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

References

• Saugstad OD. Hypoxanthine as a measure of hypoxia. Pediatr Res 1975; 9: 158–61
   PubMed Web of Science ®Google Scholar
• Harkness RA. Clinical biochemistry of the neonatal period: immaturity, hypoxia and metabolic disease. J Clin Pathol 1987; 40: 1128–44
   PubMed Web of Science ®Google Scholar
• Harkness RA. Hypoxanthine. xanthine and uridine in body fluids, indicators of ATP depletion. J Chromatogr Biomed Appl 1988; 429: 255–78
   Web of Science ®Google Scholar
• Saugstad OD. Hypoxanthine as an indicator of hypoxia; its role in health and disease through free radical production. Pediatr Res 1988; 323: 143–50
   Google Scholar
• Berne R M, Rubio R. Adenine nucleotide metabolism in the heart. Circulation Res 1974; 34: 109–18, Suppl III
   Google Scholar
• Huizer T. Myocardial ATP catabolism and its pharmacological prevention. Erasmus University and Netherlands Heart Foundation, Amsterdam 1991
   Google Scholar
• Kock Delvoux R, Sigmund B., Greiling MH. A comparative study of the concentrations of hypoxanthine, xanthine, uric acid and allantoin in the peripheral blood of normals and patients with acute myocardial infarction and other ischaemic diseases. Eur J Clin Chem Clin Biochem 1994; 32: 837–42
   PubMedGoogle Scholar
• Remme WJ, de Jong J, Verdoux WPD. Effect of pacing induced myocardial ischemia on hypoxanthine efflux from the human heart. Am J Cardiol 1977; 40: 55–62
   PubMed Web of Science ®Google Scholar
• Robbrecht J, de Buyzere, Delanghe M, de Scheerder J., Mortier I, Vanderschueren ES. Increase of hypoxanthine during cardiac surgery as measured by indirect automated enzymatic assay. Clin Chem 1989; 35: 898–9
   PubMed Web of Science ®Google Scholar
• Buhl MR. Oxypurine excretion during kidney preservation; an indicator of ischaemic damage. Scand J Clin Lab Invest 1976; 36: 169–74
   PubMed Web of Science ®Google Scholar
• Buhl MR. Purine metabolism in ischaemic kidnev tissue. Danish Med Bull 1982; 29: 1–26
   PubMedGoogle Scholar
• Sinkeler S PT, Joosten E MG, Wevers R A, Binkhorst R A, Oerlmans F T, van Bennekom CA. Ischaemic exercise test in myoadenylate deaminase deficiency and McArdle disease: measurement of plasma adenosine, inosine and hypoxanthine. Clin Sci 1986; 70: 399–401
   Web of Science ®Google Scholar
• Harkness R A, Coade S B, Walton K R, Wright D. Xanthine oxidase deficiency and 'Dalmation' hypouricaemia: incidence and effect of exercise. J Inher Metab Dis 1983; 6: 114–20
   PubMed Web of Science ®Google Scholar
• Harkness R A, Simmonds R J, Coade SB. Purine transport and metabolism in man: the effect of exercise on concentrations of purine bases, nucleosides and nucleotides in plasma, urine, leucocytes and erythrocytes. Clin Sci 1983; 64: 333–40
   Web of Science ®Google Scholar
• Harkness R A, McCreanor G M, Greenwood R. The pathogenesis of the Lesch Nyhan syndrome: ATP use is positively related to hypoxanthine supply to hypoxanthine guanine phosphoribosyl-transferase. J Inher Metab Dis 1991; 14: 202–14
   PubMed Web of Science ®Google Scholar
• Harris R C, Marlin D J, Snow D H, Harkness RA. Muscle ATP loss and lactate accumulation at different work intensities in the exercising thoroughbred horse. Eur J Appl Physiol 1991; 62: 235–44
   Web of Science ®Google Scholar
• Ketai L H, Simon R H, Kreit J W, Grum CM. Plasma hypoxanthine and exercise. Am Rev Resp Dis 1987; 136: 98–101
   PubMed Web of Science ®Google Scholar
• Bolhuis P A, Zvart R, Bar P R, de Visser M, van den Helm HJ. Rapid determination of hypoxanthine increase in ischemic exercise tests. Clin Chem 1988; 34: 1607–10
   PubMed Web of Science ®Google Scholar
• Sorlie D, Myhre K, Saugstad O D, Giersksky KE. Release of hypoxanthine and phosphate from exercising human legs with and without arterial insufficiency. Acta Med Scand 1982; 211: 281–6
