. In Clinical Biochemistry around the world has become in• many instances laboratory staff now perform extra cleri• creasingly reliant on commercially produced reagents, kits cal duties in addition to their normal laboratory duties. etc. These products are usually of high quality and meet 4. It is not improbable that the introduction of Medicare in the stringent requirements demanded by our profession. February 1984 will further accentuate the above prob• By and large we have excellent relationships with the lems. suppliers of such imported reagents and equipment in I fully accept that some rationalisation and budgetary Australia, who themselves have been affected by the cash reductions should be attempted (and are possible), but due crisis. consideration should also be taken of rising costs, overall There is however a good case for encouraging the pro• workload, increased services such as Hepatitis screening as duction of reagents and equipment here as a means of directed by the Health Commission, and the previous involving our profession in such enterprises, and where record of laboratory management/budgeting of particular appropriate reducing our reliance on imported expertise. In laboratories and hospitals. many situations it is both economical and good laboratory The current restrictions will seriously hinder the profes• practice for staff to make their own reagents. This has the sional development of Clinical Biochemists by decreasing value of developing a better understanding of methodologies or stopping method development or clinical research activi• and reversing some of the trend to "Push Button" tech• ties within the laboratory, increasing the amount of ad• nology. ministrative time spent by "senior" Clinical Biochemists in As a consequence of these and similar issues, council has attempting to meet administrative directives, decreasing the empowered its executive to prepare a position paper on the time they can spend on considering improvements in effects of government economic policies on the provision of laboratory organisation and the management of their lab• the best standards of clinical biochemistry services to this oratories and reduce Clinical Biochemists to little more country. All members of the association are encouraged to than factory managers. This submission is not intended to contribute their ideas on these matters through their state seek sympathy but to seek support from the AACB in branches. It is intended to circulate a draft document planning for a good future for Clinical Biochemists. Should through the branches early in the new year with the aim of restrictions continue in the current form, the consequences producing a document for release after the May Council for Clinical Biochemists and all laboratory personnel will meeting. It is hoped that this document will be the basis of not be good and laboratory personnel will be reduced to representations to appropriate Federal and State ministries "button pushers" with a strictly 9 am to 5 pm mentality. on these matters. The Australian Association of Clinical Biochemists and P.M. Dennis, Royal College of Pathologists of Australasia, and even the President Australian Federal Government through its National Path• ology Accreditation Advisory Council, have always recom• mended sufficient extra time for laboratory staff to par• Letter to Council ticipate in: I write to register my concern and that of other coll• — educational programmes; eagues regarding recent developments relating to the finan• — attending clinical and other meetings; cing and staffing of hospitals within Victoria. — method development, etc. I believe the Association as a whole should consider in — evaluation of new techniques. depth the immediate and long term effects of these chan• ges on the conduct of laboratories in general, and on the The AACB should support its members (and particularly practice of Clinical Biochemistry in Victoria and other its "junior" members) by representations to State and Fed• Australian States. The measures adopted this financial year eral Governments expressing concern over the current situ• by the Victorian Government will inevitably affect the ation and its potential ramifications. The Federal Govern• quality of performance and staff morale within the labora• ment has publicly commented on the lack of technological tory area. Budget allocations are considerably less than the developments within Australia yet in Clinical Biochemistry previous financial year and no allowance has been made most major developments occur overseas due to the lack of for inflation, for increased demands on the services provi• support offered Australian laboratories, the consequence ded by laboratories, or for the following: being that Australian taxpayers are supporting employment 1. Practically all reagents/kits etc. used within Clinical in technologically advanced overseas countries by importing Biochemistry are purchased from overseas in some form their reagents/kits/consumables, and their technology in or other. Due to this situation significant cost altera• general. tions occur which are beyond the individual laboratory I hope that Federal Council may find time to discuss the or the local supplier's control. In addition to the cost in• professional aspects/consequences of current Government creases in Australia and overseas countries, the devalua• directives at its November meeting, and allow some discus• tion of the Australian currency earlier this year added sion at the forthcoming AGM. further to overall cost increases. 2. Most laboratories are experiencing steady increases in Yours sincerely, workload and to a very large extent such increases are Ian Farrance, outside the control of the person in charge of the labora• BSc,MCB, FAACB

14 The Clinical Biochemist, Newsletter, December 1983 Victorian Survey of Plasma Creatinine Units Following recent discussion of the units used for repor• COMMENTS ting plasma creatinine {The Clinical Biochemist — News• A total of 23 laboratories made some comment regard• letter, No. 68, 46-48, 1983) the Victorian AQAP Regional ing the choice of units. Group conducted a survey of 80 laboratories in Victoria Of those who considered mmol/L to be the most appro• to determine their individual views on plasma creatinine priate unit, the most common reasons were as follows: units. A total of 58 (73%) of the questionnaires were 1. Plasma and urine creatinine results should be reported in returned to the Regional Group Co-ordinator. The results the same units. of the survey were as follows: 2. All other common analytes (except bilirubin and iron) were reported in mmol/L. If plasma creatinine units Question 1 — Do you report plasma creatinine in mmol/L were changed to /imol/L then plasma urate should also or ;umol/L? be changed. 46 (79%) laboratories report in mmol/L. 3. Reporting in jumol/L implies greater precision than is 11 (19%) laboratories report in /imol/L. justified for routine laboratories. 1 ( 2%) laboratory did not respond to the question. Of those who considered Mmol/L to be the most appro• This data was then grouped according to the following priate unit, the most common reasons were as follows: criteria. 1. It was less confusing using whole numbers. 2. The Beckman Astra analysers only offer /imol/L for mmol/L /imol/L plasma results. Teaching Hospitals 8 2 3. New analysers can perform plasma creatinine measure• Other Metropolitan Hospitals 9 3 ments with less imprecision than previous instruments. Country District Hospitals 17 3 4. The Australian Quality Assurance Programme uses Private Laboratories 10 2 /imol/L for creatinine results.

Question 2 — Do you intend to change the units in the near future? YES/NO. DISCUSSION 7 (12%) laboratories indicated YES. 51 (88%) laboratories indicated NO. The majority of laboratories (79%) participating in the survey, report plasma creatinine in mmol/L. There are All seven laboratories who indicated that they intended however, a significant number (19%) who report in /imol/L to change units were changing from mmol/L to /imol/L. and as seen in the data from Question 1, these are evenly Three of these laboratories commented that the reason for distributed between the various hospital and laboratory the change was because of new instrumentation. (Two classifications. In addition, 12% of participants indicated laboratories changing to Beckman Astra systems which only that they intend to change units from mmol/L to /imol/L. offer plasma creatinine units in /imol/L and one laboratory This means that in the near future, some one third of changing to a Technicon RA-1000 analyser.) laboratories in the surveyed group could be reporting in /imol/L. Question 3 — Would you be willing to change to different In addition, according to the answers from Question 4, units if the consensus indicated units different to your 54% of laboratories considered /imol/L to be the most own? YES/NO. appropriate unit, even though most report in mmol/L. This 50 (86%) laboratories indicated YES. preference for /imol/L was particularly evident in the 6 (10%) laboratories indicated NO. Country District Hospitals. 2 ( 4%) laboratories did not respond to the question. The data was then grouped as previously.

Yes No RECOMMENDATIONS Teaching Hospitals 9 I As one of the aims in introducing the SI system of units Other Metropolitan Hospitals 10 2 was to standardise numerical reporting of results, this small Country District Hospitals 18 2 survey indicates that for plasma creatinine at least, there Private Laboratories 11 1 has been a significant deviation from the original concept.

Question 4 — Irrespective of the above questions and We therefore recommend the following: answers what do you consider to be the most appropriate 1. That the AACB and RCPA undertake an urgent review unit. mmol/L or /imol/l? of the use of SI units within Australia and make recom• 24 (41%) laboratories indicated mmol/L. mendations, for adoption at a national level, with 31 (54%) laboratories indicated /imol/L. respect to plasma creatinine units. 3 ( 5%) laboratories did not respond to the question. 2. That instrument manufacturers (such as Beckman) This data was then grouped as previously. should not dictate policy on SI unit use within Austra• lia by only providing a /imol/L option for plasma mmol/L Mmol/L creatinine determinations. Teaching Hospitals 5 4 Other Metropolitan Hospitals 5 7 Peter Boyne, Country District Hospitals 6 14 Victorian AQAP Regional Group Co-ordinator, Private Laboratories 6 5 Cancer Institute, Melbourne 3000

The Clinical Biochemist, Newsletter, December 1983 15 PREPARED BY THE SCIENCE EDUCATION COMMITTEE M.D.S. Shephard, Secretary

Report to Council, October 1983

1. STRUCTURE appear in our laboratories to ensure that information con• cerning these rare conditions is disseminated to members of The present structure of the Education Committee is as the Association who may never be fortunate enough to see follows: such a condition in their own hospital. This series will con• Chairman: Ms. J.E. Robinson. clude in this issue of the Newsletter. The Secretary has Secretary: Mr. M.D.S. Shephard. attempted to utilise the talents of various members of the Branch Education Representatives: Prof. B.C. Shanley Association in the production of this series. (Old), Mr. G.I. Goodall (Vic), Mr. D.M. Schmierer (Tas), Prof. R. Hahnel (WA), Mrs. B.A. Dilena (SA), Mr. A.R.D. The Clinical Biochemist — Reviews continues to main• Brown (NSW). tain an extremely high standard. As stated in previous reports to Council, the non or late submission of promised Board of Examiners Representative: Dr. M.J. Breidahl. material for the Reviews has been a major problem for Scientific and Technical Committee Representative: Mr. members of the Editorial Committee. This year a concer• T.D. Geary. ted and constant effort has been made by the Secretary to RCPA Representative: Dr. A.N. Barker. ensure that material for publication from the Roman Publications Representative: Mr. I. Farrance. Lecturer, Current Concepts Lecturers and David Curnow Since the last report to Council, Mr. Michael Staley has Plenary Lecturer is ready well in advance of publication retired from the Committee in his capacity as Tasmanian deadlines. With the full co-operation of the lecturers con• BER and has been replaced by Mr. David Schmierer. cerned, this goal has been achieved. Michael is sincerely thanked for his active contribution to the Committee over the past four years. Professor Roland Several back issues of the Newsletter and Reviews have Hahnel has returned from study leave and has resumed his been sent by Mr. A. Elderfield, Publications Committee role as Western Australian BER. Mrs. Wendy Lynch who Business Manager, to the Secretary as it has been neces• filled in for Professor Hahnel during his absence is also sary for the Secretary to correspond with several overseas thanked for her work on the Committee. clinical biochemists some of whom know little about the AACB. The aims, functions and mode of operation of the Committee have continued to be as documented in the 5. CURRENT CONCEPTS CONFERENCE Terms of Reference submitted to Council in May 1981. Mr. D.W. Osborn and Dr. P.R. Pannall conducted the 2. MEETINGS 1983 Current Concepts Conference in July/August on the Since the Education Committee Meeting held in topic of "The Biochemistry of Intensive Care". Each State Adelaide on 31 October 1982 prior to the Annual was provided with a choice of seven major areas or blocks Scientific Meeting of the Association, no further meetings relating to this topic. Depending on whether the State required a one or one-and-a-half day Conference, either have been held. Detailed and frequent correspondence by four or six blocks respectively could be selected by each post, together with (when necessary) communication by State. Local speakers, including many from other profes• phone, appears to have been very successful in maintain• sional groups such as pharmacy and nursing, were included ing smooth and effective liaison between all members of in the programme of many States to supplement the key the Committee. speaker's presentations.

