Clinical chemistry
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Letter Case Reports
Accidental poisoning of two laboratory technologists with sodium nitrite.
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We used an automated four-wavelength spectrometer to measure the concentration of total hemoglobin, percent oxyhemoglobin, carboxyhemoglobin, and methemoglobin, and concentration of oxygen bound to hemoglobin in the blood of humans, dogs, and baboons under clinical and various experimental conditions. Measurements of total hemoglobin and methemoglobin with this simple method were comparable to those with standard spectrometric procedures. ⋯ The new instrument is as accurate as the comparison methods used to evaluate it in all parameters, is reliable, and measurements take only 63 s per sample. In addition, it requires minimal operator training, infrequent need for calibration, and no sample preparation.
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Comparative Study
Liquid-chromatographic determination of norepinephrine and epinephrine in human plasma.
We describe a "high-performance" liquid-chromatographic method for measuring picogram amounts of norepinephrine and epinephrine simultaneously in human plasma. Alumina-treated samples are injected onto a strong cation-exchange column (Zipax SCX) for the separation of catecholamines, with a sodium phosphate buffer/acetonitrile mixture as mobile phase. The separated catecholamines then enter a continuous-flow system and the reagents for the trihydroxyindole reaction are added sequentially; the fluorescent products are then measured with a spectrofluorophotometer. ⋯ For catecholamines in human plasma, within-run and day-to-day CV's were 0.2% and 1.0%, respectively, for norepinephrine, and 0.3% and 0.9%, respectively, for epinephrine. Average values for norepinephrine and epinephrine in apparently normal human plasma were 185 +/- 29 ng/L and 32 +/- 8 ng/L, respectively (mean +/- SEM, n = 10). This relatively rapid and highly sensitive system is suitable for routine use.
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This paper describes separate spectrophotometric procedures for rapidly measuring carboxyhemoglobin (COHb) and methemoglobin (MetHb) in blood. Absorbance measurements are made in the Soret region at a blood dilution near 1000-fold. For COHb estimation, the diluent contains sodium hydrosulfite, providing the two-component system COHb--Hb for absorbance measurements at 420 and 432 nm. ⋯ Absorbance measurements are made at 420 nm, before and after addiely analyzed for the total of all MetHb forms present. Each procedure requires about 3 muL of blood and can be applied to human or animal blood. Results obtained by the present methods are in satisfactory agreement with currently accepted procedures, which require much larger samples or more elaborate equipment.
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In a group of 50 neurosurgical patients receiving sodium nitroprusside as a hypotensive agent, in doses of 50--2131 microgram/kg body weight, whole blood cyanide was estimated before infusion of drug, during infusion, immediately after infusion, and 1 and 3 h later. Cyanide values increased significantly, reaching the maximum in a sample taken immediately after infusion (mean value, 333; highest value, 1800 microgram/liter). ⋯ In any case, no signs or symptoms of cyanide or thiocyanate poisoning were observed. We conclude that sodium nitroprusside, in the proper dose and given at the proper rate, does not precipitate cyanide poisoning.