   PubMedGoogle Scholar
• Dueland S, Myhre K, Dueland A N, Saugstad OD. Increased plasma hypoxanthine in humans during exposure to simulated altitude of 7620 metres (25000 feet). Aviation, Space Envir Med 1991; 62: 1044–9
   PubMedGoogle Scholar
• Bejar R, Saugstad O D, James H, Gluck L. Increased hypoxanthine concentrations in cerebrospinal fluid of infants with hydrocephalus. J Pediatr 1983; 103: 44–8
   PubMed Web of Science ®Google Scholar
• Harkness R A, Lund RJ. Cerebrospinal fluid concentrations of hypoxanthine, xanthine, uridine and inosine: high concentrations of the ATP metabolite, hypoxanthine, after hypoxia. J Clin Pathol 1983; 36: 1–8
   PubMed Web of Science ®Google Scholar
• Meberg A, Saugstad OD. Hypoxanthine in cerebrospinal fluid of children. Scand J Clin Invest 1978; 38: 437–40
   PubMed Web of Science ®Google Scholar
• Levin S D, Brown J K, Harkness RA. Cerebrospinal fluid hypoxanthine and xanthine concentrations as indicators of metabolic damage due to raised intracranial pressure in hydrocephalic children. J Neurol Neurosurg Psychiatr 1984; 47: 730–3
   PubMed Web of Science ®Google Scholar
• Castro-Gago M, Lojo S, Del Rio R, Rodriguez A, Novo I, Rodriguez-Segade S. The concentrations of xanthine and hypoxanthine in cerebrospinal fluid as therapeutic guides in hydrocephalus. Child Nerv Syst 1986; 2: 109–11
   PubMed Web of Science ®Google Scholar
• Swanstrom S, Bratteby LE. Hypoxanthine as a test of perinatal hypoxia compared to lactate, base deficit and pH. Pediatr Res 1982; 16: 156–60
   PubMed Web of Science ®Google Scholar
• Thiringer K. Cord plasma hypoxanthine as a measure of fetal asphyxia. Comparison with clinical assessment and laboratory measures. Acta Paediatr Scand 1983; 72: 231–7
   PubMed Web of Science ®Google Scholar
• Harkness R A, Geirsson R T, McFadyen IR. Concentrations of hypoxanthine, xanthine, uridine and urate in amniotic fluid at Caesarean section and the association of raised levels with prenatal risk factors and fetal distress. Br J Obstet Gynaecol 1983; 90: 815–20
   PubMedGoogle Scholar
• O'Connor M C, Harkness R A, Simmonds R J, Hytten FE. Raised hypoxanthine and uridine concentrations in meconium stained amniotic fluid and during labour. Br J Obstet Gynaecol 1981; 88: 375–380
   PubMedGoogle Scholar
• Illingworth RS. Litigation and birth. J Med Defence Union 1987; 4: 14–5
   Google Scholar
• Chen Y, Saugstad O D, Teige B, Hagve T A, Rognum TO. Can increased excretion of hypoxanthine in urine identify genuine ALT. Sudden infant death syndrome. New trends in the nineties, T Rognum. Scandinavian University Press, Oslo 1995; 326–9
   Google Scholar
• Rognum T O, Hauge S, Oyasaeter S, Saugstad OD. A new biochemical method for the estimation of post mortem time. Forensic Sci Int 1991; 51: 139–46
   PubMed Web of Science ®Google Scholar
• Rognum T O, Saugstad OD. Hypoanthine levels in vitreous humour: evidence of hypoxia in most infants who died of sudden infant death syndrome. Pediatrics 1991; 87: 306–13
   PubMed Web of Science ®Google Scholar
• Harkness R A, Coade S B, Simmonds R J, Duffy S. Effect of energy failure on adenine nucleotide breakdown in the placenta and other fetal tissues from rat and guinea pig. Placenta 1985; 6: 199–216
   PubMed Web of Science ®Google Scholar
• Saugstad OD. The determination of hypoxanthine with a pO2electrode. Pediatr Res 1975; 9: 575–9
   PubMed Web of Science ®Google Scholar
• Gardiner DG. A rapid and sensitive fluorimetric assay for adenosine, inosine and hypoxanthine. Analyt Biochem 1979; 95: 377–82
   PubMed Web of Science ®Google Scholar
• Clarke CA. Eighty years of this and that: Part 1. Proc R Coll Phys Edinb 1995; 25: 495–508
   Google Scholar
