Clinical evaluation of the effects of direct hemoperfusion on amino acid profiles.

We observed significant changes in serial aminograms during direct hemoperfusion (DHP) in clinical cases and decided to evaluate the effects of the procedure on amino acid profiles. DHP at 100 ml/min was carried out for 6 h in patients with drug intoxications. Pre- and post-column aminograms were obtained 0.5, 1, 2, 3, 4, 5 and 6 h from the beginning of DHP. Nonmolecular-weight-dependent adsorption of some amino acids to the column was observed. Methionine (MET), isoleucine (ILE), leucine (LEU), tyrosine (TYR), phenylalanine (PHE) and arginine (ARG) had high adsorption rates. Blood concentrations of TRY, PHE, TRY and histidine (HIS) were significantly reduced. Although both branched-chain amino acids (BCAA) and aromatic amino acids (AAA) were initially adsorbed by the column, AAA recovery was slow.

A fatal case of acute boric acid poisoning.

A 77 year-old male mistakenly ingested an estimated 30 g of boric acid as a single oral dose to stop hiccups. On admission, he had vomiting, diarrhea, and hiccups. Laboratory data was diagnostic of acute renal failure. Hemodialysis and charcoal hemoperfusion were performed in series. The serum concentration of boric acid was reduced by the therapy, but the patient died due to cardiac insufficiency. Acute boric acid poisoning resulting from a single oral dose in adults has rarely been reported. Our case is the fourth fatal case in adults since the 1920s following a single, acute ingestion of boric acid.

[A study of comparison between Technicon THMS H-2 and Hematrak 590].

Using 655 peripheral blood samples from normal individuals and patients, we evaluated the relationship between the measurements of red blood cell (RBC) and white blood cell (WBC) through the Hematrak 590 (Hematrak) and the generated flag systems in the Technicon H-2 (H-2). 1) Among the 12 VAR (Variation) flag positive samples in H-2, 10 samples were obtained from the patients receiving blood transfusions. The samples with high values of HDW (Hemoglobin distribution width) in H-2 seemed to have hypochromatic and polychromatic changes in RBC. 2) Hematrak is likely to be more sensitive than H-2 in discovering atypical lymphocytes (AL). When AL counts in Hematrak were over 5 or 6% of WBC, these results were coincident with ATYP flag positive in H-2. 3) In our examinations, when %Blast in H-2 was over 4%, BLASTS flag always generated positively. We think that H-2 is a tool with high reproducibility for the detection of the blast-like abnormal cells. 4) We evaluated the results of WBC differential count by the three methods of H-2, Hematrak and manual procedures in the peripheral blood samples from normal individuals. We recognized close correlations in neutrophils, lymphocytes and eosinophils (coefficients of correlation = 0.826-0.911), and relatively close ones in monocytes (r = 0.280-0.562), but no correlations in basophils (r = 0.106-0.281). To comprehend the pathophysiological states of the various diseases hematologically, it is necessary to understand the characteristics of the different measurement principles between the two instruments (H-2 and Hematrak).

Clinical studies on elevation of serum CPK activity in patients with drug intoxication.

Elevation of serum creatine phosphokinase (CPK), known to occur in only cerebral, cardiac and muscular diseases, was encountered in 34 patients with drug intoxication. The mechanism of hyper-CPKemia in drug intoxication was examined by determining the correlations between CPK variations and underlying factors. Liver function, WBC, serum total protein, albumin and blood sugar indicated correlations with serum CPK. It seemed that increased blood sugar, decreased protein, decreased albumin and increased WBC were associated with hyper-CPKemia and reflected severe acute stress to the nervous, endocrine and metabolic systems collapsing the systemic physiological homeostasis.