Quantitative determination of morphine in biological samples by gas-liquid chromatography and electron-capture detection.

A highly sensitive method for the determination of morphine in plasma and brain samples down to 500 pg ml-1 in plasma and 100 pg in 30 mg of brain tissue is described. This sensitivity is in the range of that described for radioactive and radioimmunological tehcniques. The samples (50-500 mu-l) are extracted with toluene-butanol (9:1) at pH 8.9 and then re-extracted into 0.1 N sulphuric acid and back extracted to a toluene-butanol phase at pH 8.9. The pentafluoropropionic anhydride derivatives of morphine and the internal standard nalorphine were quantitatively determined by gas-liquid chromatography with a 3-H electron capture detector.     

The fitness of human translocation carriers

A simple method to estimate the mean fitness of human translocation carriers is described. The method is based on information about the inheritance pattern of the translocations. This kind of data can be obtained from the surveys of the chromosome constitutions of new-born babies. The following fitness estimates are obtained: D/D translocation carriers, 0-94; D/G translocation carriers, 0-83; and reciprocal translocation carriers, 0-67. The estimates are rather uncertain due to the scarcity of information, but they are consistent with the expected results. More accurate estimates will be obtained in the future when more data on translocation carriers are available and the cytological classification of the different translocations becomes more exact.     

ON THE RENAL TUBULAR DAMAGE IN HEREDITARY TYROSINEMIA AND ON THE FORMATION OF SUCCINYLACETOACETATE AND SUCCINYLACETONE1

ABSTRACT. Fällström, S.-P., Lindblad, B. and Steen, G. (Department of Paediatrics, East Hospital, University of Gothenburg, Gothenburg, Department of Paediatrics, Molndal's Hospital, Molndal, Department of Clinical Chemistry, University of Gothenburg, Gothenburg, Sweden). On the renal tubular damage in hereditary tyrosinemia and on the formation of succinylacetoacetate and succinylacetone. Acta Paediatr Scand, 70:315, 1981.–Phenylalanine and homogentisate increase the concentration of succinylacetoacetate and succinylacetone both in serum and urine in patients with hereditary tyrosinemia and therefore increase the excretion of 5-aminolevulinate. Both phenylalanine and homogentisate cause a tubular proteinuria which is in agreement with our hypothesis that their metabolites maleylacetoace-tate and fumarylacetoacetate are the toxic compounds in hereditary tyrosinemia. The patient with the highest excretion of succinylacetoacetate and succinylacetone has the slightest tubular proteinuria whereas the one with the lowest excretion of these compounds has the more pronounced tubular proteinuria. It is suggested that this is caused by a difference in the ability to reduce the presumed toxic compounds fumarylacetoacetate and maleylacetoacetate, i.e. the precursors of succinylacetoacetate.     

ASSESSMENT OF LUNG FUNCTION ON HEALTHY CHILDREN USING AN ELECTRONIC SPIROMETER AND AN AIR-FLOWMETER BEFORE AND AFTER INHALATION OF AN ADRENERGIC RECEPTOR STIMULANT

Abstract. VC measured with a Monaghan electronic spirometer equipped with a backflow valve is significantly lower (about 4%) than when measured with the same spirometer without such a valve. The measurements of FEV_1.0 were not influenced by the valve. 73 healthy children were investigated with the Monaghan spirometer equipped with the backflow valve and normal reference data were established. The results were very similar to those obtained in an investigation of healthy children with the same spirometer about one year earlier. Reference data on children for a simple flow meter, Airflometer (Glaxo Ltd.), are given. The data correlated very highly to the FEV_1.0 values obtained by the Monaghan spirometer. After inhalation of salbutamol healthy children had a small and significant increase of FEV_1.0 and of the Airflometer value but not of VC. The deviations of the differences were small. A 6% increase of VC and 10% increase of FEV_1.0 were taken as normal upper limits after inhalation of salbutamol. Corresponding increase of the Airflometer values was 15 arbitrary units for children with body heights 116–145 cm and 21 units for children with body heights 146–175 cm.     

