Intracranial malignant rhabdoid tumor: report of one case

A 4-year-old boy presented with anorexia, headache, and poor spirits was found to have tumors in posterior fossa and suprasellar region which enclosed by CT scan of brain. Bilateral suboccipital craniotomy was performed by neurosurgeon. The pathological report revealed the tumor was malignant rhabdoid tumor. The patient died two and one half months after diagnosis in spite of surgical resection and radiotherapy of the tumor.

Chiral polymeric reagents for off-line and on-line derivatizations of enantiomers in high-performance liquid chromatography with ultraviolet and fluorescence detection: an enantiomer recognition approach

Optically active and detector-sensitive polymeric reagents have been synthesized, loadings determined, derivatizations/separations/detection optimized, and applications to simple amines and amino alcohols described. Such reagents have been designed to contain different chiral centers, usually amino acids, leashed via an activated ester attachment to an insoluble, structurally rigid, organic polymer backbone. 9-Fluorenylmethyl (FMOC) moieties chemically bonded to the amino acids were used as ultraviolet (UV) and fluorescence (FL) sensitive detector probes to the final diastereomers of enantiomer substrates. Such diastereomers can be readily separated by isocratic or gradient elution normal-phase methods. The kinetics for diastereomer formation have been determined, and final UV/FL responses for known mixtures of enantiomers have been compared to demonstrate overall validity of the method. Minimum detection limits, linearity of calibration plots, dual detector responses, and linear diode array spectra and absorbance ratios have also been demonstrated. In some cases, authentic standards have been prepared to calculate absolute percent derivatizations for specific enantiomer pairs. The overall approach permits, for the very first time, off-line or on-line precolumn derivatization for the formation of diastereomers having unique detector properties. It has been proven that the rates and rate constants for such formations are identical for at least those pairs of enantiomers studied. Separations are base-line or near-base-line, permitting accurate and precise quantitative determinations, by both UV and FL, of enantiomer/optical purity and chemical purity.

Polymeric activated ester reagents for off-line and on-line derivatizations of amine nucleophiles in high-performance liquid chromatography with ultraviolet and fluorescence detection

A novel polymeric activated ester reagent has been developed that improves final detectability and chromatographic performance in high-performance liquid chromatography (HPLC) for virtually all primary and secondary amines or amine analogues. This has involved the synthesis, characterization of final reagent, optimization of derivatization and separation conditions, and determination of analytical figures of merit. The polymeric reagent contained an activated ester linkage to the 9-fluorenyl group, which imparted ultraviolet (UV) and fluorescence (FL) detector properties to the final derivatives. Kinetic studies of these solid-phase (heterogeneous) reactions have been conducted, and specific rate constants were compared with those of the analogous solution reaction for the same substrates. Percent derivatizations have reached 90% and 70% for primary and secondary amines, respectively, under optimized conditions. High reaction reproducibility has been obtained by using the on-line approach, for more than 50 separate injections of the same amine substrate with a single solid-phase reactor. These solid-phase derivatizations have led to detection limits for typical amines in the low-parts-per-billion range. The final, overall methods can provide rapid, automatable, accurate, and precise detection and quantitation of primary/secondary amines and amine-like compounds in real-world sample matrices. As an illustrative example, amphetamine spiked in urine has been derivatized off-line and on-line, with minimum sample preparation, and detected via HPLC-UV/FL with acceptable accuracy and precision.

Antepartum diagnosis and management of idiopathic pericardial and pleural effusion: report of one case

A case of an antenatal ultrasound diagnosis of pericardial effusion with pleural effusion is reported. Fetal pericardiocentesis, thoracentesis and amniocentesis were performed with real-time ultrasound guidance at 37 weeks of gestation. Laboratory investigations reported a rhesus-positive blood group, no atypical antibodies, negative serologic test for syphilis, and negative titers for toxoplasmosis. The laboratory data of the pericardial effusion showed: glucose 71 mg/dl, protein 3.7 gm/dl, LDH 73 U/L, CPK 53 U/L, negative culture for virus and bacteria. The pregnancy was terminated at 37 weeks of gestation by Cesarean section because of an edematously enlarged thorax. A 3540 gm male infant was delivered in a state of asphyxia with general cyanosis and an Apgar score of 3 and 4 at one and five minutes, respectively. His condition improved after endotracheal intubation and assisted ventilation. He was transported to the neonate intensive care unit, where chest roentgenogram confirmed pleural effusion over the left side. Chest tube was placed for 7 days. The infant was discharged on day 8, but the fluid reaccumulation over the left lung four months later. Chest tube was placed for five days. The infant subsequently has thrived with appropriated development for his age. We report herein because of successful technique of antepartal intervention.

[Child abuse: report of three cases]

Child abuse, a clinical condition in young children who have received serious physical abuse, is a frequent cause of permanent injury or death. The first case is a 7-year-old boy suffering from abdominal distension and pain for 3 days. He was beaten by his mother as a result of inadequately learning his lessons. Sonogram and CT of the abdomen showed massive ascites and a pseudocyst of the pancreatic body about 3 x 3 cm in diameter. The second case is a 4-year-old girl who developed a semicomatose state after her father impulsively struck her with a chair. CT of the brain revealed subdural hematoma over the left fronto-temporal region and midline shift to the right. She expired 5 days later. The third case, a 2-year-old girl, suffered from headache, seizure, vomiting and general malaise. CT of the brain showed severe brain swelling over the right side and midline shift to the left. She expired 1 month later. Psychiatric factors are probably of prime importance in the pathogenesis of the disorder, but our knowledge of these factors is limited. Parents who inflict abuse on children do not necessarily have psychopathic or sociopathic personalities or come from borderline socioeconomic groups, although most published cases fall into one of these categories. It is clearly the responsibility of all physicians serving children to be aware of, to recognize, and to properly manage any child who has been the victim of abuse.