3. STATE ACTIVITIES The Conference once again appears to have been a resounding success from an educational viewpoint. The The educational activities of individual State Branches large number of registrants who attended the Conference are continually monitored by the respective Branch Edu• in Sydney and Brisbane was very pleasing indeed. The cation Representatives. 1982-83 Branch Reports appear Education Committee wishes to sincerely thank Mr. elsewhere in this Newsletter. Osborn and Dr. Pannall for the time and effort which they both devoted to ensure that their presentations were of 4. PUBLICATIONS exceptionally high quality. Certainly, with effective liaison The Clinical Biochemist — Newsletter continues to pro• between the lecturers, Secretary and State BER's, the vide a medium for publication of news, views, puzzles, organisation and execution of the Conference proceeded interesting cases etc. in Omniscience, the regular feature very smoothly indeed. The Lecturers have provided a con• of the Education Committee in the Newsletter. Unfortu• structive report and were, in general, pleased with accom• nately, as in previous years, the generation of material for modation, facilities and local input. this feature has again fallen almost exclusively on the shoul• The Current Concepts Conference in Adelaide was taped ders of the Secretary. This year, a series of case discussions in its entirety. A booklet, based on material contained in on rare inborn errors of metabolism has been presented in the lecturers' slides was also produced. Through advertise• Omniscience. The rationale for the incorporation of this ment in Omniscience, the tapes and Conference booklet series into Omniscience was that it was considered extre• have been made available, on loan from the Secretary, to mely important to document such cases when they do any interested member of the Association.

76 The Clinical Biochemist, Newsletter, December 1983 6. ROMAN LECTURE pation. The planning of this Seminar has been very capably handled by Mr. T. Geary and Dr. C. Fraser and every effort Dr. Peter Dennis has recently completed the 1983 Roman Lecture tour around Australia. The Roman Lecture has been made to advertise this event to as many entitled "B Cell Tumours - a Disease Model for Clinical laboratories in Australia as possible. Biochemistry" was well received in all States. In addition to presenting the formal lecture, Dr. Dennis also participa• 10.OTHER ACTIVITIES ted in a number of informal small group seminars on the The Education Committee, via the Secretary, has made a topic of "Careers in Clinical Biochemistry" and took the concerted effort to maintain and promote a high level of opportunity to visit as many institutions and talk with as correspondence and a close liaison with the IFCC many junior members of the Association as possible. Dr. Education Committee. Dennis also participated in the annual weekend meeting of Dr. C.G. Fraser and Professor B.C. Shanley have sub• the Queensland Branch in Townsville and visited Launces- mitted their report on the undergraduate teaching of ton during his stay in Tasmania. Clinical Biochemistry in Australian Medical Schools for Dr. David Goldberg (Canada) has been invited to be the publication in the journal Biochemical Education; it is Association's Roman Lecturer for 1984. An acceptance of anticipated that it will appear in print in November of this our invitation has subsequently been received from Dr. year. Goldberg. The topic suggested by Dr. Goldberg for the Modified Terms of Reference of the Education Com• 1984 Roman Lecture is "The Diagnosis of Chronic Pan• mittee were submitted to Council in May; following several creatic Disease". minor modifications, the Terms of Reference will be re• submitted for Council approval in November.

7. DAVID CURNOW PLENARY LECTURE 11. FINANCES Professor Harry Pardue, from Indiana, USA will deliver The Education Committee wishes to sincerely thank the the inaugural David Curnow Plenary Lecture at the Sydney RCPA for their continued support regarding the arrange• Conference later this year on "Recent Advances in Photo• ment concerning cost sharing of any deficit incurred in metric Detection Systems". Professor Pardue will also par• both the Current Concepts Conference and the Chemical ticipate in a Special Interest Group on Instrumentation Pathology Course. during the Conference and in the Scientific Education The generous sponsorship by Technicon Pty. Ltd. of the Seminar on the weekend following the Conference. The David Curnow Plenary Lecture has resulted in a significant organisation and full itinerary for Professor Pardue's trip saving of funds for the Education Committee. It is hoped to Australia was finalised and completed in May of this that Technicon will derive benefit and satisfaction from its year. sponsorship of this new educational event. An article concerning the David Curnow Plenary Lec• tureship has been written by the Secretary and submitted 12. EXECUTIVE COMMENT to the Editor of the IFCC News for publication in that newsletter. It is with deep regret that the Committee has learned Draft Guidelines for the David Curnow Plenary Lecture that Dr. Callum Fraser will be leaving Australia in October were submitted to Council in May 1983. Following several to take up a new post in Dundee, Scotland. Callum's minor modifications, these Draft Guidelines will be resub• endeavour, spirit and drive will be a great loss to the Asso• mitted to Council in November for further consideration. ciation as a whole. The Education Committee, in particu• Nominations for the 1985 David Curnow Plenary Lec• lar, would like to place on record its sincere thanks to turer have been called for and will be discussed at the Callum for his outstanding contribution to the Committee meeting of the Education Committee in November. during his years as Secretary. He will be especially remem• bered for his major involvement in the formation of the 8. CHEMICAL PATHOLOGY COURSE solid foundation on which the Committee is now based. To Callum, his wife and his family, we extend our best wishes A full report on the 1983 Chemical Pathology Course for the future. has been received by the Secretary of the Education Com• Mark Shephard, mittee and was published in The Clinical Biochemist — Secretary, Newsletter (June 1983, pp. 13-14). Education Committee The 1984 Chemical Pathology Course will be held in Adelaide at the Flinders Medical Centre from 20-24 February. Several major symposia will be held; however, Wilson's Disease the main thrust of the Course will be small group seminars. A novel approach will be the streaming of these seminars COPPER METABOLISM (into basic, intermediate and advanced categories) to Forty to seventy per cent of the daily dietary intake of allow registrants to participate in educational activities copper of 50-80 umol (3.2-5.1 mg) is absorbed in the small most suited to their needs. The Organising Committee is to intestine by an active transport process, while the be congratulated on their advanced planning of the Course remainder is excreted in the faeces1. at an early stage. The copper content of the plasma takes three forms: 1. An important component of the enzyme caeruloplasmin 9. SCIENTIFIC EDUCATION SEMINAR (95% of plasma copper). The physiological role of this The second Scientific Education Seminar will be held in enzyme is still uncertain but it is thought to act as a Sydney on the weekend following the Annual Scientific ferroxidase and/or in the transport of copper from the Meeting of the Association, that is, 19-20 November 1983. liver to other tissues1 >2. The title of the seminar "Decision Criteria for the Selec• 2. Bouad to the amino terminal tripeptide of albumin for tion of Laboratory Instruments and Methods" is indeed a transport to the liver from the intestine. provocative one and should ensure wide audience partici• 3. Bound to amino acids (a small ajnount only).

The Clinical Biochemist, Newsletter, December 1983 17 Copper is present in red blood cells in the enzyme super• absent and his neurological symptoms well controlled with oxide dismutase, and in other cells of the body as a com• D-penicillamine. This drug, which is the mainstay of ponent of enzymes such as the important cytochrome c therapy of Wilson's disease, acts by chelating copper to oxidase and as dopamine B-hydroxylase and lysyl oxidase. form a complex which is filtered by the glomerulus and The important and central role of the liver in the excreted in the urine. metabolism of copper has been the subject of intensive Mr. J.M.'s plasma and urine copper concentration, and investigation. It enters the liver following intestinal absorp• serum caeruloplasmin levels on admission are shown below tion and has three possible fates: and compared with values obtained in 1980 during a 1. Incorporation into enzymes, in particular caeruloplas- previous assessment at Flinders Medical Centre: min. 2. Storage as a complex with the small protein metallo- 1980 review 1982 admis• Reference thionein. sion Range (FMC) 3. Excretion into the bile by a lysosomal mechanism. Plasma copper 9.9 umol/L 36 umol/L (11-22 umol/L) Two genetic defects of copper metabolism have been Urine copper 8.0 umol/ 10.3 umol/ (0.1-0.4 umol/ identified to date, although the exact molecular mechan• 24 hr 24 hr 24 hr) isms have yet to be elucidated. Caeruloplasmin 0.20 g/L 0.17 g/L (0.15-0.60 g/L) The first of these, Wilson's disease or hepatolenticular degeneration, may be thought of as a disease of copper overload. It is inherited as an autosomal recessive trait with As may be expected, caeruloplasmin levels are usually a prevalence of 1 in 100,000. low in Wilson's disease. However many cases, like Mr. J.M., The most recently discovered defect, Menkes' disease, do not show this decrease. In a recent series of 15 patients which has an X-linked mode of inheritance, involves a in Singapore3, three patients had values within the normal more generalised failure of cellular copper transport. Most range. Although Mr. J.M.'s plasma copper was marginally of the widespread and severe manifestations of this disease, low in 1980, it was markedly elevated on admission in which are evident by three years of age and include cerebral 1982. A decreased plasma concentration of caeruloplasmin, degeneration, hypothermia, "steely" (formerly but incor• accompanied by an increased concentration of non- rectly known as "kinky" hair), and bone abnormalities, can caeruloplasmin copper, can produce a low plasma copper be explained by a concomitant deficiency in copper con• concentration, as measured by atomic absorption spectro• taining enzymes. photometry, however normal values are common. In the Singapore series, for example, only seven patients in fact showed a low value. CASE PRESENTATION In Wilson's disease urinary copper excretion is almost Mr. J.M., a 55 year old man, was admitted to Flinders always markedly increased, however a moderate increase Medical Centre in April 1982, with a two to three week may also be observed in chronic active hepatitis. Penicill• history of lethargy, drowsiness, lack of energy and amine therapy further increases urinary excretion and anorexia. He was severely jaundiced, his plasma bilirubin presumably contributed to the increase in Mr. J.M.'s level. being 825 umol/l. Neurological examination revealed that Urinary copper measurement can be used to monitor the Mr. J.M.'s speech was slow and monotonous, his gait efficacy of such therapy. slightly abnormal, he had reduced power in his right arm Three possibilities were suggested, by the clinicians, to and leg and some spasticity in his right arm. explain why Mr. J.M., whose condition had previously Wilson's disease had been diagnosed in Toronto, Canada, been well controlled, should suddenly present with severe in 1955 when he was 28 years of age, on the basis of jaundice. These were: neurological findings and the presence of Kayser-Fleischer 1. An infectious condition such as hepatitis. rings (granular yellow-brown deposits of copper in the 2. Acute exacerbation of Wilson's disease itself. cornea of the eye and pathognomonic of Wilson's disease). 3. Penicillamine toxicity (less likely).