• Benson R. Ten commandments for business success. Chem Br 1995; 31: 116–7
   Google Scholar
• Stevenson R. Crystal ball gazing. Chem Br 1995; 31: 87–8
   Google Scholar
• Myners P. Comment. Chem Br 1995; 31: 507
   Google Scholar
• Peckham M, Smith R. Health care; what's science got to do with it?. Br Med J 1995; 310: 208
   PubMedGoogle Scholar
• Smith R. Filling the lacuna between research and practice; an interview with Michael Peckham. Br Med J 1993; 307: 1403–8
   PubMedGoogle Scholar
• Smith R. Developing foresight: an interview with Sir Dai Rees. Br Med J 1994; 309: 324–6
   PubMedGoogle Scholar
• Murray AW. The biological significance of purine salvage. A Rev Biochem 1971; 40: 811–26
   PubMed Web of Science ®Google Scholar
• Stone T W, Simmonds HA. Purines: Basic and clinical aspects. Kluwer Academic Publishers, Lancaster 1991
   Google Scholar
• Scriver CR, Beaudet A L, Sly W S, Valle D. Purines and pyrimidines. The metabolic and molecular basis of inherited disease Vol II, Part 7, S Scriver, et al. McGraw Hill, New York 1995; 1: 655–840
   Google Scholar
• Siesjo BK. Brain energy metabolism. Wiley, Chichester 1978
   Google Scholar
• Iles R A, Poole Wilson PA. Ischaemia, hypoxia and reperfusion. The metabolic and molecular basis of acquired disease, RD Cohen, B Lewis, KGMM Alberti, AMS Denman. Bailliere, London 1990; Vol 1: 322–41
   Google Scholar
• Hand S C, Hardeewig I. Down regulation of cellular metabolism during environmental stress: mechanisms and implications. A Rev Physiol 1996; 58: 539–63
   PubMed Web of Science ®Google Scholar
• Barankiewicz Gelfond JE, Issekutz WA, Cohen A. Evidence for active purine nucleotide cycles in human mononuclear cells and cultured fibroblasts. J Biol Chem 1982; 257: 11597–600
   PubMed Web of Science ®Google Scholar
• Matsumoto SS, Raivio K O, Seegmiller JE. Adenine nucleotide degradation during energy depletion in human lymphoblasts. Adenosine accumulation and adenylate energy charge correlation. J Biol Chem 1979; 254: 8956–62
   PubMed Web of Science ®Google Scholar
• Atkinson DE. Cellular energy metabolism and its regulation. Academic Press, London 1977
   Google Scholar
• Wedenberg K, Ronquist Ulmstem GU, Waldenstrom A. Energy economy of human uterine muscle strips under different in vitro conditions and its dependence on tissue redox potential. Eur J Obstet Gynecol 1995; 62: 115–9
   Web of Science ®Google Scholar
• Setlow P, Kornberg A. Biochemical studies of bacterial sporulation and germination XXII Energy metabolism in early stages of Bacillus megaterium sporulation. J Biol Chem 1970; 245: 3637–44
   PubMed Web of Science ®Google Scholar
• Azzopardi Wyatt DJS, Cady E B, Delpy D, Baudin TJ, Stewart AL. Prognosis of newborn infants with hypoxic-ischaemic brain injury assessed by phosphorus magnetic resonance spectroscopy. Pediatr Res 1989; 25: 445–51
   PubMed Web of Science ®Google Scholar
• Koretsky AP. Insights into cellular energy metabolism from transgenic mice. Physiol Rev 1995; 75: 667–88
   PubMed Web of Science ®Google Scholar
• Simmonds R J, Coade SB, Harkness R A, Drury Hytten LFE. Nucleotide, nucleoside and purine base concentrations in human placenta. Placenta 1982; 3: 29–38
   PubMed Web of Science ®Google Scholar
• Hallgren R, Niklasson Terent F, Akerblom AA, Widerlov E. Oxypurines in cerebrospinal fluid as indices of disturbed brain metabolism. A clinical study of ischemic brain diseases. Stroke 1983; 14: 382–8
   PubMed Web of Science ®Google Scholar
• Cohen N S, Ekholm J E, Luthra M G, Hanahan DJ. Biochemical characterization of density separated human erythrocytes. Biochem Biophys Acta 1976; 419: 229–42
   PubMedGoogle Scholar
• Folbergrova Llunggren J, Norberg B., Siesjo KBK. Influence of complete ischaemia on glycolytic metabolites, citric acid cycle intermediates and association with amino acids in the rat cerebral cortex. Brain Res 1974; 80: 265–79