Polymeric benzotriazole reagent for the off-line high-performance liquid chromatographic derivatization of polyamines and related nucleophiles in biological fluids

A polymeric benzotriazole reagent containing a 9-fluorenylmethyleneoxycarbonyl (FMOC) group has been synthesized, characterized, and its derivatizations, off-line, for three polyamines, have been optimized with regard to solvent, time, and temperature. An authentic FMOC derivative of cadaverine has been prepared, characterized, and used as the external standard for quantitation of off-line derivatizations and identification of final derivatives. Actual percent derivatizations have been determined, rather than just percent disappearance of starting material. The polyamines in urine or other biological fluids can be derivatized without organic solvent or solid phase extraction, but rather in situ by the simple addition of the polymeric reagent to the fluid, incubation for a few minutes at room or elevated temperature, filtration and direct injection. Derivatizations could also be performed by transferring a small volume of the hydrolyzed and filtered biological fluid to a disposable pipette containing the polymeric reagent. Derivatization was then followed by elution, filtration, and direct injection onto the high-performance liquid chromatographic (HPLC) system. Automation of the overall polymeric derivatization, filtration, HPLC injection, separation, detection, quantitation, and data acquisition-interpretation is suggested. The polymeric reagent has been utilized for the qualitative and quantitative determination of cadaverine and putrescine, normally occurring polyamines, in human urine. These levels were compared with the corresponding literature values for healthy human subjects, and the values were found to be in excellent agreement. This novel derivatization approach, though off-line, provides for a much simpler, more rapid, and more efficient conversion of these and related polyamines or nucleophiles to derivatives having vastly improved chromatographic detection properties in HPLC. The final derivatives contain the FMOC group, making them extremely chromophoric and fluorophoric, and providing trace detection at ppb (microgram/l) and sub-ppb levels. The overall approach is recommended for these and other biologically occurring polyamines, in fluids and tissues, as well as related bioorganic and biologically active nucleophiles, including drugs and their metabolites.

New polymeric benzotriazole reagents for off-line derivatizations of amines and polyamines in HPLC

New polymeric reagents are synthesized, based on a polystyrene-bound benzotriazole containing an o-acetylsalicyl or 9-fluorenyl labelling moiety. This is used in an off-line mode, prior to high performance liquid chromatography (HPLC), for derivatizations of trace primary and secondary amines, polyamines, and related compounds in connection with HPLC. Standards are prepared, characterized by physical and spectral properties, and then used as external standards to determine percent derivatizations. The polymeric reagents are characterized by elemental analyses and loading determinations. The feasibility and applicability of this reagent for derivatization of nucleophiles is confirmed with a number of amines under optimized conditions. The activated labelling moiety, bonded to the polymeric support, makes the derivatization reactions extremely rapid and efficient under mild reaction conditions. This alone provides significant advantages over the analogous solution derivatizations for the same amines. A comparison of solution and solid phase derivatization reactions is reported. The limits of detection are 1 to 2 pmol for polyamines, such as cadaverine, putrescine, and 1,7-diaminoheptane, using the benzotriazole fluorenyl reagent followed by fluorescence detection.

Replacement of aromatic fluorine by a methoxy group during reaction with methyl iodide in N,N-dimethylformamide solvent

The DNA base uracil was derivatized with pentafluorobenzoyl chloride, followed by methylation with methyl iodide in the presence of N,N-dimethylformamide (DMF). In addition to a 3-pentafluorobenzoyl-1-methyl derivative of uracil, GC/MS analysis of the reaction mixture revealed the formation of an unusual product, whose molecular weight was 12 U higher than that of the prior derivative. This unexpected product has been identified as the 3-(para-methoxytetrafluorobenzoyl)-1-methyl derivative of uracil. Isotopic labeling and related experiments have revealed that the DMF solvent contributes the oxygen atom of the methoxy group that replaces the para fluorine atom. This work allowed a single derivative to be obtained for the methylation reaction by changing the solvent to acetonitrile.

A therapeutic trial of bezafibrate on patients with hyperlipidemia with or without diabetes mellitus

Bezalip (bezafibrate), at an oral dosage of 200 mg three times a day, has been used on 12 patients with idiopathic hyperlipidemia, and on 12 patients with hyperlipidemia superimposed with diabetes mellitus. Each patient received bezafibrate for 3 months and placebo for 3 months. Blood glycosylated hemoglobin (HbA1) and fasting plasma glucose (FPG) were used as indices of diabetic control. Serum triglyceride (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), and TC/HDL-C ratio were measured and calculated in order to compare the antilipemic effects of bezafibrate with that of placebo. Non-parametric Wilcoxon test was used for statistical analysis. In both the idiopathic group and diabetic group, bezafibrate significantly lowered the serum levels of TG and TC/HDL-C, as well as elevated the level of HDL-C. The serum TC levels were not significantly altered in either of the groups. These effects could not be ascribed to an improved diabetic control, since the percent changes of HbA1 were not different between the bezafibrate periods and the placebo periods. There were no significant facial flushing, nor other side effects during the treatment with bezafibrate. It is concluded that bezafibrate has antilipemic effects, and may be helpful in reducing the atherogenic risks.