COURSE AND COMMENT Further tests excluded Hepatitis A or B. A Coomb's Although the basic defect in Wilson's disease is test, and blood and urine cultures were negative, and a unknown, this condition involves: biliary ultrasound showed no evidence of intra or extra- 1. Decreased synthesis of caeruloplasmin. hepatic obstruction. A complete blood picture, however, 2. Reduction of hepatic copper excretion. revealed a severe haemolytic anaemia, consistent with an The initial effect is accumulation of copper in the liver, acute haemolytic crisis, which is a recognised feature of followed by an increase in the level of non-caeruloplasmin prolonged or severe cases of Wilson's disease. This is copper in the plasma. Secondary to this, copper is deposited thought to be caused by a sudden release of copper from in other tissues, particularly the basal ganglia of the brain, the liver2. Although no liver biopsy had been performed muscles, bones and joints, (thus Mr. J.M.'s neurological and on Mr. J.M., coagulation studies and a low plasma albumin muscular problems), the cornea (Kayser-Fleischer rings), concentration suggested that hepatic insufficiency, secon• and the kidney (leading to renal tubular defects). dary to Wilson's disease, had resulted in an inability to Three modes of presentation occur: compensate for the sudden haemolytic load. 1. Liver disease — this commonly presents between 8 and Three days after admission, Mr. J.M. developed acute 16 years of age, and if untreated, the disorder may pro• renal failure associated with an elevated plasma urea gress slowly, or alternatively can result in early death (28.1 mmol/L compared with 5.1 mmol/L on admission), from liver failure. an elevated plasma creatinine (0.409 mmol/L), haematuria, 2. After 12 years of age with neurological symptoms and and pigment casts in the urine. This renal failure was attrib• signs predominant. uted to the combined toxic effects of massive haemoglo- 3. A combination of 1 and 2. binaemia and increased plasma copper levels. Peritoneal Mr. J.M. was an example of the first of these modes. dialysis was instituted both to treat this renal failure and as Until his admission in 1982 liver abnormalities had been a further measure to decrease plasma copper levels. At this

18 The Clinical Biochemist, Newsletter, December 1983 time Mr. J.M.'s plasma total bilirubin level was 1020 umol/L, at least 90% of which was in the conjugated form. Education in the As no evidence of intra or extrahepatic cholestasis had been found, the presence of a specific bilirubin excretory State Branches 1982-1983 block, similar to that proposed in the Dubin-Johnson and The following are edited reports of the Branch Educa• Rotor syndromes, was suggested. tion Representatives. Four days later, worsening renal failure led to replace• ment of peritoneal dialysis by haemodialysis. Despite active NEW SOUTH WALES therapy, Mr. J.M.'s conscious state deteriorated, his jaun• 1982-1983 has been a busy year for educational dice worsened, and he developed a greenish tinge. Ascites activities. Regular scientific meetings were held for Branch and spider naevi appeared which supported a diagnosis of members and guests with the idea in mind of continuing hepatic encephalopathy and finally 17 days after admis• education and updating of knowledge. The programme sion, despite naso-gastric administration of lactulose, Mr. included some thoughts on information transfer in eukary- J.M. died. otic cells, cystic fibrosis screening, anorexia nervosa, An autopsy revealed cirrhosis of the liver and oesopha• allergy, computing, biochemical inheritance, urinary tract geal varices but no bile duct dilation or focal lesions. Histo- infections (low molecular weight proteins and enzymuria), chemical techniques demonstrated copper deposition in recombinant DNA technology and clinical applications of hepatocytes. Tissue samples were sent to the biochemistry immunological testing. The branch is indebted to all laboratory for analysis of copper content. As analysis by speakers for their contribution to our continued education. graphite furnace atomic absorption spectrophotometry, Following a request from a country member the scien• which is the method of choice, was not available at that tific meetings held in 1983 have been recorded with the time, samples were analysed by flame atomic absorption permission of each speaker and these tapes have been made spectrophotometry following digestion with concentra• available to country members primarily and then to mem• ted sulphuric and nitric acids. The values obtained, as bers who were unable to attend the meeting. This is proving presented in Table 1, showed significant accumulation of to be a worthwhile venture judging by the comments from copper in the liver, kidney and brain. the listeners. The 1983 Current Concepts Conference on the Biochem• Table 1. Copper Determination in Tissue Autopsy Specimens. istry of Intensive Care was a tremendous success and we would like to thank the principal speakers Dr. Pannall and Tissue umol/gm ug/gm wet Reference Range"* wet weight weight (ug/gm wet weight) Mr. Osborn for the large amount of time they must have (chemical method) spent in preparing such a comprehensive programme. Also we would like to acknowledge the contribution made by Liver 2.87 182.5 3.5-93 Kidney 0.37 23.5 1.2-3.1 the local speakers Dr. Bob Wright, Dr. Roger Wyndham, Brain 0.21 13.3 5.1-8.3 Ms. Jan Pickering, Dr. Richard Day, Dr. Barry Duffy, Dr. Heart 0 0 1.5-3.8 David Baron, Dr. Peter Lawrence, Dr. Ross Smith and Mr. Pancreas 0.06 0.94 Not reported Murray Bailey, who all helped to make the Conference the success that it was. A great deal of energy was put in on Where technically possible, diagnosis of Wilson's disease advertising the CCC to members of other societies who by graphite furnace atomic absorption spectrophotometry might gain something and be able to contribute to the dis• is the most reliable method5. Copper levels from 50 to cussion. 800 ug/gm wet weight have been reported in patients with This advertising paid off and within the total registration Wilson's disease. However, accumulation of copper, to of 100, 50% were non-members and this group included levels greater than 50 ug/gm wet weight, may occur secon• intensive care physicians, pharmacists, nursing staff and dary to other liver diseases. The demonstration of decreased medical technologists from smaller laboratories particularly incorporation of radioactive copper into caeruloplasmin has from the country. been advocated by some6 as the ultimate test for Wilson's At the beginning of 1983 it was decided by the Branch disease. Committee that a separate tutorial group should be run out of hours so that scientific staff who could not get the time off during working hours to attend the FRCPA candidates REFERENCES tutorial at St. Vincents, could attend a tutorial programme. 1 SUNDERMAN, F.W., Trace Elements. In Brown, S.S., Mitchell, This group has been organised on a fortnightly basis at F.L. and Young, D.S. (eds.) Chemical Diagnosis of Disease, p. 1009, Elsevier, Admsterdam (1979). Concord Hospital and has been regularly attended by a 2 DANKS, D.M., Heriditary Disorders of Copper Metabolism in small group of five. Hopefully some of these members will Wilson's Disease and Menkes' Disease. In Stanbury, J.B. et al. present themselves for the MAACB examination next year. (eds.) The Metabolic Basis of Inherited Disease, 5th Edn., p. This is my first year in the position of Branch Education 1251, McGraw-Hill (1983). 3 GUAN, R.etal., Biochemical Profile in 15 Patients with Wilson's Representative and I have enjoyed the challenge of provi• Disease (Hepatolenticular Degeneration). 2nd Asian-Pacific ding educational opportunities for the members but I am a Congress of Clinical Biochemistry, Abs. No. 181 (1982). little disappointed in the lack of interest by a majority of 4 CARTWRIGHT, G.E., Copper Metabolism in Normal Subjects. the membership in branch educational activities. I would Am. /. Clin. Nutr., 14, 224 (1964). like to take this opportunity to request that senior bio• 5 PERMAN, J.A. et al., Laboratory Measures of Copper Metabo• lism in the Differentiation of Chronic Active Hepatitis and chemists and laboratory directors allow the younger clinical Wilson's Disease in Children. /. Paediatr., 94, 564 (1979). biochemists as much time as possible to attend meetings 6 STERNLIEB, I. and SCHIENBERG, I.H., The Role of Radio- and encourage them to do so because the future of our copper in the Diagnosis of Wilson's Disease. Gastroenterology Association depends on these people and we all need 77, 138 (1979). continued education to keep up a working knowledge and Heather Halls, be able to communicate with our clinical colleagues. Department of Clinical Biochemistry, Flinders Medical Centre, Bedford Park, SA, 5042 A.R.D. Brown

The Clinical Biochemist, Newsletter, December J 983 19 QUEENSLAND The 1983 Current Concepts Conference "Biochemistry of Intensive Care" being organised by Dr. P. Pannall and For the first time the Queensland Branch offered a bur• Mr. D. Osborn from the Queen Elizabeth Hospital, Wood- sary for the best local paper presented at the Annual Scien• ville, SA, will be held in Adelaide on 2 and 3 August. We tific Meeting held in Adelaide in November 1982. This was look forward to strong support for what promises to be a won by Mr. A. Badrick. very interesting conference. The survey on "Undergraduate Medical Education in Two members of the Branch passed their MAACB exam• Clinical Biochemistry in Australia", carried out by Dr. C. inations in October 1982: Ms. B. Dilena and Dr. M. Fraser and Professor B. Shanley, was completed during Guerin. Numerous members organised and participated in 1983. A full report is scheduled to appear shortly in practice viva voce examinations for these candidates. "Biochemical Education". The MAACB study group, this year, has been very Monthly scientific meetings were held throughout the capably organised by Dr. M. Guerin. It started with a num• year. Topics included: "Laboratory Computers - Fact and ber of people showing interest in preparation for the 1983 Fiction" (S. Bryant), "Molecular Genetics in Clinical Bio• MAACB examinations. Enthusiasm waned, however, and chemistry" (M. Lavin), "Porphyrias in California - Diag• two determined students emerged. Two RCPA candidates nosis and Treatment Modalities" (M. Bissell, University of have also given the study group their firm support. California, San Francisco), "Quantitative Stone Analysis - Is It Really Necessary?" (D. Chalmers), "Alpha-1-Anti• The format remained basically unchanged with a series trypsin Deficiency" (H. Kunze, B. Barr, D. Cowley), of tutorials on analytical techniques, followed by a series of "Breath Tests in Gastroenterology" (M. Ward), "Technical chemical pathology tutorials. The latter part of the course and Medico-Legal Requirements for the Estimation of was extended to allow better grasp of the use of biochemi• Blood Alcohol" (D. McGregor) and "Neonatal Screening" cal tests in the clinical situation. Attention was also (F. Bowling). directed towards examination technique, particularly the viva voce, with which few science graduates have had any The 1983 Current Concepts Conference on "The Bio• experience. chemistry of Intensive Care" held at Tweed Heads on It was pleasing to note the attendance of some members 23 and 24 July was highly successful. There were 73 regis• (and non-members) at the tutorials, whose express purpose trants altogether. They were most appreciative of the high was to "brush up" on certain aspects of chemical pathol• standard of the presentations, especially those of the visit• ogy. The use of the study group as a refresher course is to ing speakers, Dr. P. Pannall and Mr. D. Osborn. It is clear be lauded, and recommended to all members of the Asso• that a great deal of forethought and planning was involved ciation, as a convenient method for maintaining current in their preparation for this Conference. We thank them information on unfamiliar aspects of clinical biochemistry. and the supporting local speakers for a most satisfactory meeting. Time and effort given by members on the preparation of topics was greatly appreciated and their continued support Dr. Peter Dennis delivered the Roman Lecture on "B-Cell is requested in the preparation of the study group agendas Tumours: a Disease Model for Clinical Biochemistry" on in the future. 25 August. This proved to be an excellent overview of the Planning for the 1984 Chemical Pathology Course by paraproteinaemias. During his stay in Brisbane, Dr. Dennis the RCPA/AACB/AIMLS joint Committee for Continuing also gave an address on "Careers in Clinical Biochemistry". Education, comprising B. Dilena, C. Beng, C. Fraser, M. The forum was Griffith University, which is offering for the Guerin, W. Hancock, D. O'Leary, P. Pannall and M. first time in 1983 a Diploma Course in Clinical Biochemis• Shephard is well advanced. try (one year full-time or two years part-time). The course will be held at the Flinders University of His remarks, which were both optimistic and provoca• South Australia from 20-24 February 1984. The proposed tive, stimulated a lively discussion. Particular emphasis was topics include biological variation, lipids, separation given to the fact that training in research should be an systems, enzymology, the effects of age and pregnancy on integral part of the training of clinical biochemists. Griffith biochemical parameters and the biochemistry of malig• University plan to introduce a research degree (M. Phil nancy. A main thrust of the course will be small group Clinical Biochemistry) in 1984. discussions. To encourage active participation, the groups After leaving Brisbane, Dr. Dennis continued on his nor• will be divided, by nomination, into three levels based on therly journey to Townsville, where he was the key speaker experience in clinical biochemistry: basic, intermediate and at the 1983 North Queensland Scientific Meeting on 27 and advanced. 28 August. He delivered four talks including the Roman Under the auspices of the Joint Committee for Continu• Lecture, "Calcium and Abnormal Proteins", "The Biochem• ing Education, Dr. M. Guerin (IMVS) and Dr. N. Walmsley istry of Alcohol Abuse" and "Prospects for Careers in Clini• (FMC) have organised monthly biochemical case discussion cal Biochemistry". The Queensland Branch is particularly sessions. They provide an opportunity for interlaboratory grateful to Dr. Dennis for the special efforts he made on discussion and are a welcome addition to educational our behalf. activities. B.C. Shanley B.A. Dilena TASMANIA SOUTH AUSTRALIA The Current Concepts Conference for 1982 once again The visit of Dr. V. Marks in September as the 1982 proved to be a very successful venture. The guest speakers, Roman Lecturer proved to be popular. His main lecture Professor Les Lazarus and Dr. Margaret Stuart, performed entitled "The Impact of Immunoassay on Clinical Labora• a marathon effort in non-stop lecturing that was greatly tory Practice" was well attended as was the dinner which appreciated by all 38 registrants. followed. Dr. Marks also spoke at a grand round at the A large amount of information was presented in a terse, Queen Elizabeth Hospital on "Current Views on the yet informal and anecdotal fashion which made the aud• Diagnosis and Treatment of Hypoglycaemia" and visited ience feel both interested and relaxed. a number of hospital laboratories. This style of presentation is proving to be extremely

