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1.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      90                                                                                                                                                                                                                                                                                                90                                                                                              4                                                                                                                                                                                                                                         5                                                                                                                                                                6                                                                                                                                        E
2.                                                                                                                                                                                                                                                                                                                B FORE                                                                                                                            4                                                                                                                                4                                                                                                                                                       hGH                                                                               1                                                                                                                                                                                                                                                                                                                                                               2     8C                    20 C                                                     2                                                                                              3                            E               TOSOH    I  HGH                                                                                                                
3.                                                                                           E               TOSOH    Il  HGH       ER  2     6                                                                        1 0 mL                                                                                                                                             2  lt  BCR          1                               E               TOSOH    I  HGH                                      WHO     hGH                     WHO 2nd IS 98 574                                                                       E               TOSOH    II        1            E               TOSOH    I                   1         100  mL                                                                                                    15   25  CC3             2   8 C             7                                                                                                                                        E               TOSOH    TI           1                                                     2 5 L                                                                                                                                                      15   25 C             30                                            E               TOSOH    II             1                                                     5L                                                                                                 
4.                                                           80             73                 7                                 hGH                                                                                                          2 1 ng mL                                                                                                                                                                                2                         1                                                                                                                                        2  Si                                                                            HGH BEZ ng mL                                          81                    a g L                                                                                         u g hGH  L   ng hGH  mL x 1 0                                                              hGH   human Growth Hormone                                                                                                                 191                                    2     2                                                       hGH                                                                                                                                                              GH                       GHRH                                                1 2                                                             HGH                          GH 
5.                                                      15   25 C             30                                   2                                                      1     2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      3  ME                  1     2     3     4       5     6     E               TOSOH    Il  HGH                                                                                                                                            75 L                                   75                                                                                                            37 C     10                                                                                                                                                                                                   B     F                                                                                                                                                                                                                                                                     