   PubMed Web of Science ®Google Scholar
• Hochachka P, Mustafa WT. Invertebrate facultative anaerobiosis. A reinterpretation of invertebrate enzyme pathways suggests new approaches to helminth chemotherapy. Science 1972; 178: 1056–60
   PubMed Web of Science ®Google Scholar
• Hisanaga K, Onodera Kogure HK. Changes in levels of purine and pyrimidine nucleotides during acute hypoxia and recovery in neonatal rat brain. J Neurochem 1986; 47: 1344–50
   PubMed Web of Science ®Google Scholar
• Mendelson S, Nordan LS, Young KDA. Rapid changes in initiation limited protein synthesis in rat thymic lymphocytes correlate with energy charge. Biochem Biophys Acta Res Commn 1977; 79: 53–60
   PubMed Web of Science ®Google Scholar
• Nowak TS, Fried R L, Lust W, Passonneau DJV. Changes in brain energy metabolism and protein synthesis following transient bilateral ischemia in the gerbil. J Neurochem 1985; 44: 487–94
   PubMed Web of Science ®Google Scholar
• Dienel G A, Cruz N, Rosenfeld FSJ. Temporal profiles of proteins responsive to transient ischemia. J Neurochem 1985; 44: 487–94
   PubMed Web of Science ®Google Scholar
• Burnstock G. Purinergic receptors. Recept Recogn Series B 1981; 12: 1–365
   Google Scholar
• Rudolphi K, Schubert AP, Parkinson F E, Fredholm BB. Neuroprotective role of adenosine in cerebral ischaemia. Trends Pharm Sci 1992; 13: 439–45
   PubMed Web of Science ®Google Scholar
• Irestedt Dahlin L, Hertzberg IT, Sollevi A, Lagercrantz H. Adenosine concentrations in umbilical cord blood of newborn infants after vaginal delivery and Caesarean section. Pediatr Res 1989; 26: 106–8
   PubMed Web of Science ®Google Scholar
• Yoneyami Y, Wakatsuki M, Sawa R, Kamoi Takahashi SH, Shin S. Plasma adenosine concentration in appropriate and small for gestational age fetuses. Am J Obstet Gynecol 1994; 170: 684–8
   PubMed Web of Science ®Google Scholar
• Yoneyami Y, Shin Iwasaki ST, Power G, Araki T. Relationship between plasma adenosine concentration and breathing movements in growth retarded fetuses. Am J Obstet Gynecol 1994; 171: 701–6
   PubMed Web of Science ®Google Scholar
• Harkness R A, Cotes P M, Gordon H, McWhinney N. Prolonged pregnancy and fetal energy supply: Amniotic fluid concentrations of erythropoetin, hypoxanthine and uridine in uncomplicated prolonged pregnancv. J Obstet Gvnaecol 1988; 8: 235–42
   Web of Science ®Google Scholar
• Ruth V, Widnes JW., Demons Raiivio GKO. Postnatal changes in serum immunoreactive erythropoetin in relation to hypoxia before and after birth. J Pediatr 1990; 116: 950–4
   PubMed Web of Science ®Google Scholar
• Spector R. Hypoxanthine transport through the blood brain barrier. Neurochem Res 1987; 12: 791–6
   PubMed Web of Science ®Google Scholar
• Guieu R, Paganelli Sampieri F, Bechis F, Levy GS, Rochat H. The use of HPLC to evaluate variations in the blood coronary adenosine levels during percutaneous transluminal angioplasty. Clin Chim Acta 1994; 230: 63–8
   PubMed Web of Science ®Google Scholar
• Driver A G, Kukoly CA, Spence P A, Chitwood W R, Mustafa SJ. Pericardial fluid adenosine in ischemic and valvular heart disease. Chest 1995; 107: 346–51
   PubMed Web of Science ®Google Scholar
• Harkness R A, Whitelaw A GL, Simmonds RJ. Intrapartum hypoxia: the association between neurological assessment of damage and abnormal excretion of ATP metabolites. J Clin Pathol 1982; 35: 999–1007
   PubMed Web of Science ®Google Scholar
• Laing I, Brown J K, Harkness RA. Clinical and biochemical assessments of damage due to perinatal asphyxia: a double blind trial of a quantitative method. J Clin Pathol 1988; 41: 247–52
   PubMed Web of Science ®Google Scholar