20 The Clinical Biochemist, Newsletter, December 1983 successful which, I suppose is manifest by the fairly broad 2. RCPA/AACB Chemical Pathology Course, spectrum of professional people who registered at this 21-25 February 1983 Conference. This was held at the Physics Department, Melbourne Professor Vincent Marks was the Roman Lecturer for University. There were 101 full registrants and an average 1982. Once again the Tasmanian Branch turned out in force of 17 day registrants. Major themes were Hypertension, to hear his presentations which were on gut hormones, Immunology, Trace Metals, Electrolytes, Biochemical alcohol related diseases and hypoglycaemia. Without doubt Emergencies and Thyroid and Adrenal Disorders. Small Professor Marks is a very good and entertaining speaker. group seminar sessions and Test and Teach sessions proved However, I must say that in this instance I felt his presenta• popular and informative. One interesting variation to the tion was somewhat disjointed and he obviously ran short of week was the Course Dinner which instead of being a single time just when he was getting into full swing. Many of the large function was split into small groups which dined at medical and scientific staff who attended were disappointed several local BYO restaurants. The Carlton and North by this. Melbourne restaurants chosen provided varied international Scheduling the lecture for the time slot normally cuisine and allowed each group to socialise more fully. allotted to the Hospital's Friday lunch-time meeting enabled many clinical staff to attend also. This should be 3. Current Concepts Conference, 28-29 July 1983 seriously considered when drafting itineraries for future Roman lecturers. Peter Pannall (Deputy Director) and Don Osborn In addition to his formal lecture and seminar, Professor (Senior Scientist) both of the Queen Elizabeth Hospital, Marks gave an impromptu viva voce examination to two Adelaide were this year's travelling lecturers. The venue was MAACB candidates at the Royal Hobart Hospital. I am Clunies Ross House and Peter and Don gave a very reward• sure that this was something they will remember for a long ing and comprehensive programme titled "The Biochemis• time!!! try of Intensive Care". They were ably supported by local Tutorials for MAACB candidates commenced early this ICU specialists covering Open Heart, Neonatal and Renal year. We expect three or four candidates to present for aspects of Intensive Care and by Meg Breidahl and David examination in 1984. It was pleasing to see that both Rutherford of the Alfred Hospital who spoke on the labor• candidates from the Royal Hobart Hospital who were suc• atory requirements of drug overdosage patients. There were cessful in obtaining their MAACB in 1982 are participating 49 registrants which is considerably more than the previous actively in this tutorial series. last few years attendances. A conference on Quality Control Schemes was held at This year the format of the local education programme Louisville Resort, a beautiful place on the east coast of has been radically changed from the previous year's pro• Tasmania. Guest speakers were Mr. Lloyd Penberthy and gramme. There is now a monthly general education lecture Dr. Stephen Sykes. So successful (and enjoyable) was the open to all laboratory staff which is an overview of a venture that another is to be held in December 1983 at specific topic. In addition there is a monthly tutorial open Rutherglen, in the north of the state, on "enzymes". If to MAACB and FAACB candidates which this year has successful, this Conference may become an annual event. been orientated towards practical aspects and higher level The Conference has been well documented by Ms. D. clinical aspects of the same monthly lecture. Attendance at Skillen in The Clinical Biochemist — Newsletter, 69, 17-19 the lecture series has averaged 25 and at the tutorial (June 1983). sessions 15. Both sessions are essentially didactic although the tutorial sessions are interactive. D.M. Schmierer The success of the Victorian programme is seen in the results of the 1982 AACB examinations. Four Victorians, John Cockley, Jim Doery, Margaret Jenkins and Phillip VICTORIA Morton, were among the 11 successful MAACB candidates. This year has been a very busy one. In addition to the This year Victoria has provided 12 candidates who are normal annual AACB activities, Melbourne has hosted the sitting for the MAACB. The postgraduate impetus is contin• 1983 RCPA/AACB Chemical Pathology Course and there uing in Victoria and is due to two main aspects; the pro• has also been a new local education programme formula• gramme itself and the willingness of laboratory directors ted and implemented. Major activities have been as follows: and senior scientific staff to lecture and give tutorials; and to the financial incentive which is paid for the MAACB and FAACB qualifications in the Victorian Hospital Scientists 1. Roman Lecture, 7 September 1982 Determination. The result for Victorian laboratories is more The Roman Lecturer was Vincent Marks, Professor of knowledgeable and experienced clinical chemists. Clinical Biochemistry of the University of Surrey, Guild• Ian Goodall ford, UK. Professor Marks gave an excellent and compre• hensive lecture entitled "The Impact of Immunoassay on Clinical Laboratory Practice". One hundred and nine WESTERN AUSTRALIA people attended the Roman Dinner at the Royal Children's I was in Europe for most of the time under review, and I Hospital and enjoyed the usual superb RCH cuisine. The am very grateful to Ms. Wendy Lynch for letting herself be lecture following the dinner attracted over 130 partici• talked into taking charge of the educational programmes of pants. Whilst in Victoria, Vincent Marks had a very full two the AACB during my absence. days programme giving further lectures to scientists arid The Current Concepts Conference on Dynamic Investi• endocrinologists at Geelong Hospital, Royal Melbourne gation of Endocrine Function was particularly interesting Hospital, Royal Children's Hospital, Alfred Hospital and and very well attended in Western Australia. the Baker Medical Centre and visiting some of the labora• In Western Australia the Roman Lecturer 1982, Prof. tories at these centres. Following his visit to Tasmania, V. Marks spoke on "Current Views on the Diagnosis and Professor Marks returned to Melbourne and led a sympo• Treatment of Hypoglycemia". Wendy brought it to the sium on Therapeutic Drug Monitoring sponsored by Ames. attention of the Federal Committee that it was unsatisfac-

777e Clinical Biochemist, Newsletter, December 1983 21 tory to have had the lecturer only for one day in Perth. effectiveness, economic analysis, clinical utility of certain The tutorials for membership candidates continued fort• tests, etc. were all discussed and may of necessity be the nightly until the end of May. A considerable number of prime consideration in the coming decade. For those in tutors (who gave their time freely) were involved. To all of industry, the various needs of the clinical laboratories are them I am very grateful for their help. I have had some identified in several papers throughout the book, but a feedback on the study programme which will be very help• particularly good overview of the European situation is ful in the planning of subsequent tutorials. This year four provided by Dr. Wahba of the World Health Organisation's candidates from Western Australia will be sitting for the European Division whilst setting the scene for the seminar Membership examinations. on "Industry and the Clinical Laboratory". The purpose in publishing this book was to contribute R. Hahnel towards one of the objectives of ECCLS — mutual educa• tion for those in industry, health agencies or the profes• sion associated with clinical laboratory practice. The book Book fulfills that educational role, there is something in it for everyone, but particularly there is the unique opportunity for discovering how and what 'the other man' is thinking Reviews or operates. J .G. Lines, CLINICAL LABORATORY SCIENCE IN Department of Clinical Chemistry, William Harvey Hospital, EUROPE: THE ROLES OF INDUSTRY, THE Ash ford, Kent, England PROFESSIONS AND HEALTH AGENCIES. Eds. S.S. Brown, D.H. Calam and E. Anne Gloag. We are grateful to Dr. John Lines, Editor of the IFCC News for permission to publish this review. Copies of the The European Committee for Clinical Laboratory Stan• book are available from ECCLS Central Office, c/- dards (ECCLS) was inaugurated in June 1979 principally Wellcome Research Laboratories, Langley Court, Becken- to promote the development, evaluation, approval and im• ham, Kent BR3 3BS UK. Cost including postage is 118 if plementation of voluntary standards (recommendations) posted airmail and LI0 surface. for clinical laboratory sciences and to maintain a forum for communication and mutual education between industry, the profession and the governmental health agencies. It is this latter objective which is addressed in this first book published by ECCLS. The book comprises the proceedings of the first three seminars of ECCLS in which Laboratory each group in turn presented itself to the others. The first seminar was "Industry and the Clinical Laboratory"; the Laughter second "Professional Societies and Clinical Laboratory Science"; and finally "Health Agencies and Clinical Labora• tory Science". The programme of each of the two-day seminars was The research project in which I was involved at Royal carefully constructed to develop specific themes and Perth Hospital a few years ago, required the simultaneous speakers were then invited for individual topics constituting measurement of creatinine and cAMP clearances. Urine the theme. The speakers themselves were all acknowledged would be collected for approximately one hour, blood experts and the book has been skilfully edited to provide a taken, and the procedure repeated after a water load. uniform logical presentation of European Clinical Labora• It was essential to know the precise period over which tory Science in the Eighties. The book can — in conse• urine had been collected: fifty-five minutes, one hour and quence — be specially commended to all those who work in ten minutes, etc. The ward staff were always very helpful clinical laboratories; to those in the governmental health and conscientious about this, sometimes recording the data agencies responsible for scientific activities; and to those with an accuracy beyond the call of duty. For example, the industrial companies who supply equipment, reagents and information accompanying one such specimen noted: services to clinical laboratories. Collection time — 36 seconds! It is not possible in this brief review of the book to list J ulie Summers, the complete contents, but merely to highlight one or two Department of Endocrinology and Diabetes, of the papers and some of the themes of seminar sessions, The Queen Elizabeth II Medical Centre, in order that the reader can assess an idea of the interest Ned lands, WA, 6009 and usefulness of the book. The philosophical but practical comments by Professor Lorentz Eldjarn and Dr. Erik Magid on the needs and structure, respectively, of clinical labora• GEMS FROM THE ANNUAL MEETING tory sciences in Europe can be used to provide a brief OF THE AACB insight into the future, as seen by two of the most eminent clinical laboratory practitioners. The papers by Grasbeck, A FREUDIAN SLIP? de Verdier and de Vries Robbe on interpretation and clini• The report of the Secretary gave favourable mention to cal relevance of test results provide not just a 'present state the Publications Committee and also paid tribute to the of the art' account but also stimulatory thoughts not just "tiresome Editor" of the Newsletter. for the profession but also for the other groups. Yet another report referred to the Education Committee Of particular interest to the Health Agencies and to the and all the "Associated Paraphernalia". individual Laboratory Director is the session on financial Whoever thought Annual General Meetings were dull? and economic aspects of clinical laboratories, when cost- Ed.