6.                                             AIA 1200                   AIA 600                                                                                                                                                                                                                                                 1 E               TOSOH   II  HGH                        pi HGH                                                                             HGH                                                                                                        2 E               TOSOH    II  HGH                          E               TOSOH    II  HGH              E               TOSOH    II  HGH              E               TOSOH    Il  HGH              E               TOSOH    II  HGH              E               TOSOH    II  HGH              E               TOSOH    II  HGH              3  BEB               TOSOH    II  HGH                     4 E               TOSOH    TI                                              SUB II               1  E               TOSOH    II         4                                                         2  E               TOSOH    Ul                    5  B               TOSOH    II             6 B               TOSOH    II                 1    2    3    4    5    6                                                                           GH                               1   1           1                                                         
7.                                      hGH                                                                                                                                       hGH                                                                                                                                                                            hGH                                                                      3 4                       1           1  BE               TOSOH    Il  HGH              1                     FUL Rate                       8  nmol   L s                        2  E               TOSOH    II  HGH  Em  1      BE               TOSOH    I  HGH               6      FU                       hGH                       FU okk TE                          1 510  nmol   L   s      ng mL                            3  E               TOSOH    II  HGH              1     6      FU         1   lt   2   lt   3    lt   4   lt   5   lt   6                        FU                                                               FU           A     B   C  A              6  O FU  B  Ben  1      FU  C               6      hGH            nmol   L s     nmol   L   s      ng mL     2              hGH            2     38 ng mL                                                                                                                           100     20  MATT                                                       HGH                                   B               TO
8.                        1     1 0 mL                     2   6                                          SE               TOSOH    II  HGH     0025266                             E               TOSOH    Il  HGH                             BE               TOSOH    II  HGH     E               TOSOH    II                    E               TOSOH    I         E               TOSOH    Il                      0015955 E               TOSOH    Il             0015956 E               TOSOH    II                                   l  Raiti  S   Tolman  R  A   eds   Human growth hormone   New York  Plenum  press  1986     2  BHRR                                                                                 1986    3  Kaplan  S  A  ea   Clinical pediatric and adolescent endo crinology   Philadelphia  WB Saunders Co   1982     4  Irie  M  et al   Increase of serum growth hormone concentration following  thyrotropin releasing hormone injection in patients with acromegaly or  giantism   J  Clin  Endocrinol  Metab   35  97 100  1972     5  Fraiser  S   in Raiti  S   ed   Growth hormone stimulation tests in children   Advances in human growth hormone research  Washington  D  C   U  S   Govt  Printing Office  632 652  1973      0015366 SER        1 0 mL     x2        0015968 100 mL     x2        100 mL        x2                                                                                                                                                                 252 1123                
9.                   2743 1                             0120  17 1200  TEL   0467  76 5384  FAX   0467  79 2550                                                                                                                      TosoH                        3 8 2  TEL   03 5427 5181  FAX  03 5427 5220              Oy                                                  toso                                         2           ST AIA PACK HGH C                 in ee dar tia E a tc O   A Haszn  lati utas  t  s t  bb nyelven el  rhet   websz  jtunkon   a uropmiske kunder  Europ  ische Kunden   www tosohbioscience eu  a    Service  amp  Support      Szolg  ltat  s    European customers   Evpwrtaio   neA  teg   Clientes  europeos   Euroopa kliendid   Consommateurs europ  ens    Eur  pai   gyfelek   Clienti europei   Europos klientai   Eiropas  klienti  Klienci europejscy   Clientes europeus   Clientii europeni    Evropski kupci   Eur  pski z  kaznici   Europeiska kunder AN Ez a term  k emberi vagy   llati forr  sanyagokat tartalmaz   ez  rt lehets  gesen fert  z  k  nt kell kezelni       s T  mogat  s  szekci   alatt  Nyomtatott v  ltozat ig  nyelhet    faxon a  32 13 66 47 49 es telefonsz  mon vagy e mailben   info raqa eu tosoh com        Muctrpykunn 3a ynoTpe6a Ha pasnmuHn esuum ca Ha  pa3nonoxeHne Ha namna ye  ca  r  www tosohbioscience eu B y          Pasmea IIomom u nop oxka  Service  amp  Support   Xaprueno Istruzioni per 1    Uso in diverse lingue sono disponibili sul    KOTTMe MO
10.                 363 nm                  447 nm                                                                                                                                                                                                  hGH                                                                                                             O                                                      O                                                           90                                                                                                                                                                                                  45 ng mL                                                                                                                                              1    5                                             kk                                                                     AIA 1800                                                                                                       HGH 029  Calibrator Lot  2003005506070000  Y  A Bx  x  d    Rate  250  200  150  160   50    0  9 10 20 30 40 50    Conc                                      1                              1     2   3     E               TOSOH    II  HGH                                                                                           hGH                                                                                                                           
