Evaluation of EMIT-TOX Enzyme Immunoassay for the analysis of benzodiazepines in serum: usefulness and limitations in an emergency laboratory

The EMIT-TOX Enzyme Immunoassay for benzodiazepines was evaluated. Reproducibility, linearity, accuracy, sensitivity, and interferences were tested and found to be in good agreement with the manufacturer's specifications. Furthermore, the reactivity of 15 benzodiazepines were studied. According their differential reactivity, the 15 benzodiazepines can be classified into three groups: good reactivity similar to diazepam (potassium clorazepate, prazepam, estazolam, medazepam, flunitrazepam, nitrazepam); medium reactivity (clobazam, clonazepam, bromazepam, chlordiazepoxide, triazolam); and low reactivity (oxazepam, ethyl loflazepate, lorazepam). A possible structure/reactivity relationship is discussed. It is concluded that this kit is well adapted for the rapid detection of most benzodiazepines, but in no way can the EMIT technique permit quantitative results without clinical information.     

Microscopic evaluation of dentin interface obtained with 10 contemporary self-etching systems: correlation with their pH

This study investigated micromorphological differences in the hybridized complex formed using 10 commercially available self-etch bonding systems. In addition, the influence of the pH of the primer of these adhesives was evaluated. The self-etching systems tested were AdheSE, Adper Prompt L-Pop, Clearfil SE Bond, Etch&Prime 3.0 (Degussa, Germany), Prime & Bond NT Non Rinse Conditioner (Dentsply, Konstanz, Germany), One-Up Bond F, OptiBond Solo Plus Self Etch, Prompt L-Pop and Xeno III. One hundred non-carious human third molars were used. The teeth were divided into two groups of 50 and prepared for evaluation by optical microscopy or scanning electron microscopy. The specimens in each group were further divided into 10 subgroups of five specimens each to evaluate the 10 bonding systems. The pH of the primers of the bonding systems was measured. The results demonstrated morphological differences at the interface, depending on adhesive composition. The differences mainly concerned thickness of the hybrid layer, the absence or presence of microscopic voids at the adhesive-composite interface and whether the dentinal tubuli were completely sealed. The pH was not the determining factor conditioning the action of the self-etching adhesives.     

Methionine-induced elevation of plasma homocysteine concentration is associated with an increase of plasma cholesterol in adult rats

BACKGROUND AND AIMS: Dietary methionine affects cholesterol metabolism in growing rats. Methionine effects on adult rats and mechanisms by which methionine alters the lipid metabolism are not fully elucidated. We investigated possible mechanisms by which dietary methionine acts on lipid metabolism of adult rats. METHODS: Male adult rats were divided into three groups (n=10) and were fed casein-based diets differing in methionine concentration (low-methionine diet: 0.96 g/kg; adequate-methionine diet: 2.22 g/kg, high-methionine diet: 6.82 g/kg) for 4 weeks. Concentrations of triacylglycerols and cholesterol in plasma and lipoproteins, concentration of homocysteine in plasma, concentration of cholesterol in liver, fecal lipid excretion, expression of hepatic HMG-CoA reductase, phosphatidylethanolamine N-methyltransferase 2 (PEMT-2) and of LDL receptor were measured. RESULTS: Rats fed the high-methionine diet had higher plasma homocysteine concentrations than rats fed the low-methionine diet (p<0.05). Although concentrations of cholesterol in plasma and lipoproteins were not different between the groups, there was a distinct positive correlation between circulating plasma homocysteine and plasma cholesterol (R(2)=0.55, p<0.001). The fecal excretion of cholesterol and bile acids was not altered by dietary methionine. The relative mRNA concentration of HMG-CoA reductase and of LDL receptor remained unaffected by dietary methionine. Gene expression of PEMT-2 was higher in rats fed the high-methionine diet than in rats fed the other diets (p<0.05). CONCLUSION: The results demonstrate that dietary methionine contributes to a rise in circulating homocysteine concentration which positively correlates with the concentration of plasma cholesterol. However, the effects of methionine on cholesterol metabolism of adult rats were relatively weak.     

Delayed Horner's syndrome during a continuous infraclavicular brachial plexus block

Horner's syndrome is a potential, albeit rare, feature of continuous infraclavicular brachial plexus local anesthetics infusion, mainly the result of anatomical considerations. Horner's syndrome may be described as an "unpleasant side effect" because it has no clinical consequences in itself. Nevertheless, patient discomfort and anxiety may reduce acceptance of the analgesic technique. Reassurance and close clinical monitoring of the patient are essential to enhance patient's safety and acceptance of the technique.     