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24 The Clinical Biochemist, Newsletter, December 1983 ACROSS DOWN 1. South American beverage for a canonized apostle (with 1. Did poor Rosie Homba hate train travel? (17) the accent on mate). (2, 12, 3) 2. Found in urea cycle disorders but without the "hyper" 13. Famous mother.(4) (10) 14. Xenon took some bismuth and made a goat of himself. 3. Or a form of Raja. (3) (4) 4. Lemonade-beer drink to do with Laurence Sterne. (8) 15. Elemental Asian people (Santa says it all the time!). 5. Hunger for a base in bone? (14) (2) 6. In Ali Leyden is a man interested in amnitoic fluid 16. When did Rome become skin-like? (7) bilirubin. (5) 19. Ola Linn got greasy from sheep. (7) 7. Scottish city in a probang. (4) 21. Reflect on a Narcissus lover. (4) 8. Fix a part of foliage, periodically, and this Russian 22. Alkaline earth metal first prepared by Davy in 1807. chemist? (10) (2) 9. The position in a bicyclic molecule nearer the main 23. Half a unit length of cloth and its termination. (3) bridge. (3) 24. Urge ovum. (3) 10. Mixed up geisha without direction and the dysentery 25. My thin 'roo had a nose op. (9) bacterium. (5) 26. Thin appearance found in the Duke of Lancaster. (5) 11. To gun Ted, i.e. ankyloglossia. (10) 27. To fome back for a people. (2) 12. Gold containing antiarthritic. (17) 28. Non-oriental king for drug therapy. (2) 17. German genuine in Bertolt Brecht. (4) 29. Sounds like you should run from this parasite. (4) 18. Initially right handed iodine filled in. (3) 30. Group VIII element used in Fritz Haber's process. (2) 20. Painter with a broken leg. (4) 31. Agreeable lemur? (6) 29. Yttrium and fluorine show disgust. (2) 34. A ute I drove for a case I mixed up. (4) 30. Learn kung fu else we'll get energy here. (5) 35. French spirit. Sounds odd. (4) 32. Confused an ogre without right for self. (3) 37. Game for this magician. (4) 33. Sky cabs and movement governed by O2. (9) 38. By returning a rare earth metal for Georges Urbain in 34. From the books for a bookplate. (8) 1907. (2) 36. Hydrogenated lanthanum to help the body tell self 40. Take a taxi. No thanks for a Greek letter. (2) from non-self. (3) 41. Love lice to get a fatty acid. (5) 39. How Nauheim Salts behave. (3) 43. A shark that sounds like a penniless hound to a Cor- 42. Cuss at roe for a Lydian king. (7) nishman. (9) 47. West Indian witchcraft is a sash. (3) 44. Fever, once thought to be produced by poisonous 49. Non-numerical part of a cephalosporonic acid found in marsh air. (7) some Clinical Chemistry laboratories. (3) 45. Deuterate vanadium the wrong way and you'll get 50. Nitroso sodium? It will be soon. (4) STD. (2) 51. Hit a sun god on the buttocks you snake. (5) 46. An image, classified by Bacon in Novum Organum. (4) 54. Bidirectional board. (2) 48. Philanthropic Indian family. Oh thankyou! Thankyou! 55. Sound feline, sir, and pay the crew. (6) (4) 57. To be rich . . . and hairy. (6) 51. We can communicate with boron and carbon. (2) 60. A new version phonetically akin to desire with emula• 52. Come back via 38. (2) tion. (2) 53. Edible constant? (2) 64. Wood in a bone of sorts. (4) 55. Broken cane lip and the water fowl therein. (7) 66. Aluminium is boronated for a religious vestment. (3) 56. Pertaining to one of the great vessels. (6) 67. In not rickets but rackets we will permit. (3) 58. We were made to sell our flesh by an Egyptian god? 70. Expensive assemblage of trees? Sounds like it. (2) Daylight hours only. (5) 71. Phoebe's acid-base part. (2) 59. Under excise for a biological category. (5) 72. Group I metal discovered by Bunsen and Kirchhoff in 61. Initially a broken rib as seen by a body of radiologists 1860. (2) in UK. (3) 73. Abbreviated railway, for some. (2) 62. An old character in an ecru nest. (4) 74. Religion returning is a plate on your car. (2) 63. Configurational change studied by Paul Walden. (9) 75. Element before noon. (2) 65. Supportive alloy for women (or strange men)? (5) 67. Sell without a returning French masculine and its Answers to Chemical Crossword No. 6. ratio. (2) 68. Carrier for radium from a seaman. (2) 69. Type of cell often found in the blood of DLE sufferers. (2) 70. Copy a primate. (3) 72. Electric bird? (3) 74. Fishy North African republic. (4) 76. Ron's delights and bay rum without you give polyos• dQ riSQtf (3 § B totic fibrous dysplasia. (9, 8) tiH ffl Jdt3u t£ sa • da inwAia

The Clinical Biochemist, Newsletter, December 1983 25 ^ Q Scientific and Technical Committee T.D. Geary, Chairman

Report to Council, October 1983

GENERAL Mr. P. Boyne has been instrumental in forming the Vic• At the Federal Council meeting held in May 1983 a torian regional group which contains 30 laboratories. proposal was made to alter the mode of operation and terms of reference of the Scientific and Technical Com• 2. Internal Quality Control Data Handling Kits mittee. The Scientific and Technical Committee was asked to formalise this request and to provide new terms of Following recommendations made at the last Scientific reference for consideration at the November Federal Coun• Education Seminar of the AACB two kits have been pre• cil meeting in Sydney. These terms of reference have been pared on internal quality control data handling. Much of distributed through the Federal Secretary. this work has been done by Mr. P. Boyne with assistance from Mr. L. Watkinson and Mr. L. Penberthy. It is hoped SCIENTIFIC AND TECHNICAL COMMITTEE that these will be available for discussion at the Sydney Annual Conference in November 1983. In view of the proposed alterations to the structure of The first kit "Assessment of Quality Control Materials the Scientific and Technical Committee no effort has been for Internal Quality Control" provides recommendations on made to fill the existing vacancy on the Committee. procedures that should be used for selection and evaluation of material for use within a laboratory. Examples of the ANALYTICAL METHODS SUB-COMMITTEE suggested procedures as well as blank check lists, tables, The Sub-committee continues to co-ordinate the assign• etc., for use within laboratories are included in each kit. ment of target values to the material used in the RCPA/ The second kit "Monitoring Internal Quality Control AACB General Serum Chemistry Programme. Materials" is similar in approach and presentation to the kit above. Graphs, tables and statistical approaches which have QUALITY CONTROL SUB-COMMITTEE proved to be useful in monitoring methods are included in the kit. Once again examples are included along with blank Members of the Quality Control Sub-committee are Mr. sheets. L.A. Penberthy (Chairman), Dr. M.C. Stuart and Mr. P. Boyne. Mr. L. Watkinson has been involved in a number of In spite of the difficulties associated with members discussions regarding the activities in internal quality spread over a number of States the achievements of the control matters. Quality Control Sub-committee are pleasing and the Chair• The Sub-committee has concentrated on two main areas. man looks forward to obtaining feed-back from the mem• Namely, the QAP General Serum Chemistry Programme bers of the Association on the Sub-committee's activities. and the production of internal quality control data hand• ling kits. INSTRUMENTATION AND DIAGNOSTIC PRODUCTS SUB-COMMITTEE 1. QAP General Serum Chemistry Programme The activities of this Sub-committee are concentrated Considerable effort has gone into developing this pro• on providing advice on new analytical systems and on the gramme. Mr. L. Penberthy is chief co-ordinator of the pro• peformance of systems currently available on the market. gramme and organises the activities of several staff who The number of requests for assistance confirms the need enter data and handle the relevant paperwork. (These staff for such a service. are reimbursed from programme funds for the time spent on this work.) General responsibility for the programme WORKING PARTIES rests with the RCPA/AACB QAP Chemical Pathology Group. Members of this committee are Dr. D.W. Thomas The number of working parties has increased. This has (Chairman), Mr. T.D. Geary and Mr. L.A. Penberthy. enabled the Scientific and Technical Committee to expand the number of members actively involved in its activities. The computing system being used for this programme The following are the preliminary reports provided by has been updated with respect to hardware, programming the Convenors. and organisation. These updates are now almost complete and progressive "unloading" of the day to day manage• 1. Glycosylated Haemoglobin Standardisation ment of the programme is being implemented by Mr. L. Penberthy. Members: Dr. R. Ryall, Flinders Medical Centre, SA The advent of the improved computing hardware has (Convenor); Dr. R.E. Davis, Royal Perth Hospital, WA; facilitated the production of regional reports. These reports Mr. I. Goodall, Austin Hospital, Victoria. are summaries of the data from a group of laboratories who Corresponding members include: Mr. D. Kerutzmann, have agreed to release their results to a central co-ordinator. Royal Alexandra Hospital for Children, NSW and Mr. L. There are currently twelve regional groups (e.g. South Aust• Coulston, Prince Henry Hospital, Victoria. ralian Group, Victorian Group) and one instrument group (Beckman-Astra). The instrument group is in no way rela• Proposed Aims of the Working Party into Glycosylated ted to the company in question but is co-ordinated by an Haemoglobin Standardisation interested clinical biochemist, Mr. L. Watkinson. 1.1 To produce a range of glycosylated haemoglobin stan-

