FM sonography in diffuse liver disease: prospective assessment and blinded analysis

FM sonography - a signal-processing technique that uses frequency and phase information as well as amplitude data - shows promise in evaluation of patients with diffuse liver disease. In a prospective blinded review of 37 patients with biopsy-proved liver disease and 42 healthy volunteers, FM sonography was clearly superior to traditional amplitude-based (AM) sonography in distinguishing healthy from diseased subjects. Statistically significant differences were seen in accuracy (FM, 98.7%; AM, 84.8%), sensitivity (FM, 97.3%; AM, 70.3%), and negative predictive value (FM, 97.7%; AM, 78.8%). Our data also suggest that current FM sonographic techniques cannot differentiate among histologic findings associated with different hepatic parenchymal abnormalities. It is unclear, therefore, whether FM imaging can reduce the numbers of patients who require biopsy for diagnosis or the frequency of biopsy procedures in patients with known disease.     

Selenium depletion and its correction in a child with homocystinuria

A child of 10 months with proven homocystinuria was found to be selenium depleted and we report the serial monitoring of replacement therapy. Selenium, as an enriched yeast preparation, equivalent to 50 mug on alternate days was required for maintenance. Indices of selenium status returned to normal in varying times. The child initially demonstrated an abnormality of an in vitro challenge by hydrogen peroxide to her erythrocytes, that returned to within normal limits with selenium therapy alone, the serum vitamin E concentration being normal.     

In Vitro Activity of wALADin Benzimidazoles against Different Life Cycle Stages of Plasmodium Parasites

wALADin1 benzimidazoles are specific inhibitors of δ-aminolevulinic acid dehydratase from Wolbachia endobacteria of filarial nematodes. We report that wALADin1 and two derivatives killed blood stage Plasmodium falciparum in vitro (50% inhibitory concentrations, 39, 7.7, and 12.8 μM, respectively). One of these derivatives inhibited gliding motility of Plasmodium berghei ANKA infectious sporozoites with nanomolar affinity and blocked invasion into hepatocytes but did not affect intrahepatocytic replication. Hence, wALADin1 benzimidazoles are tools to study gliding motility and potential antiplasmodial drug candidates.     

Intramural intestinal gas in adults

It is important that a routine search be done roentgenographically for intramural intestinal gas. Several different patterns may be present, but unfortunately, classification of the findings is not helpful in predicting either the cause, or the presence, of gangrene. Also, the clinical circumstances in which intramural intestinal gas is discovered are important--if seen in a patient with acute pain in the abdomen, panmural gangrene is nearly always present and early operation desirable. However, if first discovered in the early postoperative period, a more selective approach is possible. Although many of the patients with intramural intestinal gas died, approximately one-quarter will survive. Hopefully, more timely recognition of intramural intestinal gas will allow earlier surgical intervention in some patients with ischemia of the intestine.     

Simultaneous development of six LC-MS-MS methods for the determination of multiple analytes in human plasma

Traditional sequential single analyte method development is both time-consuming and labor-intensive. In this report, a concept of simultaneously developing multiple liquid chromatography coupled with tandem mass spectrometry (LC–MS–MS) methods were proposed. Mass spectrometric and chromatographic conditions as well as sample preparation methods for all analytes were optimized concurrently. Mass spectrometric conditions for six analytes, i.e. clonidine (CLO), albuterol (ALB), fentanyl (FEN), ritonavir (RIT), naltrexone (NAL), and loratadine (LOR), were established simultaneously using the Sciex Analyst software. LC–MS–MS sensitivities obtained using gradient elution methods on reversed-phase Inertsil ODS3 and normal phase Betasil silica columns were compared. Sample extraction methods using protein precipitation, liquid/liquid extraction, or solid-phase extraction (SPE) were evaluated. Recovery of analytes was determined. Matrix effects and interference due to endogenous compounds were investigated. Selection of a potential internal standard was discussed.