• O'Connor M C, Harkness R A, Simmonds R J, Hytten FE. The measurement of hypoxanthine, xanthine, inosine and uridine in umbilical cord blood and fetal scalp blood samples during hypoxia. Br J Obstet Gynaecol 1981; 88: 391–90
   PubMedGoogle Scholar
• Fairweather D VI, Eskes T KAB. Amniotic fluid research and clinical applications. Excerpta Medica Foundation, Amsterdam 1978
   Google Scholar
• Gaffney G, Sellers S, Flavell V, Squier M, Johnson A. Case control study of intrapartum care, cerebral palsy and death. Br Med J 1994; 308: 743–9
   PubMed Web of Science ®Google Scholar
• Adams A, Harkness RA. Purine uptake from erythrocytes by rabbit tissues in vivo. Biochem Soc Trans 1973; 1: 138–9
   Google Scholar
• Maganasik B, Karibian D. Purine nucleotide cycles and their metabolic role. J Biol Chem 1960; 235: 2672–81
   PubMed Web of Science ®Google Scholar
• Bell A H, Skov L, Lundstrom K E, Saugstad O D, Greisen G. Cerebral blood flow and plasma hypoxanthine in relation to surfactant treatment. Acta Paediatr Scand 1994; 83: 910–4
   PubMed Web of Science ®Google Scholar
• Harkness R A, McCreanor G M, Simpson D, McFadyen IR. Pregnancy in and incidence of xanthine oxidase deficiency. J Inher Metab Dis 1986; 9: 407–8
   PubMed Web of Science ®Google Scholar
• Harkness R A, McCreanor G M, Watts R WE. Lesch-Nyhan syndrome and its pathogenesis: purine concentrations in plasma and urine with metabolic profiles in CSF. J Inher Metab Dis 1988; 11: 239–52
   PubMed Web of Science ®Google Scholar
• Watts R WE, Harkness R A, Spellacy E, Taylor NF. Lesch-Nyhan syndrome: growth delay, testicular atrophy and a partial failure of the lip-hydroxylation of steroids. J Inher Metab Dis 1987; 10: 210–23
   PubMed Web of Science ®Google Scholar
• Brown GK. Pyruvate dehydrogenase Ela deficiency. J Inher Metab Dis 1992; 15: 625–33
   PubMed Web of Science ®Google Scholar
• Cartier PH. Adenine uptake by isolated thymocytes. J Biol Chem 1980; 255: 4574–82
   PubMed Web of Science ®Google Scholar
• Mager J, Hershko A, Zeitlin-Beck R, Shoshani T, Razin A. Turnover of purine nucleotides in rabbit erythrocytes. 1. Studies in vivo. Biochim Biophys Acta 1967; 149: 50–8
   PubMedGoogle Scholar
• Watts R WE. Some regulatory and integrative aspects of purine nucleotide biosynthesis and its control: an overview. Adv Enz Regulation 1983; 21: 33–51
   PubMedGoogle Scholar
• Pomales R, Bieber S, Friedman R, Hitchings GH. Augmentation of the incorporation of hypoxanthine into nucleic acids by administration of an inhibitor of xanthine oxidase. Biochim Biophys Acta 1963; 72: 119–20
   PubMedGoogle Scholar
• Jones DP. Renal metabolism during normoxia, hypoxia and ischemic injury. A Rev Physiol 1986; 48: 33–50
   PubMed Web of Science ®Google Scholar
• Saugstad OD. The role of xanthine oxidase and its inhibitor in hypoxia: reoxygenation injury. Pediatrics 1996; 98: 103–7
   PubMed Web of Science ®Google Scholar
• Mehmet H, Yue X, Squier M V, Lorek A, Cady E, Penrice J, et al. Increased apoptosis in the cingulate sulcus of newborn piglets following transient hypoxia-ischemia is related to the degree of high energy phosphate depletion during the insult. Neurosci Lett 1994; 181: 121–5
   PubMed Web of Science ®Google Scholar
• Kemp A M, Sibert JR. Outcome in children who nearly drown: a British Isles study. Br Med J 1991; 302: 931–3
   PubMedGoogle Scholar
• Harkness RA. Is post-hypoxic-ischemic cell damage associated with excessive ATP consumption rather than a failure of ATP production?. Acta Paediatr Scand 1997; 86: 1–5
   Web of Science ®Google Scholar
• Perlman J M, Tack ED. Renal injury in the asphyxiated newborn; relationship to neurological outcome. J Pediatr 1988; 113: 875–9
   PubMed Web of Science ®Google Scholar
• Warnick C T, Lazarus HM. Recovery of nucleotide levels after cell injury. Can J Biochem 1981; 59: 116–21