26 The Clinical Biochemist, Newsletter, December 1983 dards with values from low normal (approximately 3%) It will be our policy to co-opt the help and opinion of to high diabetic (approximately 20%) which can be used our peers in all our work so as to provide as complete a in colourimetric, chromatographic, electrophoretic or representative view of the problem as possible. other methods currently employed in measuring glyco• sylated haemoglobins in routine diagnostic service 3. Standardisation of Urinary Oxalate laboratories. Members: Mr. N. Potezny, IMVS, SA (Convenor); Mrs. 1.2 To define the glycosylated haemoglobin content of each B. Mazzachi, Flinders Medical Centre, SA; Dr. R. Bowyer, of the standards in terms of: Royal Perth Hospital, WA; Mr. S. Langton, Fremantle (a) pure heamoglobin Ale, Hospital, WA;and Dr. R. Bais, IMVS, SA. (b) concentration of glycosylated amino groups, (c) any other practical units. The aims of the working party 1.3 To determine the conditions under which these standards are stable for storage and shipment to labora• 3.1 To review the literature and prepare for publication a tories throughout Australia. report on the methods for measurement of urinary oxalate (R. Bowyer and S. Langton). Proposed Schedule for the Achievement of these Aims 3.2To provide recommendations for the collection, preser• vation and storage of urine specimens (B. Mazzachi). January/February 1983 — Collation of experiences of 3.3To provide recommendations for the preparation and the working party in relation to the storage and stability of storage of standards used in the measurement of urin• glycosylated haemoglobin samples. Allocation of tasks to ary oxalate (N. Potezny). working party laboratories. 3.4 To provide recommendations for a procedure for the March/September 1983 — Preparation of glycosylated preparation and storage of material for use in internal haemoglobin standards, their quantitative analysis and in• quality control programmes (R. Bais and N. Potezny). vestigations of their short term stability. 3.5To recommend to the Australian Association of Clinical October/November 1983 — Review of findings and Biochemists, Scientific and Technical Committee, report to the Analytical Methods Sub-committee of the methods suitable for the analysis of oxalate in urine. Scientific and Technical Committee of the AACB. December 1983/March 1984 — Production of standards 4. Chorionic Gonadotrophin ready for circulation to Australian laboratories. Members: Mr. K. Crawshaw, Queen Elizabeth Hospital, SA (Convenor); Dr. M. Stuart, Garvan Institute, NSW; and 2. Neonatal Bilirubin Mr. A. Reynolds, Australian Diagnostic, Victoria. Members: Mr. M. McKay, Royal Children's Hospital, Victoria (Convenor); Mr. L. Watkinson, Flinders Medical Aims Centre, SA; Miss M. O'Halloran, Royal Alexandra Hospital To make recommendations to the Scientific and Tech• for Children, NSW; and Mr. T. Mahoney, Princess Margaret nical Committee on the following: Hospital for Children, WA. 4.1 Nomenclature for assays which measure chorionic gona• dotrophin and/or its sub-units. Aims 4.2Appropriate reference preparations for each of these To reduce the inter-laboratory variability in total bili• assays. rubin determinations at the critical paediatric level of 4.3Provision of information about the performance of these 300-400 umol/l. assays by authors of scientific papers and manufacturers of reagents and kits. Objective 4.4Clinical applicability of the various single and mixed specificity assays. To recommend a standard for total bilirubin assays and It is proposed that a survey which would be aimed at to monitor its effectiveness in achieving the above aim. defining the specificity of assays currently in use in Aust• The members of the working party all agree that the ralia is to be undertaken. packing, stability and certification to NBS Bilirubin of a Preliminary recommendations, once agreed to by the commercial product would make it a suitable standard for working party, will be published in The Clinical Biochem• this purpose. Consequently, our efforts will be directed to ist — Newsletter and members will be invited to comment. justification of a choice rather than to a re-evaluation of all It is envisaged that final recommendations will be avail• available materials. The working party also recognises that able at the time of the 1984 Annual Conference. the use of this or any other standard will make a substantial difference to the results for patients in the paediatric range. Laboratories using material that does not contain NBS cer• 5. Blood Gas/pH tified bilirubin will encounter up to 20% change for Members: Mr. L. Watkinson, Flinders Medical Centre controls and patients in the 300-400 umol/l range. This (Convenor). The membership will be finalised at the Annual relationship between the recommended standard and other Conference, November 1983. calibrating material must be documented so users can be This group is in its early stages and members have not forewarned of the changes they can expect. been formally announced. It is the intention of the working party to make a recom• A quality assurance programme for blood gases and pH mendation and provide a report to the Technical and Scien• has just been completed in South Australia. This pro• tific Committee prior to the Annual Conference in Sydney gramme was performed to assess the "state of the art" for in November. blood gas/pH measurement and to assess the requirements The working' party must also look at the methods of for a national quality assurance programme. The program• monitoring the progress of its aims to reduce inter- me was completed successfully and its continuation has laboratory variability. We anticipate that this will be the been asked for by participants. second phase of our work to commence early in 1984. It is envisaged that members of the working party will be

The Clinical Biochemist, Newsletter, December 1983 27 recruited after the November AACB meeting and that some of the members will be from the organisation representing TM respiratory function laboratories. The group will work on MACRODUCT assessing the state-of-the-art throughout Australia and the improvement of blood gas/pH measurement. THE ULTIMATE 6. Biogenic Amines CONCEPT IN Members: Dr. John Earl, Royal Alexandra Hospital for Children, NSW (Convenor). SWEAT COLLECTION A progress report will be tabled at the Council meeting. Reproduced below is the contents of a letter sent 3 May 1983. A NEW ERA IN CYSTIC FIBROSIS DIAGNOSIS I would be pleased to initiate the working party for bio• genic amines as you have suggested and will write to ask Dr. The introduction of MACRODUCT byWescor, Fraser for a list of laboratories performing HMMA analysis. a further refinement of the Model 3500 We have a group of five laboratories in NSW willing to form Webster Sweat Collection System, climaxes a local quality control programme and exchange specimens years of research and development. of urine from new cases of neural crest/carcinoid tumours. Three of these are also interested in determination of recov• MACRODUCT offers a major simplification eries. of the sweat test collection procedure with• out compromising the highest standards of According to my very rough calculation we should expect to see only 5-10 phaeochromocytomas and 30-50 quality assurance. neuroblastomas in the whole of Australia each year. Thus • MACRODUCT totally avoids evaporation some laboratories may rarely see a positive specimen. Per• and condensation error; providing fully haps a scheme could be developed where some positive representative sweat samples for analysis. and borderline normal specimens could be distributed on a • MACRODUCT provides visual quantif• national basis each year. This would not only assist labora• ication of sweat production during tories where metanephrins rather than HMMA measure• collection. ments are performed but may encourage more careful screening (e.g., deciding whether to send borderline HMMA • MACRODUCT allows freedom of patient specimens on to another centre for further testing). I hope movement during collection. that there would also be dissemination of information The MACRODUCT System incorporates the about new cases of rare tumours (thoracic, carotid body, 3600 Webster Sweat Inducer with fail-safe enterochromaffin) and difficult tumours (5-10% may show circuitry and single switch operation, powered only marginal elevation of all analytes). by an internal capacitorbankcharged in one I look forward to receiving the procedures for forming a minute. working party. I have spoken to Veronica Wiley and it seems likely that some provision could be made for prelim• It employs PILOGEL™ discs for safe, con• inary discussions at the November meeting. venient and efficient sweat gland stimulation Comment: It is hoped that interested laboratory workers by pilocarpine iontophoresis. whether or not they are members of the Association will Sweat samples obtained by the MACRODUCT assist with the activities of the working parties. System may be analysed for osmolality using a Wescor Vapor Pressure Osmometer STANDARDS ASSOCIATION OF AUSTRALIA - or by traditional sodium and/or chloride COMMITTEE CH/6 - ANALYSIS OF assay. BODY FLUIDS FOR METALS CONTENT These improvements represent the ultimate This Committee has met in April and August of this in sweat test reliability with the minimum of year, 1983, and will hold its final meeting for the year in time, labour and potential for human error. December in Adelaide. CURRENT USERS OF THE MODEL 3500 Work on the micro method for lead in blood has procee• WEBSTER SWEAT COLLECTION SYSTEM CAN ded satisfactorily once the initial problems with the micro- AVAIL THEMSELVES OF AN INEXPENSIVE extraction of lead from 200 ul of blood specimen were CONVERSION KIT TO ENABLE THEM TO overcome. A draft document has been prepared and when USE MACRODUCT COLLECTORS, WITH all the precision data provided by members of the Com• WHICH THE MODEL 3500 IS COMPATIBLE. mittee have been collated then this document will be circu• Available ONLY from lated for public comment. Projects involving the determination of cadmium in WEBSTER SCIENTIFIC blood, arsenic in urine, aluminium in plasma and biological Pty. Ltd. sample digestion methods are being carried out by sub• groups within the Committee. These sub-groups are drawn SOLE DISTRIBUTORS OF ALL WESCOR INSTRU• from members who have a particular interest and MENTS: VAPOR PRESSURE OSMOMETER-COLLOID experience with the problems involved. Their brief is to OSMOMETER — CELSEP~ CELL SEPARATING complete initial evaluations of methods prior to tabling the SYSTEMS. most appropriate in their opinion for fuller evaluation by Post Office Box 3, Edgecliff N.S.W. 2027 all members of the Committee. Telephone: (02) 326-1529 T.D. Geary, Chairman