11.                390 mg dL                                              17 mg dL ET  WAW                         18 mg dL                        1 600 mg dL                                    5 0 gl   dL                                          20 mg dL                               100 U mL                                                                                                                                                                                                     5  EDTA                                                                                               6  2     8C                                                                     15   25 C                                                                                                              1                                                                              1     2     3     4     5     6                            E               TOSOH    II  HGH                                                                                                             15   25 C             1 AL 2  SCRE C7                                                   E               TOSOH    ll  HGH                                                                                                                                                            2     8 C             7                                           E            TOSOH  II  HGH              1                                                 
12.                TOSOH    I  HGH                          E               TOSOH    U  HGH  HARE  E               TOSOH    II                                              SUB II               E               TOSOH    I            E               TOSOH    TH              7                                                                 hGH                                                                                                                                                                                                                              HAMA  Human Anti mouse Antibody                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              2                                               1                       HIV  HBV  HCV                                                                                                                                                                                                                                                                                                           
13.            AIA 1200                       AIA 600                                                                                                                     10         2                          hGH                                                    1                                      REIA   IEMA                    3      hGH                                                                   DUGH                                                                                                                                                                                         4                                                                                                                                                                                                                                  5                                                                                                                                                 2                                             2                                  1                                    EIA  IEMA                                                                    hGH                                                                                                                                     hGH                                                                                                                                                                                                      
14.    es  adequadas     Pour les clients en Am  rique du Nord et en Am  rique du Sud   veuillez consulter les documents AIA AAM sur le CD pour  P information appropri  e        ST AIA PACK HGH    For Quantitative Measurement of human growth hormone  hGH  in Serum or Heparinized  Plasma    NAME AND INTENDED USE  ST AIA PACK HGH is designed for IN VITRO DIAGNOSTIC USE ONLY for the quantitative  measurement of human growth hormone  hGH  in human serum or heparinized plasma on  TOSOH AJA System Analyzers     SUMMARY AND EXPLANATION OF TEST   Human growth hormone  also known as hGH or somatotropin  is one of the main hormones  produced by the anterior portion of the pituitary gland  Unlike most hormones  hGH acts to  directly stimulate the target cells without the intermediate involvement of a target endocrine  organ  HGH promotes growth in soft tissue  cartilage and bones  aids protein synthesis and  greatly influences the metabolism of carbohydrates and lipids    HGH is a polypeptide made up of 191 amino acids and has a molecular weight of 21 500 daltons   The half life of circulating human growth hormone is relatively short  20 30 minutes   The  release of hGH from the pituitary is influenced by a variety of factors including chemical stimuli  and the balance between growth hormone releasing factor  GHRF  and somatostatin  growth  hormone release inhibiting hormone   1 2   Sleep  stress  exercise  fasting  high protein meals   hypoglycemia and certain amino acids such as L dopa  g
