Ingestion of false hellebore plants can cross-react with a digoxin clinical chemistry assay.

INTRODUCTION: We report a case of digoxin-like toxicity because of ingestion of foraged plants. This patient presented with nausea, vomiting, bradycardia, and hypotension after ingesting Veratrum viride (false hellebore). The patient's serum specimen demonstrated a positive digoxin level (0.38 ng/mL) measured by a clinical tubidimetric immunoassay. We hypothesize that steroidal alkaloid compounds contained in V. viride cross-react with the Multigent Digoxin immunoassay reagent antibodies. RESULTS: Plant extracts from V. viride demonstrated cross-reactivity to Multigent reagent antibodies but did not bind therapeutic DigiFab antibodies. Gas chromatography/mass spectrometry analyses identified several steroidal alkaloid compounds present in the V. viride extracts: jervine, ribigirvine, solanidine, and veratraman. CONCLUSIONS: This study indicates that compounds extracted from V. viride can cross-react with a clinical Digoxin immunoassay. Yet these extracts did not bind DigiFab antibody fragments used for therapeutic intervention. Providers should not unnecessarily administer DigiFab fragments as an antidote in symptomatic V. viride toxic patients.

Foliar phenolics in sugar maple (Acer saccharum) as a potential indicator of tropospheric ozone pollution.

Tropospheric O3 has been implicated in the declining health of forest ecosystems in Europe and North America and has been shown to have negative consequences on human health. We have measured tropospheric ozone (O3) in the lower canopy through the use of passive monitors located in five woodlots along a 150 km urban-rural transect, originating in the large urban complex of Toronto, Canada. We also sampled foliage from 10 mature sugar maple trees in each woodlot and measured the concentration of a number of phenolic compounds and macronutrients. O3 concentrations were highest in the two rural woodlots, located approximately 150 km downwind of Toronto, when compared to the woodlots found within the Greater Toronto Area. Foliar concentrations of three flavonoids, avicularin, isoquercitrin, and quercitrin, were significantly greater and nitrogen concentrations significantly lower at these same rural woodlots, suggesting some physiological disruption is occurring in those sites where exposure to tropospheric O3 is greater. We suggest that foliar phenolics of sugar maple may be a biochemical indicator of tropospheric ozone exposure.

Estrogenic potency of chemicals detected in sewage treatment plant effluents as determined by in vivo assays with Japanese medaka (Oryzias latipes).

Gonadal intersex and high prevalences of the female phenotype have been observed in fish populations in urbanized areas. Environmental estrogens discharged in sewage treatment plant effluents may be responsible for feminization of fish but many compounds with the potential to induce these responses occur in effluents, including natural and synthetic estrogen hormones, degradation products of alkylphenol ethoxylate surfactants, and plasticizers. In this study, the estrogen hormones 17 alpha-ethinylestradiol, 17 beta-estradiol, estrone, and estriol induced intersex (i.e., testis-ova) and altered sex in Japanese medaka (Oryzias latipes) when these fish were exposed to nanogram per liter concentrations of test compounds from hatch to approximately 100 d after hatch. A mix of nonylphenol mono- and diethoxylate induced a weak response and a mix of nonylphenol mono- and diethoxycarboxylate did not give a response in this assay at microgram per liter concentrations, indicating that these degradation products of nonylphenol ethoxylates have little or no estrogenic activity in fish. Bisphenol A induced testis-ova in medaka exposed to a concentration of 10 micrograms/L, but diethylhexyl phthalate did not induce a response. Results with the medaka assay were consistent with estrogenic responses in the yeast estrogen screening assay. Analyses of monitoring data reported in the literature indicate that concentrations of estrogen hormones detected in the final effluents of sewage treatment plants are generally greater than the lowest-observed-effect levels for alterations to gonadal development in medaka.

Electrospray ionization tandem mass spectrometric study of salt cluster ions. Part 1--investigations of alkali metal chloride and sodium salt cluster ions.