   PubMedGoogle Scholar
• Bourchier J. Birth asphyxia and associated oliguria; relationship to outcome at 1 year. J Pediatr Child Health 1991; 27: 302–3
   Google Scholar
• Blair E, Stanley FJ. Intrapartum asphyxia: a rare cause of cerebral palsy. J Pediatr 1988; 112: 515–9
   PubMed Web of Science ®Google Scholar
• Nelson K B, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986; 315: 81–6
   PubMed Web of Science ®Google Scholar
• Pasternak JF. Hypoxic-ischemic brain damage in the term infant. Pediatr Clin North Am 1993; 40: 1061–72
   PubMed Web of Science ®Google Scholar
• Light DW. Effectiveness and efficiency under competition: the Cochrane test. Br Med J 1991; 303: 1253–64
   PubMed Web of Science ®Google Scholar
• Scottish Stillbirth and Neonatal Death Report 1993. Scottish Health Services Common Services Agency, Edinburgh 1994
   Google Scholar
• Harkness R A, Gordon H. Myometrial stimulation by a fetal distress signal? Some evidence for an adenosine based mechanism in man. J Obstet Gynaecol 1991; 11: 186–90
   Google Scholar
• Harkness R A, Simmonds R J, Coade S B, Lawrence CR. Ratio of the concentration of hypoxanthine to creatinine in urine from newborn infants. A possible indicator of metabolic damage due to hypoxia. Br J Obstet Gynaecol 1983; 90: 447–52
   PubMedGoogle Scholar
• Thacker S B, Berkelman SL. Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques. Obstet Gynecol Surv 1986; 41: 121–41
   PubMedGoogle Scholar
• O'Driscoll K, Coughlan M, Fenton V, Skelly M. Active management of labour; care of the fetus. Br Med J 1977; 2: 1451–3
   PubMedGoogle Scholar
• Krebs H B, Petres R E, Dunn L J, Jordaan H VF, Segreti A. Intrapartum fetal heart rate monitoring III Association of meconium staining with abnormal fetal heart rate patterns. Am J Obstet Gynecol 1980; 137: 936–43
   PubMed Web of Science ®Google Scholar
• Howie PW. Fetal monitoring in labour. Br Med J 1986; 292: 427–8
   PubMedGoogle Scholar
• OECD Financing and delivering health careA comparative analysis of OECD countries. OECD: Social Policy Studies. No 4: 11–14, Ch 1
   Google Scholar
• Smith JH, Anand KJS, Cotes P, Davies MG, Harkness SR, Howlett ATA. Antenatal fetal heart rate variations in relation to the respiratory and metabolic status of the compromised human fetus. Br J Obstet Gynaecol 1988; 95: 980–9
   PubMedGoogle Scholar
• Osswald Schmitz HH, Kempen JR. Tissue content of adenosine, inosine and hypoxanthine in the rat kidney after ischaemia and postisch-aemic circulation. Eur J Physiol 1977; 371: 45–9
   PubMedGoogle Scholar
• Goday A, Simmonds H A, Webster D R, Levinsky R J, Watson AR, Hoffbrand AV. Importance of platelet free preparations for evaluating lymphocyte nucleotide levels in inherited or acquired immunodeficiency syndromes. Clin Sci 1983; 65: 635–43
   Web of Science ®Google Scholar
• Gannon K. Mortality associated with anaesthesia. A case review study. Anaesthesia 1991; 46: 962–6
   PubMed Web of Science ®Google Scholar
• Forest J, Render B, Goldsmith KC, Cahalan HMK, Levy W J, Strumin Bota LW., et al. Multicenter study of general anesthesia I and II. Anesthesiology 1990; 72: 252–68
   PubMed Web of Science ®Google Scholar
• Niklasson Helta F, Degrell JI. Hypoxanthine. xanthine, urate and creatinine concentration gradients in cerebrospinal fluid. Ups J Med Sci 1988; 93: 225–32
   PubMed Web of Science ®Google Scholar
• Agren H, Niklasson Hallgren FR. Brain punnergic activity linked with depressive symptomatology: Hypoxanthine and xanthine in CSF of patients with major depressive disorders. Psychiatr Res 1983; 9: 179–89
   PubMed Web of Science ®Google Scholar
• Ronquist Callerud G, Niklasson T, Friman FG. Studies of biochemical markers in cerebrospinal fluid in patients with meningoencephalitis. Infect Immun 1985; 48: 729–34