15.  2                                                                                                                                                                                                                                                                                                                                                                                                  3                          1                                                                                                                                                                                                                                                                                                                                                                                  2                                                                                                                                                                           121  C   20                                                                         3                                                                                                                                                                                                                                                                    1                 2     8 C          2                127A                                                                                                                                100        
16.  rekvireres pr  fax  32 13 66 47 49  eller e mail  info raqa eu tosoh com     Lieto  anas instrukcijas dazadas valod  s ir pieejamas m  su  interneta vietn    www tosohbioscience eu sada        Service  amp   Support     Apkalpo  ana un Atbalsts   Druk  tu versiju  iesp  jams sa  emt pa faksu   32 13 66 47 49 vai e pastu     A Dette produkt indeholder menneskelige eller animalske tered acne tenon coy    udgangsmaterialer og bor behandles som potentielt infektigst  IN Sis produkts satur cilv  ku vai dzivnieku izejmateri  lus un ir  uzskat  ms par potenciali infekciju saturosu                          ES Bedienungsanleitungen in verschiedenen Sprachen sind anf     unserer Webseite www tosohbioscience eu Im Kapitel   Service   amp  Support     erh  ltlich  Ein Papierexemplar erhalten Sie auf  schriftliche Anfrage an Faxnummer  32 13 66 47 49 oder per  E Mail an  info raqa eu tosoh com     Instrukcja U  ytkowania w r    nych j  zykach jest dost  pna na  naszej stronie internetowej  www tosohbioscience eu w zak  adce     Service  amp  Support      Serwis i Wsparcie   O wersje papierow    mo  na pyta   pod nr faksu   32 13 66 47 49 lub e mailem     info raqa eu tosoh com    Dieses Produkt enth  lt menschliches oder tierisches       Basismaterial und sollte daher wie eine potenzielle y Produkt zawiera materia   pochodzenia ludzkiego lub  Infektionsquelle behandelt werden  zwierz  cego i dlatego nale  y go traktowa   jako potencjalnie  sii zaka  ny             Oa Bpgtr tig O  nyieg x
17.  since human specimens  will be used for samples and other quality control products in the lab may be derived from  human serum  please use standard laboratory safety procedures in handling all specimens and  controls    5  Do not use beyond the expiration date    6  The ST AIA PACK HGH has been designed so that the high dose    hook effect    is not a  problem for the vast majority of samples  Samples with hGH concentrations between 45  and 1 100 ng mL will read  gt  45 ng mL  The    hook effect    phenomenon may occur at hGH  concentrations  gt 1 100 ng mL    7  TOSOH AIA 1200 series or AIA 600 Immunoassay Analyzers can NOT be used to perform  the ST AIA PACK HGH assay     STORAGE AND STABILITY  All unopened materials are stable until the expiration date on the label when stored at the specified  temperature     Materials Cat  No    2 8  C    ST AIA PACK HGH 0025266   AIA PACK HGH CALIBRATOR SET 0020366   AfA PACK HGH SAMPLE DILUTING SOLUTION 0020566   AIA PACK SUBSTRATE SET I 0020968   AIA PACK WASH CONCENTRATE 0020955   AIA PACK DILUENT CONCENTRATE 0020956  1 30  C    AIA PACK DETECTOR STANDARDIZATION TEST CUP 0020970   AIA PACK SAMPLE TREATMENT CUP 0020971    ST AIA PACK HGH test cups may be stored at 18 25  C for up to 1 day  Calibrators and  Sample Diluting Solution should be used within 1 day and 7 days of opening or reconstituting   respectively  provided the vials are kept tightly sealed and refrigerated at 2 8  C  Reconstituted  substrate solution is stable for 3 d
18.  spatial interference may occur        Specimens from patients taking medicines and or medical treatment may show erroneous  results    e Specimens from patients who have received preparations of mouse monoclonal antibodies for  diagnosis or therapy may contain human anti mouse antibodies  HAMA   Such specimens  may show falsely elevated values when tested for human growth hormone     e For more complete understanding of the limitations of this procedure  please refer to the  SPECIMEN COLLECTION AND HANDLING  WARNINGS AND PRECAUTIONS   STORAGE AND STABILITY  and PROCEDURAL NOTES sections in this insert sheet     EXPECTED VALUES   Each laboratory should determine a reference interval which corresponds to the characteristics of  the population being tested  As with all diagnostic procedures  clinical results must be interpreted  with regard to concomitant medications administered to the patient  6      Reference Ranges  The reference value  less than 2 1 ng mL  was determined by applying parametric analysis to  serum samples from 80 healthy Asian individuals  73 males and 7 females      Conversion Factors  HGH concentrations in this application are in units of ng mL  Conversion to SI units of ug L and  mIU mL may be made using the following equation    ng hGH  L   nghGH mLx 1 0   mIU hGH  mL   ng hGH mL x30    PERFORMANCE CHARACTERISTICS   ACCURACY   a  Recovery  Three serum pools were spiked with three different levels of hGH and assayed  before and after spiking     Sample In
19.  which is performed entirely in  the AIA PACK test cups  Growth hormone present in the test sample is bound with monoclonal  antibody immobilized on a magnetic solid phase and enzyme labeled monoclonal antibody in  the AIA PACK test cups  The magnetic beads are washed to remove unbound enzyme labeled  monoclonal antibody and are then incubated with a fluorogenic substrate  4 methylumbelliferyl  phosphate  4MUP   The amount of enzyme labeled monoclonal antibody that binds to the  beads is directly proportional to the hGH concentration in the test sample  A standard curve is  constructed  and unknown sample concentrations are calculated using this curve     MATERIAL PROVIDED  ST AiA PACK HGH  Cat  No  0025266    Plastic test cups containing lyophilized twelve magnetic beads coated with anti HGH mouse  monoclonal antibody and 75 pL of anti HGH mouse monoclonal antibody  to human growth  hormone  conjugated to bovine alkaline phosphatase with sodium azide as a preservative     MATERIALS REQUIRED BUT NOT PROVIDED   The following materials are not provided but are required to perform human growth hormone  analysis using the ST AIA PACK HGH  Cat  No  0025266  on the TOSOH AIA System Analyzers   They are available separately from TOSOH     Materials Cat  No   AIA Nex    IA or AIA 21 0018539  AIA Nex    IA or AIA 21 LA 0018540  AJA 1800 ST 0019836  AIA 1800 LA 0019837  AIA 2000 ST 0022100  ATA 2000 LA 0022101  AIA 600 II 0019014  AIA 600 II BCR 0019328  AIA 360 0019945  AIA PACK SUBST