Salt cluster ions of alkali metal chlorides ACl (A = Li(+), Na(+), K(+), Rb(+) and Cs(+)) and sodium salts NaB (B = I(-), HCOO(-), CH(3)COO(-), NO(2)(-), and NO(3)(-)), formed by electrospray ionization, were studied systematically by mass spectrometry. The influences on the total positive ion and negative ion currents of variation of solvent, solution concentration, desolvation temperature, solution flow-rate, capillary voltage and cone voltage were investigated. Only cone voltage was found to influence dramatically the distribution of salt cluster ions in the mass spectra observed. Under conditions of normal cone voltage of approximately 70 V, cluster ions having magic numbers of molecules are detected with high relative signal intensity. Under conditions of low cone voltage of approximately 10 V, the distribution of cluster ions detected is characterized by a relatively low average mass/charge ratio due to the presence of multiply charged cluster ions; in addition, there is a marked reduction in cluster ions having a magic number of molecules. Product ion mass spectra obtained by tandem mass spectrometry of cluster ions are characterized by a base peak having a magic number of molecules that is less than and closest to the number of molecules in the precursor ion. Structures have been proposed for some dications and some quadruply charged ions. At pH 3 and 11, the mass spectra of NaCl clusters show the presence of mixed clusters of NaCl with HCl and NaOH, respectively. The effects of ionic radius on 20 distributions of cluster ions for 10 salts were investigated; however, the fine structure of these effects is not readily discerned.

Observation of Na(+)-bound oligomers of quercetin in the gas phase.

While developing a liquid chromatography/tandem mass spectrometry method for the analysis of the flavonoid quercitin, it was observed that quercetin (3,3',4',5,7-pentahydroxyflavone) exhibited clustering in both the positive and negative ion mode. Two series of positive ion clusters were observed; the first series corresponds to singly charged [2M + Na](+) at m/z 627.2 to [13M + Na](+) at m/z 3947.5, while the second series corresponds to doubly charged [7M + 2Na](2+) at m/z 1080.4 to [25M + 2Na](2+) at m/z 3798.5. In the negative ion mode, the behavior of quercetin parallels that of apigenin (4',5,7-trihydroxyflavone) in that [M + NO(3)](-), [2M + NO(3)](-), and [3M + NO(3)](-) were observed at m/z 364.1, 666.0, and 968.9, respectively; in addition, quercitin clusters with chloride ions ([2M + Cl](-) at m/z 638.9 and [3M + Cl](-) at m/z 940. 9) were observed. The results of tandem mass spectrometric examination of several cluster ions are reported.

Mass spectrometric study of persistent acid metabolites of nonylphenol ethoxylate surfactants.

A mass spectrometric study was carried out on two nonylphenoxycarboxylic acids, NP1EC and NP2EC (where 1 and 2 indicate the number of ethoxylate units attached to the nonylphenoxy moiety), that are persistent metabolites of widely used nonionic surfactant nonylphenol ethoxylates. In a gas chromatographic/mass spectrometric (GC/MS) study of the methyl esters of NP1EC and NP2EC, two series of fragment ions were observed in electron ionization (EI) mass spectra; m/z (179 + 14n, n = 0-7) and m/z (105 + 14n, n = 0-4) for NP1ECMe and m/z (223 + 14n, n = 0-7) and m/z (107 + 14n, n = 0-5) for NP2ECMe. Similarity indices were used to compare quantitatively the mass spectra of isomers. The mass spectra of two isomers were found to be similar whereas those of the remaining isomers were readily distinguishable from each other. The abundant fragment ions of the two NPECMes were investigated further by GC/MS/MS; product ions resulting from cleavage in the alkyl moiety, cleavage in the ECMe moiety and cleavage in both moieties were detected. Possible structures of the nonyl groups in the two esters were inferred. GC/chemical ionization (CI) mass spectra of the NPECMes with isobutane as reagent gas showed characteristic hydride ion-abstracted fragment ions shifted by 1 Da from those in the corresponding EI mass spectra. The sensitivity of a selected ion monitoring quantitation method for the NPECMes is enhanced under CI conditions compared with that under EI conditions. With electrospray ionization MS/MS, [M - H](-) ions of NP1EC (m/z 277) and NP2EC (m/z 321) were observed and, upon collision-induced dissociation of [M - H](-) of each of the two acids, fragment ions of m/z 219 corresponding to deprotonated nonylphenol, were observed in each case. Based on this observation, a rapid, simple and reliable selected product ion quantitation method is proposed for NP1EC and NP2EC.