Histone H1 and cdk1 kinase activities in early embryos of four mouse strains after X-irradiation

The cdk1/cyclin B1 complex is a universal regulator known to be responsible for driving the cell-cycle from the G2- to the M-phase. To investigate the effects of irradiation on the activity of this complex in preimplantation embryos, we irradiated one- and two-cell mouse embryos with X-rays, and measured the fluctuations of histone H1 and cdk1 kinase activity. Four mouse strains with different radiation sensitivities were chosen: the BALB/c and the Heiligenberger (radiation-sensitive) and the C57BL and the CF1 (radiation-resistant) strains. Embryos irradiated in the first cell-cycle arrested in the G2-phase. However, the dynamics of this radiation-induced G2-block were different between the mouse strains tested. Indeed, in the C57BL and the CF1 strains, X-irradiation with 2.5 Gy induced a very short G2 block before the one-cell embryos could then proceed to mitosis. On the contrary, X-irradiation in BALB/c induced a G2-arrest that lasted about 20 h, with the percentage of embryos blocked in G2 depending on the dose, whilst in the Heiligenberger strain, all irradiated embryos developed a G2-block, which was dependent in duration on the radiation dose. In all mouse strains, the histone H1 kinase activity remained low during the G2 arrest, while it showed values comparable to that of control embryos during mitosis. X-irradiation is known to induce a change in the phosphorylation state of the cdk1 protein kinase in adult somatic cells. In embryos from the BALB/c and C57BL strains, the histone H1 kinase activities were confirmed by the cdk1 phosphorylation pattern: the inactive and phosphorylated form of cdk1 was observed in G2 arrested 1-cell embryos, while the active and dephosphorylated form of cdk1 was present in dividing control and irradiated 1-cell embryos. X-irradiation at the 2-cell stage only induced a short G2-arrest in all tested mouse strains. In conclusion, cell-cycle effects in early embryos under normal conditions and after irradiation are strictly paralleled by changes in the activity of the central cell-cycle driving enzyme complex.     

Disseminated arterial occlusions revealing bilateral venous thrombosis with paradoxical embolisms

Paradoxical embolism is a diagnosis of exclusion. Clinical triad associates deep venous thrombosis with or without pulmonary embolism, arterial embolism, and intracardiac communication with right-to-left shunt. The intracardiac communication is generally related to a patent foramen ovale (PFO). We report a 75-year-old patient, who presented with bilateral deep venous thrombosis of the legs, complicated by massive pulmonary embolism and paradoxical embolisms through a PFO. This resulted in cerebral, mesenteric, splenic and bilateral kidney infarctions. A promptly initiated anticoagulant treatment allowed a favourable outcome.     

Occurrence and distribution of steroids,hormones and selected pharmaceuticals in South Florida coastal environments

The common occurrence of human derived contaminants like pharmaceuticals, steroids and hormones in surface waters has raised the awareness of the role played by the release of treated or untreated sewage in the water quality along sensitive coastal ecosystems. South Florida is home of many important protected environments ranging from wetlands to coral reefs which are in close proximity to large metropolitan cities. Because, large portions of South Florida and most of the Florida Keys population are not served by modern sewage treatment plants and rely heavily on the use of septic systems, a comprehensive survey of selected human waste contamination markers was conducted in three areas to assess water quality with respect to non-traditional micro-constituents. This study documents the occurrence and distribution of fifteen hormones and steroids and five commonly detected pharmaceuticals in surface water samples collected from different near shore environments along South Florida between 2004 and 2006. The compounds most frequently detected were: cholesterol, caffeine, estrone, DEET, coprostanol, biphenol-A, β-estradiol, and triclosan. The concentration detected for estrone and β-estradiol were up to 5.2 and 1.8 ng/L, respectively. Concentrations of caffeine (5.5–68 ng/L) and DEET (4.8–49 ng/L) were generally higher and more prevalent than were the steroids. Distribution of microconstituents was site specific likely reflecting a diversity of sources. In addition to chemical analysis, the yeast estrogen screen assay was used to screen the samples for estrogen equivalency. Overall, the results show that water collected from inland canals and restricted circulation water bodies adjacent to heavily populated areas had high concentrations of multiple steroids, pharmaceuticals, and personal care products while open bay waters were largely devoid of the target analytes.