20. 1006671001 059C       3             HGH    Immuno Enzymometric Assay                                                                  E               TOSOH    II  HGH     ST AIA PACK HGH           4     1006671001 059C                                      20094 5                 3          2006     10                 2                            13A2X00174000013                                                                 OE               TOSOH    I  HGH                             EIA                                                                                    GH                                                  1                                                                                                                                                2                                                                                                                                         3                                                                                        4                                              HBs           HIV               HCV                                                                                                                                                                             5                                                                                                                                                                                                               6                                   
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22. RATE SET II 0020968   AIA PACK SUBSTRATE REAGENT II  AIA PACK SUBSTRATE RECONSTITUENT II  AIA PACK HGH CALIBRATOR SET 0020366  CALIBRATOR  1  0 ng mL  CALIBRATOR  2  1 9 ng mL  approx    CALIBRATOR  3  3 8 ng mL  approx    CALIBRATOR  4  11 3 ng mL  approx    CALIBRATOR  5  22 6 ng mL  approx    CALIBRATOR  6  49 1 ng mL  approx    ATA PACK HGH SAMPLE DILUTING SOLUTION 0020566  AJA PACK WASH CONCENTRATE 0020955  AIA PACK DILUENT CONCENTRATE 0020956  SAMPLE CUPS 0018581  AIA PACK DETECTOR STANDARDIZATION TEST CUP 0020970  AIA PACK SAMPLE TREATMENT CUP 0020971  Additional Requirements for AIA Nex IA   AIA 21 only     PIPETTE TIPS 0018552  PRELOADED PIPETTE TIPS 0018583  Additional Requirements for AIA 600 II  AIA 1800 and ATA 2000   PIPETTE TIPS 0019215  TIP RACK 0019216  PRELOADED PIPETTE TIPS 0022103    Only materials obtained from TOSOH should be used  Materials obtained elsewhere should not  be substituted since assay performance is characterized based strictly on TOSOH materials     WARNINGS AND PRECAUTIONS   1  The ST AIA PACK HGH is intended for in vitro diagnostic use only    2  Test cups from different lots or different assays should not be mixed within a tray    3  The ST AIA PACK HGH contains sodium azide  which may react with lead or copper  plumbing to form potentially explosive metal azides  When disposing of such reagents   always flush with large volumes of water to prevent azide build up    4  Human serum is not used in the preparation of this product  however 
23. SOH     II  HGH                                                                                            3                     hGH            2       38 ng mL                                  2                                   10                                                                                                15                        4                  0 07   45 ng mL                           0 07 ng mL                      1     6                                                L BRE  1      FU                        y WH    2 x SD  10                                                                                                                                                                                 1 100 ng mL                                                         x  8     5                                                              hGH 100  Prolactin 0 335  hPL 0 005  TSH N D   LH N D   FSH N D   hCG 0 002      N D                   6                              ASE  y             EIA      x                                                                                                           3     y   0 938 x   0 042    r   0 999  n  50  BB  ARCOS Vv mgt  y              x                                                                                        y   0 963 x     0 018  r   0 999  n 116                                                  1                           1                                                                  
24. ated as potentially infectious  Acest produs con  ine materiale de provenien     uman   sau    animal   si trebuie tratate ca potential infec  ioase                           Las instrucciones de uso estan disponibles en diferentes     Sa   E Bu    idiomas en nuestra pagina web  www tosohbioscience eu en la Vecjezicna navodila za uporabo so na voljo na nasi spletni    secci  n de    Service  amp  Support     Servicio y Soporte   Tambi  n strani  www tosohbioscience eu v razdelku    Service  amp   podemos enviarle una versi  n impresa a trav  s del fax  32 13 Support  Servis in podpora   V papirni obliki jih lahko  66 47 49 o por correo electr  nico  info raga eu tosoh com  prejmete po faksu   32 13 66 47 49 ali elektronski po  ti     info raqa eu tosoh com        A Este producto contiene tejidos de origen humano o animal    y debe ser tratado como producto potencialmente infeccioso  Penzdcle   vsebuje materiale cloveskeea all Zivalakesa    izvora  kar lahko privede do okuzb        L    E3 N  vod na pou  itie vo viacer  ch jazykoch je dostupn   na na  ej  web str  nke  www tosohbioscience eu  v sekcii    Service  amp   Support      Vytla  en   verziu mo  no z  ska   faxom  32 13 66 47  49 alebo cez e mail  info raqa eu tosoh com              Eri keeltes kasutusjuhendid on saadaval meie veebilehel  www   tosohbioscience eu alajaotuses    Service  amp  Support       Paberkandjal versiooni saab tellida faksinumbril  32 13 66 47 49  v  i e posti teel  info raqa eu tosoh com      g