   PubMed Web of Science ®Google Scholar
• Livingston JH, Brown J K, Harkness R, Mc A, Creanor GM, O'Hare AE. Cerebrospinal fluid nucleotide metabolites following short febrile convulsions. Dev Med Child Neurol 1989; 31: 161–7
   PubMed Web of Science ®Google Scholar
• Tomlinson Sugarman PID. Complications with shunts in adults with spina bifida. Br Med J 1995; 311: 286–7
   PubMedGoogle Scholar
• Bohmer T, Kjekshus Vaagenes JP. Biochemical indices of cerebral ischemic injury. Scand J Clin Lab Invest 1983; 43: 261–5
   PubMed Web of Science ®Google Scholar
• Braghiroli Sacco A, Erbetta C, Ruga M, Donner VCF. Overnight urinary uric acid: creatinine ratio for the detection of sleep hypoxemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure. Am Rev Resp Dis 1993; 148: 173–8
   PubMedGoogle Scholar
• Risk assessment. Report of a Royal Society Study Group, London 1983
   Google Scholar
• Card W I, Mooney GH. What is the monetary value of a human life?. Br Med J 1977; 2: 1627–29
   PubMed Web of Science ®Google Scholar
• Lazzlo Petrakis PL. A riskv business. Chem Br 1995; 31: 555–6
   Google Scholar
• J Med Def Union 1995; 11: 13
   Google Scholar
• Griner P, Mayewski FR, Mushin JA, Greenland IP. Selection and interpretation of diagnostic tests and procedures. Principles and applications. Ann Int Med 1981; 95: 980–9
   Google Scholar
• Smith R. European healthcare systems. Br Med J 1991; 303: 1457–9
   PubMedGoogle Scholar
• Westgate Garibaldi J.J., Greene MKR. Umbilical cord blood gas at delivery: a time for quality data. Br J Obstet Gynaecol 1994; 101: 1054–63
   PubMedGoogle Scholar
• Kalckar HM. Differential spectrophotometry of purine compounds by means of specific enzymes. 1. Determination of hydroxvpurine compounds. J Biol Chem 1947; 167: 429–42
   PubMed Web of Science ®Google Scholar
• Saugstad O, Wung DWE, Howell S B, Gluck L. Determination of plasma hypoxanthine: a comparison of high pressure liquid chromatographic and oxygen consumption methods. Analyt Biochem 1982; 122: 159–63
   PubMed Web of Science ®Google Scholar
• Mansell M, Allsop AJ, North ME, Simmonds R J, Harkness RA, Watts R WE. Effect of renal failure on erythrocyte purine nucleotide, nucleoside and base concentrations and some related enzyme activities. Clin Sci 1981; 61: 757–64
   Web of Science ®Google Scholar
• Simmonds R J, Harkness RA. High performance liquid chromatographic methods for base and nucleoside analysis in extracellular fluids and in cells. J Chromatogr Biomed Appl 1981; 226: 369–81
   Google Scholar
• Pietz J, Guttenberg Gluck NL. Hypoxanthine: a marker for asphvxia. Obstet Gynecol 1988; 72: 762–66
   PubMed Web of Science ®Google Scholar
• Boulieu Bory R, Baltassat C, Gonnet PC. Hypoxanthine and xanthine levels determined by high performance liquid chromatography in plasma, erythrocytes and urine samples from healthy subjects: the problem of hypoxanthine level evolution as a function of time. Analyt Biochem 1983; 129: 398–404
   PubMed Web of Science ®Google Scholar
• Dean B, Perrett M, Sensi DM. Changes in nucleotide concentrations of man. rabbit and rat during short term storage. Biochem Biophvs Res Commun 1978; 80: 147–54
   PubMed Web of Science ®Google Scholar
• Simmonds H, Micheli A, Davies VP, Mc M, Bride MB. Erythrocyte nucleotide stability and plasma hypoxanthine concentrations: improved ATP stability with short term storage at room temperature. Clin Chem Acta 1990; 192: 121–32
   PubMed Web of Science ®Google Scholar
• Harkness R, Coade AS, Mansell BM, Simmonds RJ. Nucleotide concentrations in leucocytes and their use in controlling the quality of cell preparations. Biochemistry and function of phagocytes, F. Rossi, P Patriarca. Plenum Publishing Corporation, New York 1982; 583–90