Mass spectrometry applied to the analysis of estrogens in the environment.

Environmental analytical chemistry has recently changed focus from analysis of non-polar, persistent contaminants (e.g. polychlorinated biphenyls and dioxins) to more polar and labile compounds that interfere with biological processes. For example, natural and synthetic estrogens and their metabolites have been detected in sewage treatment plant effluents at nanogram/liter concentrations that are similar to those at which both total sex reversal and intersex (containing both testes and ova) is induced in fish exposed to these compounds in laboratory experiments. The development of techniques for the analysis of natural and synthetic estrogens in biological fluids (i.e. serum and urine) has been a priority in the biomedical field. However, the recent recognition that estrogen hormones are contaminants in the environment that may contribute to endocrine disruption has focused attention on the need for highly sensitive and specific techniques that are applicable for trace analysis in complex environmental matrices. Three optimized mass spectrometric protocols have been developed for the determination and quantitation of steroid hormones in environmental matrices using gas chromatography/tandem mass spectrometry (GC/MS/MS), liquid chromatography/mass spectrometry selected ion monitoring, (LC/MS - SIM) and liquid chromatography/tandem mass spectrometry (LC/MS/MS). The advantages and disadvantages of each method are presented.

Simulation of ion trajectories in a quadrupole ion trap: a comparison of three simulation programs

An attempt has been made to compare the performance, design and operation of three simulators, ISIS, ITSIM and SIMION-3D, when applied to the calculation of ion trajectories in a quadrupole ion trap. For the simulation of the trajectory of a single ion in a collision-free system, the calculated spatial trajectory components, kinetic energies and secular frequencies from the three simulators were virtually identical. It is concluded that, despite the various approaches to electrode design, calculation of fields, integration methods and ion generation tactics, there is a remarkable degree of consistency among the products of the simulators when dealing with collision-free conditions. The results of the ion injection simulations under collisional conditions were indicative of the complexity that can be introduced into the simulations with little effort. Random effects such as collisions of ions with He buffer gas and accumulated calculation errors together with the different collision model settings and the different approaches to field calculation are thought to have contributed to the somewhat minor differences in trapping efficiency. SIMION is the simulator of choice for the simulation of ion trajectories in hybrid instruments and in custom-designed assemblies of electrodes; and ITSIM would appear to be the best choice on the basis of computational speed for running multiparticle simulations and user friendliness. Both ISIS and ITSIM are adept at providing detailed information of collision events. Copyright 1999 John Wiley & Sons, Ltd.

The relationship of rectus muscles to the globe: a study with coronal CT scanning.

Coronal computerized tomographic scans of 25 patients were reviewed in order to determine the normal relationship of rectus muscles to the globe. Using a horizontal reference line constructed along the anterior cranial fossa, the mean horizontal rectus muscle axis was found to be slightly excyclotorted in both eyes, and the mean vertical rectus muscle axis slightly incyclotorted in both eyes. In addition, the mean superior temporal quadrant angle formed by the intersection of the horizontal and vertical rectus muscle axis was significantly greater than the mean superior nasal quadrant angle in the same eye. The presence of large anatomical variations in individual patients may make it difficult to implicate rectus muscle malposition as an important etiology of A- and V-pattern strabismus.

Training consultation to the cairo family planning association, egypt.

A case history of the consultation process between the Cairo Family Planning Association in Egypt and a Ford Foundation short-term health education and training consultant. The viewpoint is that of the consultant and the then resident Ford population and family planning program advisor. Gordon and Ronald Lippitt's six phases of the consulting process are used as a framework for presentation.