25. ays at 18 25  C or 7 days at 2 8  C  Working diluent and wash  solutions are stable for 30 days at 18 25  C  Reagents should not be used if they appear cloudy  or discolored     SPECIMEN COLLECTION AND HANDLING     Serum or heparinized plasma is required for the assay  EDTA and citrated plasma SHOULD  NOT BE USED      If using serum  a venous blood sample is collected aseptically without additives  Store at  18 25  C until a clot has formed  usually 15 45 minutes   then centrifuge to obtain the serum  specimen for assay      If using heparinized plasma  a venous blood sample is collected aseptically with designated  additive  Centrifuge and separate plasma from the packed cells as soon as possible    e Specimen types should not be used interchangeably during serial monitoring of an individual  patient  Measured concentrations may vary slightly between sample types in certain patients        Samples may be stored at 2 8  C for up to 24 hours prior to analysis  If the analysis cannot  be done within 24 hours  the sample should be stored frozen at  20  C or below for up to 60  days        Repeated freeze thaw cycles should be avoided  Turbid serum samples or samples containing  particulate matter should be centrifuged prior to testing  Prior to assay  bring frozen samples  to 18 25  C slowly and mix gently        Diluted serum or heparinized plasma should be used within 24 hours and should not be  stored      The sample required for analysis is 75 pL     PROCEDURE  For the AJA N
26. e added to human   specimens      Hemoglobin  up to 390 mg dL   free bilirubin  up to 17 mg dL  and conjugated bilirubin  up  to 18 mg dL  do not interfere with the assay      Lipemia  as indicated by triglyceride concentration  up to 1 600 mg dL   does not interfere  with the assay      Ascorbic acid  up to 20 mg dL  does not interfere with the assay    e Protein  as indicated by human albumin concentration  up to 5 0 g dL   does not interfere with  the assay       Heparin  up to 100 U mL  does not interfere with the assay     REFERENCES   1  Raiti  S   Tolman  R  A   eds   Human Growth Hormone  New York  Plenum Press  1986     2  Fujita  T   et al   Essentials of Endocrinology and Metabolism  Tokyo  Medical Press  34 77   1986     3  Kaplan  S  A   ea   Clinical Pediatric and Adolescent Endocrinology  Philadelphia  W  B   Saunders  Co  1982     4  Irie  M   et al   Increase of Serum Growth Hormone Concentration Following Thyrotropin  Releasing Hormone Injection in Patients with Acromegaly or Giantism  J  Clin  Endocrinol   Metab   35  97 100  1972     5  Frasier  S   in Raiti  S   ed   Growth Hormone Stimulation Tests in Children  Advances in  human growth hormone research  Washington  D  C   U S  Govt  Printing Office  632 652   1973     6  Young  D   Effects of Drugs on Clinical Laboratory Tests  3rd Edition  Washington  DC   American Association for Clinical Chemistry Press  1990      TOSOH CORPORATION    Shiba koen First Bldg   3 8 2 Shiba  Minato ku  Tokyo 105 8623  Ja
27. ex IA   AIA 21  AIA 600 II  AIA 1800  AIA 2000 and AIA 360  please refer to  their Operator   s Manual for detailed instructions        Reagent Preparation   A  Substrate Solution  Bring all reagents to 18 25  C before preparing the working reagent  Add the entire contents of  the AIA PACK SUBSTRATE RECONSTITUENT II  100 mL  to the lyophilized AIA PACK  SUBSTRATE REAGENT I and mix thoroughly to dissolve the solid material    B  Wash Solution  Add the entire contents of the AIA PACK WASH CONCENTRATE  100 mL  to approximately  2 0 L of CAP Class I or NCCLS Type I Reagent Grade water  mix well  and adjust the final  volume to 2 5 L    C  Diluent  Add the entire contents of the AIA PACK DILUENT CONCENTRATE  100 mL  to  approximately 4 0 L of CAP Class I or NCCLS Type I Reagent Grade water  mix well  and  adjust the final volume to 5 0 L     ll  Calibration Procedure   A  Calibration Curve  The calibrators for use with the ST AIA PACK HGH have been standardized on WHO 2nd IS  98 574   The calibration curve for ST AIA PACK HGH is stable for up to 90 days  Calibration stability  is monitored by quality control performance and is dependent on proper reagent handling and  TOSOH AIA System maintenance according to the manufacturer   s instructions   Recalibration may be necessary more frequently if controls are out of the established range  for this assay or when certain service procedures are performed  e g  temperature adjustment   sampling mechanism changes  maintenance of the wash 
28. itial hGH Expected Measured Percent  Value Added Value Value Recovery   ng mL   ng mL  name   ng mL       Serum Al 0 08 32 15 2 23 30 50 94 6  0 08 16 07 len 15 28 946  0 08 8 04 8 12 773 95 2  Serum Bl 0 23 32 15 32 38 30 27 93 5  0 23 16 07 16 31 14 94 91 6  0 23 8 04 8 27 7 73 93 5  Serum Cl 1 65 32 15 33 79 34 56 102 3  1 65 16 07 17 72 18 18 102 6  1 65 8 04 9 68 10 19 105 3    b  Dilution  Three serum samples containing high concentrations of hGH were serially diluted  with AIA PACK HGH SAMPLE DILUTING SOLUTION and assayed     Sample Dilution Expected Measured Percent  Factor Value Value Recovery   ng mL   ng mL       Serum A2 none 41 20  75 10 30 90 31 55 102 1  5 0 10 20 60 21 56 104 6  2 5 10 10 30 10 90 105 8  10 10 4 12 4 47 108 6  Serum B2 none 40 22  75 10 30 16 29 55 98 0  5 0 10 20 11 19 88 98 9  2 5 10 10 05 10 04 99 8  1 0 10 4 02 4 04 100 4  Serum C2 none 39 26  75 10 29 44 29 74 101 0  5 0 10 19 63 20 27 103 3  2 5 10 9 81 10 24 104 3  1 0 10 3 93 4 13 105 3    PRECISION   a  Within run precision was determined using three controls in a total of 20 runs  Within each  run  one set of duplicates per control was assayed  The mean of each duplicate was used to  obtain the pooled standard deviation  SD   which was then used to calculate the coefficient of  variation  CV      Sample Mean Pooled SD CV    ng mL   ng mL       Serum A3 2 60 0 048 19  Serum B3 7 87 0 100 13  Serum C3 25 3 0 227 0 9    b  Total precision was determined by the duplicate assay of three c
29. lucagon  arginine and histamine all cause  increases in hGH secretion  HGH release is inhibited by glucose  cortisol  free fatty acids and  circulating hGH  g   The effect of hypersecretion of growth hormone depends on the age of the patient  Acromegaly   a progressive enlargement of the extremities  is caused by excess hGH in adults  In children   hypersecretion causes the phenomenon of accelerated growth with weakened bones and muscles  termed gigantism  Hypersecretion can be caused by pituitary hyperplasia or tumors or by  secondary factors such as a lack of release inhibiting factors or ectopic production of hGH by  certain types of carcinoma  3 5     Hyposecretion of hGH may be caused by lesions within the hypothalamus  an increase in the  production of somatostatin  a lack of growth hormone releasing factor  pituitary tumors which  destroy the cells producing hGH or even damage to the pituitary by external factors such as  trauma or infection  Children deficient in hGH are said to have a condition known as pituitary  dwarfism  Random growth hormone measurement is not usually meaningful  Screening tests for  hGH deficiency  hGH hypersecretion and assessment of pituitary hypothalamic function  utilize  a variety of provocative tests  challenge tests   In this type of testing  serial blood samples are  drawn and hGH response is measured against criteria for the specific testing protocol     PRINCIPLE OF THE ASSAY   The ST AIA PACK HGH is a two site immunoenzymometric assay