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The Clinical Biochemist, Newsletter, December 1983 29 sample one of Hobart's better known seafood restaurants. Dr. P. Dennis came to Hobart on 28 September to give BRANCH the annual Roman Lecture which was held at the Repatria• tion General Hospital. His talk was found to be most inter• esting by all those who attended. In the evening, Branch NEWS Committee members who live in Hobart took him to sample some of Hobart's French Cuisine. The morning of 29 September saw Dr. Dennis in Launceston where he was QUEENSLAND taken out to breakfast at the Casino. His lecture at Laun• The Annual General Meeting of the Queensland Branch ceston General Hospital was much appreciated by the staff was held on 29 June 1983 at the Mater Hospital. The of various disciplines within the hospital who attended. following members were elected for 1983-84. At both Hobart and Launceston Clinical Biochemistry staff Chairman: Russell Richards. appreciated his informal discussion on Career Prospects in Treasurer: John Smuts. Clinical Biochemistry. Secretary: John Galligan. We will be holding our Summer Meeting on 10 Decem• Branch Representative to Council: Beth Barr. ber 1983 at Rutherglen Holiday Village, Hadspen. Various Education Representative: Prof. Brian Shanley. aspects of "Enzyme Analysis" will be discussed and further Committee Members: Dr. David Kleinman, Barbara details may be obtained from Chris Showell at Launceston Mottram. General Hospital (003) 32-7242. Publications Representative: Greg Ward. Julie Morcom, After the election of office-bearers Frank Bowling spoke Publications Representative on "Neonatal Screening". Phenylketonuria, Congenital Hypothyroidism, Galactosaemia and Cystic Fibrosis were VICTORIA discussed with relation to: biochemical defect, incidence of disease and problems in disease detection. The Victorian Branch Committee for 1983-1984 is: Chairman: Peter Flett. The Current Concepts Conference was held at the Tweed Secretary: David Hay. Heads RSL Hall on 23 and 24 July. An excellent turnout of Treasurer: Lyn McKinley. 73 registrants were presented with an informative and well Branch Representative: Stephen Slater. co-ordinated program. The key speakers Dr. Peter Pannall Branch Education Representative: Ian Goodall. and Don Osborn were supported by local speakers who in• Committee Members: Nick Balazs, Jimmy Ip, Craig cluded: Dr. Charles Mitchell, Dr. Peter Craswell, Barbara Wehner. Matthews, Dr. David Tudehope, Dr. James Petrie, Dr. Ian Airey and Dr. Hugh Kunze. Thanks to all who contributed The Victorian Branch Membership now stands at 221. to this successful weekend. Associates 171, Members 39, Fellows 10, Honorary Fellows 1. August was the month of the 1983 Roman Memorial Lecture. An excellent lecture entitled "B-Cell Tumours — Following our previous attempts to vary the venue for A Disease Model" was delivered by Dr. Peter Dennis. It was the monthly scientific meetings, we have found ourselves however disappointing that this fine presentation was not a permanent headquarters in the refurbished Kathleen well attended. "Careers in Clinical Chemistry" was the title Syme Centre at the Royal Women's Hospital, which is for a lecture given by Dr. Dennis at Griffith University. proving to be an eminently useful and convenient location. Apart from his lecturing commitments Dr. Dennis visited This year, the Committee has tried to produce for these local laboratories where discussions he had with staff mem• meetings, a balance between AACB and guest speakers: bers were greatly appreciated. Next destination for Dr. In August 1982 Hubert Fong spoke on "Red Cell Dennis was Townsville where he partcipated in the North Ferritin" and John Secombe on "Filter Paper Biochem• Queensland Scientific Weekend. Approximately 30 people istry". In October, Dr. Jo Sabto, Director of the renal unit from throughout the north of the state attended this inter• at the Alfred Hospital presented a review of "Hypercal- esting weekend. The meeting was organised by Austin ciuria and Recurrent Stone Formation". The December Adarraga. Local speakers included Dr. Y. Yinford, Dr. L. meeting was the Branch's customary barbecue, this year Lindoy and Associate Professor E. McEvoy-Bow. held in the Flagstaff Gardens. Specificity of antibodies was the topic for the Septem• Our activities started for 1983 with the Education ber meeting. Dr. John Hinds covered the subject with Week held this year at Melbourne University. (A report depth of understanding. Practical and theoretical problems of this event appeared in The Clinical Biochemist — encountered in the raising of antisera were discussed. Newsletter, No. 69, 13 (1983).) The scientific programme Recent developments in the measurement of free hormones started in March with Dr. David Campbell and Dr. Sujiva including the structure of the Amersham Amerlex FreeT4 Ratnaike alerting us to "Problems with the Assay of Acid tracer were given. Phosphatase". In April, John Aldons, Ian Farrance and Greg Ward, Peter Flett demonstrated how to achieve "The Correct Diagnosis by Laboratory Error!". The May meeting illus• Publications Representative trated the complementary roles of "Angiographic and TASMANIA Enzymatic Monitoring of Streptokinase Therapy for On 30 July we had our "Current Concepts" all day Sem• Coronary Artery Occlusion". Speakers were Dr. Peter inar for which we have to thank Dr. P. Pannall and Mr. D. Dennis and Dr. Andris Saltups, Director of Cardiology at Osborn for most informative lectures and talk-back Prince Henry's Hospital. In July, The Royal Women's sessions. The TPN Sister at the Royal Hobart Hospital also Hospital Biochemistry Department gave us two overviews, contributed an interesting lecture. The meeting was well one by Andrew Andrews on "Current Trends in Prenatal attended both by AACB Members from around the State Assessment of Foetal Lung Maturity" and the other on and by hospital staff from other disciplines. In the evening "Methods and Clinical Applications of Monitoring Ovula• the Branch Committee took their guest speakers out to tion" by Colin Waddell. "Glycosylated Haemoglobins '83

30 The Clinical Biochemist, Newsletter, December 1983 — Current Views and Laboratory Aspects" was the title of a talk given to the Branch in August by Ian Goodall. New Products The Education programme for this year has been modi• fied slightly from previous years, and continues to be well and supported. Ian Goodall's report appears elsewhere in this edition of the Newsletter. Developments The Victorian Branch has proposed that the Association should bid to host the 1990 IFCC Congress in Melbourne. This following information is provided by the manufacturers or their The formal application had to be received by mid-Novem• agen ts. ber. A small Steering Committee has held a number of meetings and obtained advice from several parties with ex• perience of conference organisation in Melbourne. As a ULTRA-VIOLET EQUIPMENT result, we have prepared an application and forwarded it to Mastatek Pty. Limited, the Sydney based instrumenta• the IFCC. If the proposal is accepted as being reasonable, tion company, has released a range of Ultra-Violet Equip• then the next step will be to form a team, from within ment from the UK company, Ramley Engineering Co. Ltd. AACB members going to Rio, to lobby for the Australian The instruments include the UVITEC range of short cause, prior to the final vote. With a certain degree of good wave (254nm) models with power outputs from 800 to luck and gentle persuasion, we could expect an estimated 20,000 microwatts and the UVISPEC fully portable 2000 biochemists from Australia and overseas to meet in handlamp, which is available in a longwave (367nm) and a Melbourne, in February 1990. long wave plus short wave model. Applications for these Stephen Slater, instruments include security checking, forensics, biochem• Secretary istry, mineralogy and fake restoration and repair detection. For further information contact Mastatek Pty. Limited, WESTERN AUSTRALIA 1a Leonard Street, Hornsby, NSW 2077. Phone (02) 477-6120 or, in Victoria, Multisource International Pty. The new Branch Committee for 1983-84 decided to Ltd., phone (03) 82-8287. launch their Scientific Meeting programme with something more medicinally orientated rather than biochemical. In NEW APPOINTMENT conjunction with AIMLS an informal wine tasting was or• ganised with Dorom Mann from Sandalford Wines telling us BDH Chemicals Australia announce the appointment of something about the increasing application of scientific Gordon Saunders to the position of Sales Representative in and technological practices to the making of wine. He also Queensland. arranged a plentiful supply of material upon which mem• Mr Saunders will be responsible for all sales activities for bers could 'test' the influence of such practices and those the Reagents, Industrial and Diagnostic Division of BDH. who were present agreed that, for once, the low meeting Mr Saunders will reside in Queensland after initial attendance did have advantages in terms of consumption. training in Sydney and Melbourne. In August the Current Concepts Conference took place at the Repatriation Hospital, Hollywood. Approximately ORTHO-TOLIDINE CARCINOGENIC 50 people attended and many of these judged the Confer• SUBSTANCE ence very successful. Peter Pannall and Don Osborn con• Ortho-tolidine is a carcinogenic substance widely used as tributed about 75% of the material with local speakers an indicator and stain. It is particularly effective as a contributing the remainder and this balance appeared to be stain in the separation of haptoglobin phenotypes using ideal. As some recompense for their labours Don and Peter gradient polyacryla'mide gels. were wined and dined at the Mediterranean Restaurant on Leucomalachite green (BDH C/N 29054) has been tested the evening after the Conference by the Branch Com• as an alternative for the detection of haptoglobin pheno• mittee and other members. types and has been found to be an efficient and acceptable Dr. Peter Dennis visited Western Australia in September substitute. to deliver the Roman Lecture, entitled "/3-celI tumours - a For further information, contact BDH Chemicals disease for Clinical Biochemists". In addition to giving the Australia Pty. Ltd., 700 High Street, East Kew, Victoria, lecture Dr. Dennis visited the two major teaching hospitals 3102. and Fremantle Hospital. Those colleagues whom he met are appreciative of his efforts to fulfill all the criteria of ISE ELECTRODE/METER OFFER the Roman Lecturer. The Branch Committee hopes that he For a limited period, the Orion Research Model 901 found his stay in WA rewarding and that we will not only Microprocessor lonalyzer will be provided with a Handbook be remembered for the Federal Secretary's microwaved of Electrode Technology and an ion selective electrode free breakfast or his somewhat 'delayed' departure. of charge from the following list: ammonia, bromide, The remainder of the Scientific Programme this year calcium, chloride, cyanide, iodide, lead, nitrate, potassium, includes Dr. Graham McLellan describing some rare abnor• silver/sulphide, water hardness. malities of thyroid function testing and Dr. Harry Pardue Full applications support will still be included from the talking about data processing of kinetic assays. local agent. We hope to open next year's activities with two local For further information please contact: Linbrook members discussing amongst other topics, their experiences International Pty. Ltd, PO Box 172, Caulfield South, 3162. up the Nile, whether Egypt will be mounting a challenge for Telephone (03) 211-8300. the America's Cup and perhaps telling us something about the proceedings of the 2nd Near East Congress of Clinical Chemistry in Cairo. AMMONIA ELECTRODE TRADE-IN OFFER C. Rebeiro, For a limited period, Orion Research are offering a Publications Representative $50.00 trade-in on any ammonia gas-sensing electrode