PRENATAL DIAGNOSIS OF METHYLMALONIC ACIDURIA

Abstract. Mahoney, M. J., Rosenberg, L. E., Lindblad, B., Waldenström, J. and Zetterström, R. (Departments of Human Genetics and Pediatrics, Yale University, New Haven, USA, the Department of Clinical Chemistry, University of Gothenburg, Gothenburg, Sweden and the Department of Pediatrics, Karolinska Institutet, St. Göran's Hospital for Children, Stockholm, Sweden). Prenatal diagnosis of methylmalonic aciduria. Acta Paediatr Scand, 64: 44, 1975.–Prenatal diagnosis using amniocentesis was sought in two midtrimester pregnancies, each at risk for a different type of inherited methylmalonic aciduria. In one pregnancy a normal fetus was diagnosed from studies of cultured amniotic fluid cells and the diagnosis confirmed after the baby was born. In the second pregnancy a fetus with a methylmalonyl-CoA mutase apoenzyme defect was found. The diagnosis was based on Cultured cell studies and supported by an elevation of methyl-malonate in both amniotic fluid and maternal urine. Confirmatory studies were obtained using cultured cells from the aborted fetus. At the present time, assays of cultured amniotic fluid cells are imperative for firm diagnosis. With more experience, quantities of amniotic fluid and maternal urine methylmalonate may prove sufficient if differentiation among the various types of methylmalonic aciduria is not required.     

Evaluation of an Educational Programme for Telephone Advisers in Primary Health Care

Marklund B, Silfverhielm B and Bengtsson C. Evaluation of aneducational programme for telephone advisers in primary healthcare. Family Practice 1989; 6: 263–267. Telephone advisers, usually registered nurses, have a very importantrole in the Swedish primary health care service. In order toimprove this service, a special educational programme has beenworked out for registered nurses working at a Swedish healthcentre. The purpose of this paper is to evaluate this educationalprogramme at one of the health centres. The quality of the telephoneadvice was evaluated by a blind observer. After the educationalprogramme the quality of advice was improved. Among the participatingnurses, the confidence and the satisfaction with the work increasedafter the educational programme.     

Acrodermatitis Chronica Atrophicans Herxheimer Can Often Mimic a Peripheral Vascular Disorder

ABSTRACT During the past few years five patients have been referred to the angiology section at Danderyd Hospital under the diagnosis of chronic venous insufficiency but who were instead suffering from acrodermatitis chronica atrophicans (ACA). The typical case of ACA starts with a limited inflammatory lesion, which is gradually replaced by atrophy and the skin shows a bluish, red discoloration. Late changes may be subluxation of joints in hands or feet and periosteal thickening. Capillary microscopy often reveals a clear picture of atrophy and a prominent, dilated subpapillary venular plexus. If localized to the leg the blood flow of the foot and lower leg may be increased, skin temperature elevated and venous capacity and return augmented. All these variables can consequently mimic venous insufficiency of the leg. ACA is caused by a Borrelia infection and serological testing will always show a significantly elevated titer to Borrelia. The disease is most often easily cured by 2–3 g of penicillin daily for two to three weeks.     

Increase in Plasma Atrial Natriuretic Peptides during Acute Volume Expansion in Hypertensive Man

ABSTRACT. A new hormonal system originating from cardiac atria has recently been discovered. These peptide hormones have important functions in the regulation of blood volume and fluid homeostasis. We have measured plasma concentrations of atrial natriuretic peptides (ANP) in two patients during acute volume expansion. ANP concentrations increased in relation to an increase in right atrial pressure, and significant diuresis/natriuresis was observed. We conclude that hormonal as well as neuronal mechanisms are activated by acute volume loading in man.     

Epidemiological assessment of hyperlipidaemia management in primary health care

To evaluate the impact of contemporary management of hyperlipidaemiaoutside well planned and monitored investigations we studiedthe laboratory records of primary hearth care patients. Thestudy comprises 14,988 primary health care patients who hadbeen subject to at least one determination of serum-cholesterolduring an 18-month period. About half of the group was subjectto more than one examination during the period and presumablyparticipated in an intervention programme. Concentration means(S-cholesterol, S-triglycerides and S-HDL-cholesterol) werecalculated for all and for those returning for a repeated measurement.An overrepresentation of women over 50 and an underrepresentationof men of the same age and in the National Cholesterol EducationProgram (NCEP) risk group was found among those being screened.Patients in the highest cholesterol risk group were the mostsuccessful in reducing S-cholesterol whereas an inaease of S-cholesterolwas found in the lowest risk group. Women under 50 in the highestcholesterol risk group were the most successful group in loweringtheir cholesterol concentrations. Men under 50 were more likelyto return for follow-up than women of the same age; people aged50–70 were the most likely to return, irrespective ofgender and risk group. It was found that initial S-cholesterolwas the only significant predictor of the S-cholesterol concentrationat follow-up. Further attention should be directed to the intermediatecholesterol risk group in an effort to combat preventable IHDand to develop programmes that attract younger women and mento a higher degree than is currently the case.