Quantitative gas chromatographic mass spectrometric determination of pinaverium-bromide in human serum

A method has been developed for quantitative determination of pinaverium-bromide, a quaternary ammonium derivative with papaverine-like activity, in human serum. The method involves a chloroform extraction of serum spiked with N-(6,6-dimethyl bicyclo[3.1.1]2-heptenyl-ethoxyethyl) perhydro-1,4-oxazine as internal standard. After evaporation of the solvent, and reduction of the residue with Raney-Nickel, the internal standard and the reduced pinaverium-bromide are re-extracted from the reaction mixture with toluene and analysed isothermally on a fused silica column coated with OV-101. Although chemical ionization with methane revealed intense protonated molecular ions for both pinaverium-bromide and the internal standard, selectivity and sensitivity were significantly lower in comparison with electron impact ionization at 70 e V. Therefore, quantification was performed in the electron impact mode by single ion monitoring of the common fragment ion at m/z 100.2. A linear detector response was observed up to 160 ng ml-1. A within-run assay precision better than 2% CV (n = 5) was found, and a detection limit of 1 ng pinaverium-bromide ml-1 of serum was attained.

Effects of oxametacin on coumarin anticoagulation and on platelet function in humans

In 12 chronically anticoagulated patients the administration of 1-p-chlorobenzoyl-5-methoxy-2-methyl-3-indoacetohydroxamic acid (oxametacin, Flogar), three times 100 mg a day, decreased the thrombotest percentage from a mean of 11.2% to a mean of 8.3% after one week and of 7.8% after two weeks of treatment. A potentiating effect of oxametacin was also found when the prothrombin time or the activated partial thromboplastin time were used as parameters. In one third of our patients an adaptation of the coumarin dose or even an interruption in the warfarin administration was necessary. Although no severe bleedings occurred, care should be taken in prescribing oxametacin to anticoagulated patients. In a second part of this study we compared the ex vivo effects of a single oral dose of 1 g of acetylsalicylic acid, 50 mg of indometacin and 100 mg of oxametacin in human volunteers. Platelet aggregation and 5HT--14C release induced by collagen. Thrombofax, ADP, adrenaline (epinephrine), bovine plasma and ristocetin were measured before, 1 and 24 h after drug administration. A clear-cut inhibitory effect as induced by acetylsalicylic acid was not found for oxametacin.

Postvagotomy dysphagia necessitating surgical relief

A case of severe dysphagia following transthoracic truncal vagotomy is reported. Stenosis of the esophagus was due to a periesophageal fibrotic band. Surgical treatment was mandatory and relief was brought by resection of the stricture and restoration of the continuity by colonic interposition. A review of the literature on the subject is presented.

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L'étude de la démographie valenciennoise entre 1800 et le début du XXe siècle met en évidence la spécificité de son évolution : taux de natalité élevés, taux de mortalité également supérieurs à la moyenne nationale, mais nuptialité très basse. Le modèle démographique valenciennois apparaît ainsi comme relativement archaïque.

Dans l'ensemble, la population augmente modérément, la surcharge démographique liée à l'industrialisation se portant surtout sur les communes périphériques, et l'augmentation observée dans la ville même résulte avant tout d'une immigration de provenance régionale. De ce fait, la pyramide des âges y est caractérisée par le poids relativement élevé des éléments jeunes.

Dans le dernier quart du xixe siècle, cette spécificité valenciennoise s'atténue cependant rapidement, avec la quasi disparition des crises périodiques de surmortalité, et le rapprochement des taux démographiques urbains des moyennes nationales.

Il faut souligner l'évolution particulière de l'illégitimité, dont les taux restent très élevés, malgré une tendance à la baisse, tout au long du xixe siècle ; on peut mettre ce phénomène en rapport avec la présence d'une garnison importante dans la ville, et le rôle que joue cette dernière comme pôle d'un « plat pays » à la population très dense.

Alpha 1-antitrypsin in pancreatitis

A possible relationship between alpha 1-antitrypsin deficiency and pancreatitis was studied. Pi phenotype distribution in a group of 90 patients with proven pancreatitis was compared to a control group of 549 randomly selected blood donors. No significant differences were found between the patient group and the controls, nor between acute and chronic forms of pancreatitis. It is concluded that alpha 1-antitrypsin phenotype does not play an important role in pancreatic disease.