   Google Scholar
• Harkness R, Coade ASB, Webster A DB. ATP, ADP and AMP in plasma from peripheral venous blood. Clin Chim Acta 1984; 143: 91–8
   PubMed Web of Science ®Google Scholar
• Guilbault G, Brignac GP, Zimmer M. Homovanillic acid as a fluorimetric substrate for oxidative enzymes. Analytical applications of the peroxidase, glucose oxidase and xanthine oxidase systems. Analyt Chem 1968; 40: 190–6
   PubMed Web of Science ®Google Scholar
• Sumi T, Umeda Y. Fluorimetric determination of xanthine and hypoxanthine in tissue. Clin Chim Acta 1979; 95: 291–9
   PubMed Web of Science ®Google Scholar
• Childs R E, Bardsley WG. The steady state kinetics of peroxidase with 2,2'-azino-di (3-ethyl-benzthiazoline-6-sulphonic acid) as a chromogen. Biochem J 1975; 145: 93–103
   PubMed Web of Science ®Google Scholar
• James D R, Price CP. Interference in colorimetric reactions for measuring hydrogen peroxide. Ann Clin Biochem 1984; 21: 398–404
   PubMed Web of Science ®Google Scholar
• DeRenzo EC. Chemistry and biochemistry of xanthine oxidase. Adv Enzymol 1949; 17: 293–328
   Google Scholar
• Nishino T. The conversion of xanthine dehydrogenase to xanthine oxidase and the role of the enzyme in reperfusion injury. J Biochem 1994; 116: 1–6
   PubMed Web of Science ®Google Scholar
• Broughton P MG, Buckley BM. Performance requirements of tests performed nearer the patient. Scand J Clin Lab Invest 1987; 47: 99–104
   PubMed Web of Science ®Google Scholar
• Inouye H, Fuchs S, Sele M, Littauer UZ. Anti-inosine antibodies. Biochim Biophys Acta 1971; 240: 594–603
   PubMed Web of Science ®Google Scholar
• Ferrendelli J A, Gray M H, Sedgwick W G, Chang MM. Quick freezing of the murine CNS: Comparison of regional cooling rates and metabolic levels when using liquid nitrogen or Freon-12. J Neurochem 1972; 19: 979–87
   PubMed Web of Science ®Google Scholar
• Wyatt J. Non invasive assessment of cerebral oxidative metabolism in human newborn. J Roy Coll Phys Lond 1994; 28: 126–32
   PubMedGoogle Scholar
• Mathew O P, Bland H, Boxerman S B, James E. CSF lactate levels in high risk neonates with and without asphyxia. Pediatrics 1980; 66: 224–7
   PubMed Web of Science ®Google Scholar
• Fysh W J, Turner G M, Dunn PM. Neurological normality after extreme birth asphyxia. Case report. Br J Obstet Gynaecol 1982; 89: 24–6
   PubMedGoogle Scholar
• Adams J E, Abendschein D R, Jaffe AS. Biochemical markers of myocardial injury. Is MB creatine kinase the choice for the 1990s?. Circulation 1993; 88: 750–63
   PubMed Web of Science ®Google Scholar
• Zanardo V, Bondio M, Perini G, Temporin GF. Serum glutamic oxaloacetic transaminase and glutamic pyruvic transaminase activity in premature and full term asphyxiated newborns. Biol Neonate 1985; 47: 61–9
   PubMedGoogle Scholar
• Tack E D, Perlman J M, Robson AM. Renal injury in sick newborn infants: A prospective evaluation using urinary β2-microglobulin concentrations. Pediatrics 1988; 81: 432–40
   PubMed Web of Science ®Google Scholar
• Tsukahara H, Fujii Y, Kuriyama M, Tsuchida S, Hiraoka M, Kikuchi K, Sudo M. Urinary growth hormone excretion in preterm neonates. Biol Neonate 1993; 63: 8–13
   PubMedGoogle Scholar
• Whitelaw A GL. Functional imaging in neonatal neurology. Acta Paediatr 1994; 83: 345–7
   PubMed Web of Science ®Google Scholar
• Trudinger B J, Gordon Y B, Grudzinskas J G, Hull M, JR, Lewis P J, Amans M EL. Fetal breathing movements and other tests of fetal well being-a comparative evaluation. Br Med J 1979; 2: 577–9
   PubMedGoogle Scholar
• Robinson R. Cost effectiveness analysis. Br Med J 1993; 307: 793–5
   PubMedGoogle Scholar
• Dilts D, Khamalah J, Plotkin A. Using cluster analysis for medical resource decision making. Med Decis Making 1995; 15: 333–47
   PubMed Web of Science ®Google Scholar