The Clinical Biochemist, Newsletter, December 1983 31 against the purchase of the new model 95-12 ammonia amylase is a single step test which requires no sample electrode. blanks, centrifugation or filtration. The new design of the 95-12 offers better reliability, There is no interference from endogenous glucose and easier assembly, low-cost replacement membranes, greater the short reaction time of five minutes means that results sensitivity at lower levels, smaller sample required, and fits can be available for stat reporting. the average test tube. The reconstituted reagent is stable for 24 hours but Additionally, the model 95-12 is provided with a two studies at Gilford's Technical Services Department have year warranty, and an extensive range of applications shown that the frozen reagent can be thawed and reused bulletins is available. for up to three weeks. For further information please contact Linbrook Stable for 14 days when reconstituted, Gilford's International Pty Ltd, PO Box 172, Caulfield South 3162. Cholesterol reagent contains no noxious or corrosive Telephone (03) 211-8300. chemicals and exhibits excellent specificity. Gilford also offers the choice of UV or Colour BECKMAN HPLC COLUMNS FOR Tryglycerides. Both have superb linearity (600 and 700 PURIFICATION OF PROTEINS mg/dl respectively) and the single vial colour reagent is stable for five days. Beckman Instruments Inc. has introduced several new FSE Scientific offers the complete range of Gilford preparative 21.1 mm (1") ID Spherogel™ TSK-SWG diagnostic reagents. This now includes Acid Phosphatase. columns for high performance liquid chromatographs. The Using a kinetic methodology, it allows the choice of columns are designed for large scale purification of total, prostatic and non-prostatic. The kit includes acetate proteins. More than 350 mg of BSA has been purified by buffer for stabilisation and has high linearity up to 40 ul. these new columns. Seven day reconstituted stability means very little waste. Columns come in 30 cm and 60 cm lengths in 2,000, FSE Scientific, 40 Hilly Street, Mortlake Point. 3,000 and 4,000 SW packing materials. To extend column Telephone (02) 736-2088. life, pre-column and column repair material is available. For more information, contact Beckman Instruments NEW AUSTRALIAN DISTRIBUTOR Australia Pty. Ltd., 24 College Street, Gladesville, NSW FOR KIMBLE LABORATORY GLASSWARE 2111 Australia. Telephone (612) 896-2288 or (008) CIG Medishield Ramsay has just been appointed the 226-423 In Watts. exclusive Australian distributor for Kimble Laboratory P ROTE I N/PEPTIDE SEQUENCER Glassware. Kimble's top quality product has placed them PROVIDES RELIABILITY, VERSATILITY among the world's leading manufacturers of scientific glassware. Beckman Instruments, Inc's System 890M Protein/ The range will include beakers, pipettes, flasks, tubes, Peptide Sequencer automatically converts ATZ amino cylinders, bottles, funnels and volumetric glassware for acids to PTH amino acids for analysis on an HPLC general laboratory applications. Specialised glassware for system. Sensitivity is down to 200 picomoles over 20 the dairy, oil and clinical markets will also be available. cycles. The system offers a wide dynamic range of A catalogue of Kimble Laboratory Glassware is avail• sensitivity, from micro-sequencing of picomole quan• able from CIG Medishield Ramsay at 7 Khartoum Road, tities to the analysis of large nanomole samples. North Ryde, NSW 2113. Microprocessor control provides ease of programming, storage of up to eight programs, precise replication of every FOURTH AND FIFTH GEMENI'S INSTALLED program command and linking and switching of programs. BY STATE HEALTH DEPARTMENT System 890M enables sample application subroutines, OF QUEENSLAND reduced cleavage times and double coupling programs. The The State Health Department of Queensland has instal• user can select manual or fully automatic operation. led its fourth Gemeni centrifugal analyser at Mount Isa An integral cold trap efficiently condenses reagent and Hospital and a fifth at Bundaberg Hospital. solvent vapors. This feature eliminates the contamination of The Mount Isa unit, which includes a loader, represents a vacuum pump oil by volatile vapors. substantial upgrade of the Mount Isa laboratory capabili• Chemicals are an integral part of the System 890M's ties. The sophisticated Gemeni system is said to be one of performance. Beckman manufactures specially purified the simplest and most reliable available. It utilises a 20 sequencer-grade reagents and solvents, as well as apomyo- place disposable disc, this design philosophy results in globin protein standard. considerably simplified operation. In addition contamina• An advanced rotary seal electropneumatic vacuum valve tion due to improper cleaning of the disc is eliminated. has been incorporated into the System 890M for increased For further information please contact Meeco, 13-14 reliability. It provides more efficient vacuum operation and Hordern Place, Camperdown, 2050. Phone (02) 517-2377. single pump configuration to offer efficiency, precision and speed to the system. SWEAT COLLECTION SYSTEM For more information, contact Beckman Instruments Australia Pty. Ltd., 24 College Street, Gladesville, NSW, The ultimate concept in sweat collection is the culmina• 2111 Australia. Telephone (612) 896-2288 or (008) tion of years of intensive research and development by Dr. 226-423 In Watts. H. Lewis Webster, Managing Director of Webster Scientific, Edgecliff, NSW. NEW PRODUCTS FROM GILFORD'S The Macroduct Sweat Collection System brings major FSE Scientific market Gilford's complete range of improvements in the induction and collection of sweat. diagnostic reagents. An automated method for measuring Like the Webster Sweat Collection System from which it serum magnesium levels is now available. evolved, Macroduct abolishes intrinsic errors that have This kinetic method requires no protein precipitation accompanied all previous sweat testing methods and inaugu• and gives good correlation to atomic absorption. rates a new era of simplicity and convenience in the labora• Available from FSE Scientific, Gilford's enzymatic tory diagnosis of cystic fibrosis.

32 The Clinical Biochemist, Newsletter, December 1983 HAVE AUSTRALIAN BIOCHEMISTS BOUGHT SO MANY TECHNICON WHY RA1000 ANALYZERS?

PROBABLY BECAUSE THE TECHNICON RA1000 IS THE FLEXIBLE RANDOM ACCESS ANALYZER WITH SUPERB ANALYTICAL PERFORMANCE.

POSSIBLY BECAUSE TECHNICON PROVIDES OUT• STANDING NATIONWIDE SERVICE.

MAYBE BECAUSETHE TECHNICON RA1000 SYSTEM STILL HAS A LOW INTRODUCTORY PRICE.

WHY NOT FIND OUT WHAT TECHNICON RA1000 USERS SAY. IFttWDDiXB fc) §§§TO

EQUIPMENT PTY. LTD. 5 80 TALAVERA RD., TECHNICON NORTH RVDE 111 NSW 2113

The Clinical Biochemist, Newsletter, December 1983 33 Vth International Symposium on Urolithiasis and Related \ Clinical Research Forthcoming J9_ 1 -5 April, Garmisch-Partenkirchen, West Germany Contact: < Prof. P.O. Schwille, Meetings ^°*£»S^- University Hospital, V y Experimental Surgery and Urology, AUSTRALIA 1984 Maximiliansplatz, D-8520, Erlangen, West Germany. Fourth International Symposium on HPLC in the Biologi• XII International Congress of Clinical Chemistry cal Sciences 20-22 February, Regent Hotel, Melbourne, Victoria 29 April-5 May, Rio de Janeiro, Brazil Contact: Contact: The Secretary, Executive Secretary, Mrs. S. Tregellas, XII International Congress of Clinical Chemistry, International Symposium on HPLC in the Biological Rua Vincente Licinio 95, CEP 20270 Sciences, Rio de Janeiro, RJ Brazil. c/- St. Vincent's School of Medical Research, 41 Fitzroy Parade, XXXII Annual Colloquium - Protides of the Biological Fitzroy, Victoria 3065 Fluids 30 April-2 May, Brussels, Belgium 3rd Adelaide International Bone Symposium "Metabolic Contact: Bone and Stone Disease" Colloquium - Protides of the Biological Fluids 16 and 17 March, Royal Adelaide Hospital, Adelaide, SA Secretariate Institute for Medical Biology, Contact: Alsembergsesteenweg Symposium on "Bone", 196 Chaussee d' Alsemberg S.A.P.M.E.A. Inc. B-1180 Brussels, Belgium G PO Box 498, Adi-iaide, SA, 5001. Impact 1984 — Association of Clinical Biochemists Colloids and Surfaces in Biological Systems 21-23 May, Buxton, Derbyshire, England This is a joint meeting arranged by the Australian Bio• Contact: chemical Society and the Royal Australian Chemical Dr. C. Toothill, Institute. Department of Chemical Pathology, 12-14 May, University of Sydney University of Leeds, Contact: Leeds LS2 9J7, UK. Dr. L. Fisher, See page 9 this Newsletter. CSIRO Division of Food Research, PO Box 52, Vllth International Congress of Endocrinology 1-7 July, Quebec, Canada North Ryde, NSW, 2113 Contact: Further details on page 7. 54th ANZAAS Congress Vllth International Congress of Endocrinology, Le Centre Hospitalier de I'Universite Laval, 14-18 May, Australian National University, Canberra 2705 Laurier Boulevard Information: Ste-Foy, Quebec, Canada G1V 4G2 ANZAAS Congress Secretariat, Dulcie Stretton Assocs, 2nd International Congress on Automation and New Tech• 70 Glenmore Road, nology in the Clinical Laboratory Paddington, NSW 2021 1 5-18 October, Barcelona, Spain 22nd Annual Conference of the AACB Contact: 19 October (jointly with RCPA) until 23 October The Secretary of the Second Congress, Venue: Dr. R. Galimany, Sheraton Hotel, Perth, WA Apartado de Correos 543, Contact: Barcelona, Spain Dr. R.G.Wilson, This congress on laboratory automation is sponsored by Box D184,GPO, the I FCC and the IUPAC. Perth, WA, 6001 N.B. Mr. Des Geary (IMVS Adelaide) is a member of the Organising Committee and can provide further information. OVERSEAS 1984 Also see page xx this Newsletter for possible travel Biointeractions '84 arrangements. This meeting will study the interactions between physi• cal and biological systems. (Sponsored by the journal Biomaterials.) 1985 4-6 January, City University, London, England Contact: 6th European Congress of Clinical Chemistry Mary Korndorffer, 1 -6 September, Israel Conference Organiser, The following meeting will be held in Israel either before PO Box 63, or after this meeting. Westbury House, Bury Street, Guildford, 5th International Congress for Clinical Enzymology Surrey, GU2 5BH, England 8-11 September

The Clinical Biochemist, Newsletter, December 1983 / \ SCIENTIFIC FOUNDATIONS OF CLINICAL BIOCHEMISTRY

VOLUME 2, BIOCHEMISTRY IN CLINICAL PRACTICE

Edited by DAVID L. WILLIAMS and VINCENT MARKS

Scientific Foundations of Clinical Biochemistry, a unique reference work for laboratory scientists and clinicians, is now complete in two volumes, Analytical Aspects (volume 1) and Biochemistrry in Clinical Practice (volume 2).

BIOCHEMISTRY IN CLINICAL PRACTICE, is concerned with the physiological, clinical and interpretive aspects of the subject and fill a need, long felt by post• graduate students of clinical biochemistry, for a book describing the clinical basis of the analytical procedures which they use. The authors include senior physicians, surgeons and clinical biochemists, and the material is arranged systematically for ease of reference by laboratory scientists and clinicians alike.

No attempt has been made in this volume to describe analytical methods in detail, and the physical and chemical principles of clinical biochemistry are covered in Volume 1. Together, the two volumes of Scientific Foundations of Clinical Biochemistry will be especially valuable for those intending to make a career in medical laboratory science, and will also be of interest to clinicians seeking a deeper understanding of the way in which the analytical information upon which they rely so heavily is produced and interpreted.

CONTENTS:— Disorders of fluid and electrolyte balance; Disorders of the gastro• intestinal system; Disorders of the blood constituents; Disorders of the renal tract; Disorders of the skeletal system; Pharmacology and toxicology; Disorders of the neuromuscular system; Disorders of the cardiovascular system; Neuropsychiatric disorders; Disorders of the endocrine system; Clinical biochemistry of pregnancy and the neonatal period.

1983, 720 pages, Cased, ISBN 0 433 36384 3 Recommended retail price — $165.00

VOLUME 1 - ANALYTICAL ASPECTS, CONTENTS:-

Basic principles; Photometry; Chromatography; Enzymology; Immunology and Electrophoresis; Radio-isotope methods; Automation; Miscellaneous techniques; The assessment of results.

1978, 512 pages, Cased, ISBN 0 433 36383 5 Recommended retail price — $85.00

HEINEMANN MEDICAL BOOKS Distributed in Australia by:—

MEDTEC BOOK DISTRIBUTORS PTY. LTD., 31 Advantage Road, Highett, 3190

The Clinical Biochemist, Newsletter, December 1983 35 T-^™ from ABBOTT.

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