Serum molybdenum in diseases of the liver and biliary system

We determined the serum molybdenum concentration by neutron activation analysis in apparently healthy subjects and in patients with diseases of the liver and biliary system. The level was found to be markedly elevated in the initial phase of acute viral hepatitis (mean +/- S.D. 3.10 +/- 1.46 ng/ml vs. 0.55 +/- 0.21 in controls) and to return to normal during convalescence, in parallel with the liver function tests. The most significant correlations were found between the serum molybdenum concentration and the serum levels of GOT ( r = 0.710, p less than 0.001) and GPT (r = 0.683, p less than 0.001). Besides, the serum molybdenum level (mean +/- S.D.) was observed to be definitely increased in patients with HBsAg-positive chronic active hepatitis (0.97 +/- 0.49 ng/ml), HBsAg-positive liver cirrhosis (1.01 +/- 0.50), alcoholic liver disease (1.32 +/- 0.56), liver metastases (1.40 +/-0.39), gallstones (1.28 +/- 0.38), tumors of the gallbladder or extrahepatic bile ducts (1.64 +/- 0.44), and carcinoma of the head of the pancreas (1.61 +/- 0.91). Finally, the serum molybdenum level was found to be raised in two patients with primary biliary cirrhosis and in two out of four patients with drug-induced liver injury. The etiologic mechanism and the clinical importance of the observed abnormality remain to be established. Our study enlarges the existing information concerning the disorders of trace element metabolism in liver diseases.

Quantitative determination of fecal bile acids as their methyl ether methyl esters by the repetitive scan technique

Quantification of bile acids has been carried out by selected ion monitoring and by repetitive scanning. The latter method has been explored critically and found to be very suitable. A 24 h collection of feces was submitted to Soxhlet extraction. The extract was purified on Servachrom XAD-2, and separated into sulfated and non-sulfated fractions over DEAP-Sephadex-LH20. Conjugated and sulfated bile acids were enzymatically deconjugated and desulfated prior to permethylation. Deuterated bile acid derivatives were added as external standards and an aliquot was injected onto a capillary column of SE-52. The reconstructed chromatogram traces of specific ions were integrated to quantify known bile acids. Spectra of all metabolites were available for identification purposes simultaneously.

In vitro inhibition of platelet aggregation by bile salts

In a series of in vitro experiments, the influence of bile salts on platelet aggregation by ADP or by collagen and on serotonin-14C release by collagen, was studied. Sodium salts of the following bile acids showed a clear inhibitory effect: glycochenodeoxycholic acid, taurochenodeoxycholic acid, glycocholic acid, taurocholic acid and cholic acid. Lowering the pH of the platelet-rich plasma resulted in decrease platelet aggregation by ADP and by collagen. Bile salts further enhanced the inhibitory effect of pH change. In contrast the sodium salt of chenodeoxycholic acid was the sole aggregation inducing bile salt we studied. Relating the above studies to the clinical situation of upper gastroduodenal mucosal haemorrhage, we suggest that biliary reflux as well as the acidic environment may contribute to a poor haemostatic response by impaired platelet aggregation in the upper gastrointestinal tract of otherwise normal human subjects.

Testosterone metabolism in normal males and male cirrhotics

The following physiopathological mechanisms for the abnormalities of testosterone metabolism observed in cirrhotic patients may be postulated: 1. The decreased testosterone secretion has a primary testicular origin; it seems probable that, as a result of direct toxicity the 17-beta-reductase is inhibited, resulting in decrease of testosterone and an increase of androstenedione. 2. The hypothalamic-pituitary function is nearly normal in cirrhotics. Basal level of LH and FSH are often slightly elevated, indicating a normal reactivity of the pituitary. 3. The conversion of androgens to oestrogens (androstenedione to oestrone) which occurs essentially extrahepatically, is increaed in cirrhosis.

Determination of molybdenum in human serum by neutron activation analysis

Several investigators have reported serum molybdenum determinations in healthy humans. However, their results diverge quite widely. We determined the element by neutron activation analysis in 30 individuals. We found a mean value of 0.58 ng/ml, a standard deviation of 0.21 ng/ml and a range of 0.28--1.17 ng/ml.

Jejunal bile salts and microflora in patients with partial gastrectomy

Bile acids and microflora were studied in the proximal jejunum in 31 patients with Billroth I or II gastrectomy. At least 10(5) bacteria/ml., most frequently aerobic or facultative aerobic organisms, were isolated in 25 patients. Deconjugation diminished considerably in only three of seven patients with bile salt deconjugation treated with clindamycin. The relationship between bacterial overgrowth, deconjugation, steatorrhea, cholesterolemia and the relationship between bile salt concentration after testmeal and steatorrhea, are discussed. Bacterial overgrowth and bile salt deconjugation are only minor causes of steatorrhea in this series.