30. nce of the wash probe or  detector lamp adjustment or change    After daily maintenance  at least two levels of the control should be run in order to verify the  overall performance of the TOSOH AJA System Analyzers     If one or more control sample value s  is out of the acceptable range  it is necessary to investigate  the validity of the calibration curve before reporting patient results    Standard laboratory procedures should be followed in accordance with the strict regulatory agency  under which the laboratory operates     LIMITATIONS OF THE PROCEDURE     For diagnostic purposes  the results obtained from this assay should be used in conjunction  with other data  e g  symptoms  results of other tests  clinical impressions  therapy  etc        Using ST AIA PACK HGH  the highest measurable concentration of human growth hormone  in specimens without dilution is 45 ng mL  and the lowest measurable concentration in  specimens is 0 07 ng mL  assay sensitivity       Although the approximate value of the highest calibrator is 49 7 ng mL  the exact concentration  may be slightly different  The assay specification  ASSAY RANGE HIGH  should be defined  as the upper limit of the assay range  45 ng mL        Although hemolysis has an insignificant effect on the assay  hemolyzed samples may indicate  mistreatment of a specimen prior to assay and results should be interpreted with caution      Lipemia has an insignificant effect on the assay except in the case of gross lipemia where 
31. ontrols in 20 separate runs  The  means of each run were used to calculate the pooled standard deviation  SD  and coefficient of  variation  CV      Sample Mean Pooled SD CV    ng mL   ng mL        Serum A3 2 60 0 105 40   Serum B3 787 0 262 33   Serum C3 25 3 0 695 2 7  CORRELATION    The correlation between serum  x  and heparinized plasma  y  on ST AIA PACK HGH was  carried out using 116 patient specimens     Slope 0 963   y Intercept  0 018   Correlation Coefficient 0 999   Range of Samples 0 07   45 17   Number of Samples 116  SPECIFICITY    The following substances were tested for cross reactivity  The cross reactivity     is the  percentage of the compound which will be identified as hGH  If these compounds are present  in the specimen at the same concentration as hGH  the final result will be increased by these  percentages     Compound Cross reactivity       hGH 100   Prolactin 0 335   hPL 0 005   TSH N D   LH N D   FSH N D    hCG 0 002    N D   not detectable    SENSITIVITY    The minimal detectable concentration  MDC  of human growth hormone is estimated to be  0 07 ng mL  The MDC is defined as the concentration of hGH which corresponds to the rate of  fluorescence that is two standard deviations from the mean rate of fluorescence of 20 replicate  determinations of a CALIBRATOR  1      INTERFERENCE   Interference is defined  for the purposes of this study  as recovery outside of 10  of the   known mean concentration of the specimen after the following substances ar
32. ormation regarding calibration  consult the TOSOH AIA System Operator   s  Manual     Ill  Quality Control Procedure  A  Commercially Available Controls  Commercially available controls should be run at least once per day  It is recommended that  at least two levels of controls  normal and abnormal  be used  Laboratory policy for this  particular assay designates the following   Control Material   Frequency   Lot number of control material  acceptable limits  and corrective action to be taken if controls  do not meet laboratory criteria will be found in a separate quality control document maintained  by the laboratory   B  Quality Control Procedure  1  Assay quality control specimens as instructed in the specific Operator   s Manual for your  analyzer  In addition  refer to the TOSOH AIA System Operator   s Manual for detailed  instructions on defining and editing the files   2  Quality control material to be run with this assay is defined by individual laboratory policy        IV  Specimen Processing   A  Preparation  Following specific instructions in the Operator   s Manual for the analyzer  place samples on the  instrument appropriately  Barcoded primary tubes as well as sample cups can be run on the  AIA Nex IA   ATA 21  AIA 600 II  AIA 1800  ALA 2000 and AIA 360    B  Assay Procedure   1  Ensure a sufficient quantity of ST AIA PACK HGH test cups for the number of samples to be  run    2  Load patient samples as instructed in the Operator   s Manual and proceed with anal
33. pan    Phone   81 3 5427 5181  Fax    81 3 5427 5220    TOSOH EUROPE N V   IEC  REP   Transportstraat 4  B 3980 Tessenderlo  Belgium    Phone   32 13 66 88 30  Fax   32 13 66 47 49       TOSOH BIOSCIENCE  INC   Supplied by 6000 Shoreline Ct   Suite 101  South San Francisco  CA94080  USA  Phone   1 650 615 4970  Fax   1 650 615 0415  Phone   800 248 6764  Fax   800 685 7595       CC VD   5 Xx    European Conformity In vitro diagnostic medical device Consult instructions for use Temperature limitation    LOT  MM  ER gg    Authorized representative  in the European Community    Supplied by N     Catalogue number Supplied by Sufficient for    Part number    Batch code   Lot number Manufacturer Use by date       
34. pnons oe 7OAAEc yAwoasg otn Sradectvaki  Tonodeoia nac  www tosohbioscience eu otnv ev  tnta    Service  amp   Support      Mnopeite va Berg tnv   vrurn popoh vroB  llovras       As instru    es de utiliza    o encontram se dispon  veis em  diversos idiomas no nosso sitio  www tosohbioscience eu na          aitnon p  co gag otrov apt  u    32 13 66 47 49 Eoo sec    o    Service  amp  Support     Servi  os e Assist  ncia   Pode ainda  NAEKTPOVIKOD Taxv  poueiov  info raqa eu tosoh com  obter uma vers  o em papel atrav  s do fax  32 13 66 47 49 ou  A   i i A do email info raqa eu tosoh com   To npo    v avt   replEXEL vA  k   avOpwrnivys A Cwucis  rpo  levons kat da npenei va avtipetwmivetat w     vvn tia A Este produto cont  m materiais de origem humana ou  OADOLCt     UKO  animal e deve ser tratado como potencialmente infeccioso                    Instructions For Use in multiple languages are available on our  ro  Instructiuni de utilizare in diverse limbi sunt disponibile pe    website  www tosohbioscience eu under the    Service    site ul nostru  www tosohbioscience eu  la sectiunea    Service  Support    section  A paper version can be obtained by fax  32  amp  Support     Service si asistent   tehnic     O versiune pe h  rtie  13 66 47 49 or e mail  info raqa eu tosoh com  poate fi obtinut   comand  nd o prin fax  la  32 13 66 47 49     sau prin e mail  la info raqa eu tosoh com     IN This product contains human or animal source materials   i ae  gt   and should be tre