Epithelial changes in the oral mucosa resulting from a variation in hormone stimulus.

PIP: The relative influence of progesterone and estrogen on oral mucosal development was investigated and increased estrogen levels were associated with maturation and keratinization or oral mucosa while high levels of progesterone were associated with retarded maturation. The relationships were significant at the 0.05 level. The study population consisted of 360 women who had normal estrous cycles and who were either patients or students at a local dental clinic. For each woman, a questionnaire was used to obtain information in regard to age, contraceptive use, hormone therapy, and menstrual history and scrappings were made of the buccal gingiva at the second premolar and the buccal mucosa at Stenson's papilla. Using the questionnaire information, each woman was assigned to 1 of 5 groups on the basis of hormone status. The groups were 1) women using oral contraceptives with a high progesterone component; 2) postmenopausal women being treated with estrogen; 3) postmenopausal women not receiving hormones; 4) women who were sampled during the 11-18 day of their menstrual cycle when estrogen influences prevail; and 5) women who were sampled during the days 1-10 or 19-28 of their cycle when progesterone influences prevail. The smears were then examined cytologically by a certified diagnostic cytologist who was aware of the patient's medical history. A consistent pattern was found in the buccal smears; the smears of those patients with high estrogen levels exhibited an increased number of superficial and keritanized epithelial cells, while those with higher progesterone levels exhibited an increase in the number of intermediate epithelial cells and a decrease in the number of keritanized cells. Tables comparing the 5 groups using the one-way test of variance and photographs of smears displaying cell maturation and lack of complete cell maturation are included.^ieng

Distributions of spike bursts in cat duodenum.

The histograms of spike bursts over short distances were examined in the isolated cat duodenum with multiple electrodes arranged circumferentially and longitudinally. At a single cross section of the duodenum, spike bursts occurred simultaneously in any single slow-wave cycle, but all eight monitored sites in the circumference participated simulatenously only in a bout 25% of the spike-burst cycles. There also were wide variations in the incidence of spike bursts at different locations in a planar cross section. In a longitudinal section, net level of activity over short distances varied widely. Also, spike bursts were out of phase in the longitudinal axis, appearing to spread caudad; 80% of spike burst groups involved less than an average of 5.5 consecutive electrode sites (spaced at 5-mm intervals). Since spike bursts seem to be correlated with ring contractions of the circular muscle, the fact that they appear sequentially in time along the duodenum indicates that such contractions must always be peristaltic. An estimated 80% of such contractions sweep less than about 3 cm. Records of spike bursts from a single electrode do not accurately reflect activity beyond that one point site.

Neurokinetics of lidocaine in the infraorbital nerve of the rat in vivo: Relation to sensory block.

The kinetics of neural uptake and efflux of lidocaine hydrochloride were studies by means of a standardized technique for blocking the intraorbital nerve of the rat, using a palatal jig. Following injection of 14-C-labeled local anesthetic, groups of ten animals were saccraficed at incipient recovery from sensory block or at othertimes. The nerves were weighed and assayed for radioactivity. The lengths of nerve containing high levels of lidocaine varied inversely with the times elapsed since onset of block. In experiments where a fixed quantity (2 mg) drug was injected, the incidence of block 2 hours later was concentrated-dependent, occuring in 80 per cent of animals after 2 per cent, in 40 per cent after 1 per cent, and in none after 0.5 per cent lidocaine. Epinephrine, 1:200,000, prolonged by 80 per cent the block effected with 0.2 ml of 1 per cent lidocaine. At the onset of recovery the neural contents of lidocaine at the sites of injection were 484 plus or minus 404 ng/mg of nerve in epinephrine-treated nerves, and 274 plus or minus 218 ng/mg in nonepinephrine-treated nerved (N.S., P greater than 0.05). Quantitative comparisons of in-vivo effectiveness of local anesthetic solutions can be made with this technique.