Epidural epinephrine and the systemic circulation during peripheral vascular surgery.

This study was designed to determine the haemodynamic effects of epidural epinephrine, 5 micrograms.ml-1, added to bupivacaine, 0.75 per cent, in elderly patients with cardiac disease undergoing peripheral vascular surgery (PVS).

Catecholamine-secreting paraganglioma of glomus jugulare region.

A 43-year-old woman had clinical and biochemical evidence of a secreting paraganglioma of the glomus jugulare region. Catecholamine secretion was exacerbated during embolization of the tumor before surgery and resulted in a life-threatening vasomotor attack. Preoperatively, pharmacologic blockade of excessive catecholamine secretion with prazocin controlled her blood pressure, tachycardia, and symptoms.

Determination of encainide and its metabolites by high-performance liquid chromatography.

Encainide (ENC) and its metabolites O-demethylencainide (ODE), 3-methoxy-O-demethylencainide (MODE), N-demethylencainide (NDE) and bis-N,O-demethylencainide (NODE) have been measured by two HPLC procedures. The method of Mayol using a mu Porasil column with ethanol-water-methanesulphonic acid as mobile phase was not able to separately measure NODE and NDE in plasma. A new method is described using a mu Bondapak Phenyl column with acetonitrile-phosphate buffer (0.

Renal dose response and pharmacokinetics of atrial natriuretic factor in dogs.

The present studies investigated the dose-plasma level-response relationships with the use of increasing doses of atrial natriuretic factor [ANF-(99-126)] administered by constant infusion in conscious dogs. The preinfusion plasma immunoreactive ANF increased 12, 19, 23, and 35 times during 45-min consecutive infusions of 50, 75, 125, and 175 ng.kg-1.

Measurement of biological disulfides by postcolumn sulfitolysis following separation by HPLC.

We developed a method to measure disulfides which is applicable to biological fluids. It consisted of two parts. First, certain thiols and disulfides were separated by HPLC.

Molecular forms of atrial natriuretic peptides in dog atrium and plasma.

The level of immunoreactive ANP (iANP) as determined by radioimmunoassay, exhibits a fairly even distribution throughout the canine atria. However, the maximal concentration was found in the appendages of both the left and right atrium, and the level was significantly higher on the left side in all analyzed localizations. Reverse-phase HPLC of atrial extracts, coupled with RIA, revealed the presence of three iANP fractions.

Atrial natriuretic peptide: blood levels in human disease and their measurement.

The atrial hormonal system consists of 126 amino acid-containing prohormone (proANP) stored in the secretory granules of atrial myocytes and 28 amino acid-containing hormone (ANP) that is secreted into the bloodstream in response to raised atrial pressure. ANP participates in the homeostasis of body fluid volume through its main receptor-mediated effects; natriuresis, inhibition of renin and aldosterone secretion, and vasodilation. It counteracts the renin-angiotensin system with the putative primary role of regulating the circulating blood volume.

Cystinuria--an experience in management over 18 years.

Data on 23 patients with cystinuria are presented. These have been analysed for age, sex and the incidence of surgical procedure. Urinary amino acid data have been analysed to confirm homozygosity which was achieved in all but one of the cases.

Systemic mastocytosis: management of an unusual case with histamine (H1 and H2) antagonists and cyclooxygenase inhibition.

A patient with urticaria pigmentosa and systemic mastocytosis developed hypotension following indomethacin administration. He then developed further episodes not related to indomethacin. Based upon the experience of others with the management of patients with systemic mastocytosis who showed exceptional reaction to cyclooxygenase inhibition, it was decided to treat him with H1 and H2 blockade followed by aspirin, another cyclooxygenase inhibitor.

Separation of biological variant insulin molecules from different species by reversed-phase high-performance liquid chromatography (HPLC).

Three different isocratic systems for the separation by reversed-phase high-performance liquid chromatography (HPLC) of different species of insulin have been investigated. The effect of different solvent compositions and temperatures on elution time and resolution have been studied. These studies have been used to devise a method for reversed-phase liquid chromatographic separation of bovine, porcine, and human insulin, as well as the A and B chains of bovine insulin.

A review of the clinical presentation and laboratory findings in two uncommon hereditary disorders of sulfur amino acid metabolism, beta-mercaptolactate cysteine disulfideuria and sulfite oxidase deficiency.

Two hereditary disorders of sulfur amino acid metabolism, beta-mercaptolactate-cysteine disulfideuria and sulfite oxidase deficiency, were described twenty years ago. Other examples of these disorders have been limited to about 5 of each in the world literature since then. Reasons for the apparent rarity of these conditions are discussed and the analytical procedures to identify them are reviewed.

Determination of the metabolites of mexiletine in human plasma.

A liquid chromatographic method for the determination of mexiletine and unconjugated metabolites in plasma has been developed. A reversed-phase C18 column is used with isocratic elution and either UV or amperometric detection. Sample pretreatment involves double extraction of the metabolites.

Circulating immune complexes in patients with rheumatoid arthritis and the effect of penicillamine in vitro.

Protein precipitated from the sera of 15 patients with rheumatoid arthritis (RA) by increasing concentrations of polyethylene glycol 6000 (PEG) was compared with that from 20 normal controls. The wide range of precipitable protein obtained was only significantly different for the two groups when a 4% PEG concentration was used. To increase the discrimination of the procedure, the precipitated protein was measured for IgG, IgM, C3 and C4 using immunospecific antisera and laser nephelometry.

Methods for assaying D-penicillamine in a clinical setting.

Penicillamine disulfides have been analysed by automatic amino acid analysis. Because the free thiol reacts poorly with ninhydrin, other detection methods are preferred, particularly high pressure liquid chromatography using an electrochemical detector or gas chromatography with a flame ionization detector. Pharmacokinetic studies have now been reported using these techniques.

Separation and quantitation of oxypurines by isocratic high-pressure liquid chromatography: application to xanthinuria and the Lesch-Nyhan syndrome.

An isocratic HPLC technique has been developed for the separation and measurement of urine and plasma oxypurines in a patient with xanthinuria. The case history and laboratory data are presented. Xanthine excretion was 172 mg/g creatinine and hypoxanthine was 45 mg/g creatinine.

A survey of analytical approaches to the measurement of D-penicillamine and penicillamine disulfides.

This paper evaluates the usefulness of different methods for measuring aminothiols and disulfides in biological fluids. The major approaches usually involve liquid or gas-liquid chromatography. Techniques tested and currently used by the authors are discussed.

Proteinuria in D-penicillamine-treated rheumatoid arthritis.

The incidence of proteinuria in D-penicillamine-treated rheumatoid arthritis has been between 10% and 20% in the 1st year of therapy; afterward, few develop proteinuria. Incidence is related to both quantity of penicillamine administered and inherent response variability. About 1/3 of those with proteinuria may proceed to a nephrotic syndrome if therapy is continued.

Experience with penicillamine in the treatment of cystinuria.

Some patients with cystinuria can be treated with a high fluid intake, but some continue to form stones and require penicillamine treatment. The incidence of complications particularly proteinuria is reviewed. Reduction of penicillamine dosage is desirable to prevent complications, but this is accompanied by an increase of cystine excretion.