35. probe or detector lamp adjustment or  change   For further information regarding instrument operation  consult the TOSOH AIA  System Operator   s Manual   A sample calibration curve from AIA 1800 follows and shows the algorithm used for  calculating results      RHGH 029  Calibrator Lot  2003005506070000  Fe Ag  B  r  D    Rate  250  200  150  100   50    0  9 10 20 30 40 50    Cone     B  Calibration Procedure   1  Refer to the appropriate TOSOH AIA System Operator   s Manual for the procedural  instructions    2  Verify that both the calibrator lot and concentration numbers have been correctly entered into  the software    3  CALIBRATOR  1  for ST AIA PACK HGH is provided ready for use  TOSOH recommends  that all calibrators should be run in triplicate    4  CALIBRATOR  2   6  for ST AIA PACK HGH are lyophilized  All levels should be  reconstituted with 1 0 mL of CAP Class I or NCCLS Type I Reagent Grade water  TOSOH  recommends that all calibrators should be run in triplicate    C  Calibration Acceptability Criteria   1  The mean rate for the CALIBRATOR  1  should be  lt  3 0 nmol  L s     2  Since there is a direct relationship between concentration and rate  the rate should increase as  the concentration increases    3  The replicate values should be within a 10  range    D  Calibration Review and Acceptance   1  Review the calibration curve carefully  using the criteria listed above    2  Edit the calibration if necessary  then accept the calibration     For further inf
36. s for each analyte  at one time  Therefore  up to two different lots of ST AIA PACK HGH test cups can be used  during the same run    5  If the assay specifications for this test are not ready in the system software  the specifications  must be entered under test code 066     CALCULATION OF RESULTS   The TOSOH AIA System Analyzers perform all sample and reagent handling operations  automatically  The TOSOH AIA System Analyzers read the rate of fluorescence produced by the  reaction and automatically convert the rate to human growth hormone concentration in ng mL     For samples requiring dilution  the AIA Nex IA   AJA 21  AIA 600 II  AIA 1800 and AIA 2000  will automatically perform dilutions and calculate results if the dilution factors are entered into the  software  Dilution factors may be entered into the Test File  or pre defined dilution factors may  be selected in Specimen Processing     EVALUATION OF RESULTS   Quality Control   In order to monitor and evaluate the precision of the analytical performance  it is recommended that  commercially available control samples should be assayed according to the local regulations     The minimum recommendations for the frequency of running internal control material are   After calibration  three levels of the internal control are run in order to accept the calibration  curve   The three levels of controls are repeated when certain service procedures are performed  e g   temperature adjustment  sampling mechanism changes  maintena
37. t  See toode sisaldab inim  v  i loomse p  ritoluga aineid ning IN Tento v  robok obsahuje material z   udsk  ch alebo zvierac  ch  v  ib olla nakkusohtlik  zdrojov a malo by sa s n  m zaobch  dza   ako s potenci  lne  infek  n  m materi  lom          Les instructions d    utilisation sont disponibles en plusieurs  langues sur notre site web  www tosohbioscience eu  dans la  rubrique    Service  amp  Support     Vous pouvez obtenir un  exemplaire papier par fax  au n     32 13 66 47 49  ou par e mail     P adresse   info raqa eu tosoh com           Bruksanvisning p   flera spr  k finns att tillg   p   v  r webbplats   www tosohbioscience eu under rubriken     Service  amp  Support       En pappersversion kan erh  llas per fax  32 13 66 47 49 eller  e post  info raqa eu tosoh com        Ce produit contient des substances animales ou humaines  et doit  par cons  quent    tre trait   comme un produit  potentiellement infectieux     A Denna produkt inneh  ller material med humant eller  animalt ursprung och skall behandlas som potentiellt infekti  s                    1006671001 059C  Rev  05 09    Attention    For North and South American Customers  Please refer to the  AIA AAM Docs on CD for the appropriate information     Para los Clientes en Norte y Sur Am  rica  favor de referirse a los  documentos AIA AAM en Disco para la informaci  n apropiada     Aos clientes da Am  rica do Norte e Am  rica do Sul  favor consultar    os documentos do AIA AAM que est  o em CD para informa 
38. ysis  Note   The AIA Nex IA   AIA 21  AIA 600 II  AIA 1800 and AIA 2000 will require AIA PACK  SAMPLE TREATMENT CUPs if onboard dilutions are utilized     PROCEDURAL NOTES   1  Lyophilized substrate must be completely dissolved    2  Ligand assays performed by the TOSOH AIA System Analyzers require that the laboratory  use water designated by the College of American Pathologists as Class I or by NCCLS as  Type I  Water should be tested at least once per month and should be free of particulate  matter including bacteria  The pH of the water should also be routinely tested  For further  information  consult the NCCLS document    Preparation and Testing of Reagent Water in the  Clinical Laboratory     NCCLS Document C3 A3  Volume 11 No  13  originally approved as a  guideline by NCCLS in October 1997    3  If a specimen human growth hormone concentration is found to be greater than the upper  limit of the assay range  45 ng mL  the specimen should be diluted with the AIA PACK HGH  SAMPLE DILUTING SOLUTION and reassayed according to the Assay Procedure  The  recommended dilution for specimens containing greater than 45 ng mL is 1 10 or 1 100  It is  desirable to dilute the specimen so that the diluted specimen reads between 0 07 and 45 ng mL   The dilution factor should be entered into the software  For further information on the dilution  of specimens  refer to the TOSOH AIA System Operator   s Manual    4  The TOSOH AIA System Analyzers can store two different calibration curve
    
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