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1.
Burns ; 36(8): 1271-6, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20547000

ABSTRACT

Urinary output, a key parameter guiding fluid resuscitation in burn trauma, is an inadequate measure of renal function. In this study, the clearance of iohexol (CL) was used to follow the glomerular filtration rate during the first week after burn. Nineteen adults with major burns received an intravenous bolus injection of iohexol every other day. Plasma concentration of iohexol was measured over 4h and CL was calculated by a one-compartment kinetic model. The results were compared to the CL as obtained by a two-compartment model and also to the CL measured in 10 healthy controls. The results show that CL values for burn patients were high. The first day after burn, median CL was 155 mL/min/1.73 m(2) (range 46-237), which exceeded that for the controls (mean 117 mL/min/1.73 m(2); P<0.01). However, on day 7 the CL approached the expected baseline (mean 122 mL/min/1.73 m(2)). CL was 10% lower when calculated from two-compartment kinetics, and a correction factor of 0.9 was applied to all results obtained by the one-compartment calculations to give results comparable to those from the two-compartment kinetics. In conclusion, CL is increased early after burn. The mechanism is unclear but it parallels the period of vascular dysfunction and increased cardiac output.


Subject(s)
Burns/physiopathology , Contrast Media/pharmacokinetics , Glomerular Filtration Rate/physiology , Iohexol/pharmacokinetics , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Metabolic Clearance Rate , Middle Aged , Renal Insufficiency/diagnosis , Young Adult
2.
Oncogene ; 27(20): 2910-22, 2008 May 01.
Article in English | MEDLINE | ID: mdl-18026138

ABSTRACT

Mammalian target of rapamycin (mTOR) has been shown to play an important function in cell proliferation, metabolism and tumorigenesis, and proteins that regulate signaling through mTOR are frequently altered in human cancers. In this study we investigated the phosphorylation status of key proteins in the PI3K/AKT/mTOR pathway and the effects of the mTOR inhibitors rapamycin and CCI-779 on neuroblastoma tumorigenesis. Significant expression of activated AKT and mTOR were detected in all primary neuroblastoma tissue samples investigated, but not in non-malignant adrenal medullas. mTOR inhibitors showed antiproliferative effects on neuroblastoma cells in vitro. Neuroblastoma cell lines expressing high levels of MYCN were significantly more sensitive to mTOR inhibitors compared to cell lines expressing low MYCN levels. Established neuroblastoma tumors treated with mTOR inhibitors in vivo showed increased apoptosis, decreased proliferation and inhibition of angiogenesis. Importantly, mTOR inhibitors induced downregulation of vascular endothelial growth factor A (VEGF-A) secretion, cyclin D1 and MYCN protein expression in vitro and in vivo. Our data suggest that mTOR inhibitors have therapeutic efficacy on aggressive MYCN amplified neuroblastomas.


Subject(s)
Antibiotics, Antineoplastic/pharmacology , Down-Regulation/drug effects , Growth Inhibitors/pharmacology , Neuroblastoma/pathology , Nuclear Proteins/antagonists & inhibitors , Nuclear Proteins/genetics , Oncogene Proteins/antagonists & inhibitors , Oncogene Proteins/genetics , Protein Kinases/metabolism , Animals , Cell Line, Tumor , Cell Proliferation/drug effects , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Mice , Mice, Nude , N-Myc Proto-Oncogene Protein , Neuroblastoma/drug therapy , Neuroblastoma/metabolism , Nuclear Proteins/biosynthesis , Oncogene Proteins/biosynthesis , Phosphatidylinositol 3-Kinases/physiology , Protein Kinases/biosynthesis , Protein Kinases/genetics , Proto-Oncogene Proteins c-akt/biosynthesis , Proto-Oncogene Proteins c-akt/genetics , Proto-Oncogene Proteins c-akt/physiology , Signal Transduction/drug effects , Signal Transduction/genetics , Sirolimus/pharmacology , TOR Serine-Threonine Kinases
3.
Scand J Clin Lab Invest ; 64(6): 559-64, 2004.
Article in English | MEDLINE | ID: mdl-15370461

ABSTRACT

5-S-L-Cysteinyl-L-dopa is a well-known pigment intermediate and analysis of its serum concentration is well suited for evaluation of treatment and follow-up of stage III and IV malignant melanoma. A simplified analytical method is described using organic extraction followed by clean-up on a boronate gel to capture the compound containing vicinal hydroxyls. Weak acid solution elutes the 5-S-cysteinyldopa suitable for high-performance liquid chromatography (HPLC). The absolute recoveries of cysteinyldopa and its diastereomer 5-S-D-cysteinyl-L-dopa (used as an internal standard) were 81.5 +/- 2.8% and 81.3 +/- 2.7%, respectively, and use of the internal standard for the whole procedure gave an analytical recovery of 101 +/- 0.8%. The limit of quantitation was 1.5 nmol/L and the imprecision of the method was < 5.0% over the analytical range 1.5-500 nmol/L. The method is cheap and easy to perform and compares well with other described techniques. The use of the method is illustrated by results obtained during treatment of a patient with metastatic malignant melanoma.


Subject(s)
Chemistry, Clinical/methods , Cysteinyldopa/blood , Aged , Chromatography, High Pressure Liquid , Humans , Melanoma/blood , Melanoma/secondary , Reproducibility of Results , Skin Neoplasms/blood , Skin Neoplasms/pathology
4.
Scand Cardiovasc J ; 37(5): 283-7, 2003 Sep.
Article in English | MEDLINE | ID: mdl-14534070

ABSTRACT

OBJECTIVE: Biochemical markers of myocardial injury are frequently elevated after cardiac surgery. It is generally accepted that release unrelated to permanent myocardial damage explains a proportion of these elevations. However, little is known about the magnitude and temporal characteristics of this diagnostic noise. One way to address this issue would be to study a group without permanent myocardial injury. DESIGN: The unique release kinetics of troponin-T (permanent myocardial injury causes a sustained release of structurally bound troponin) were used to identify patients with no or minimal permanent myocardial injury. Blood was sampled from patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) before surgery, 3 and 8 h after unclamping the aorta, and each morning until postoperative day 4, for analysis of enzymes and troponin-T. From 302 consecutive patients a subgroup was identified that fulfilled the following criteria: (a) normalized troponin-T levels < or = postoperative day 4; (b) no ECG changes indicating myocardial injury. RESULTS: Seventy-seven patients fulfilled the criteria above and in this subgroup troponin-T (2.08 +/- 1.42 microg/l; range 0.35-8.99 microg/l) peaked at the 3 h recording and creatine kinase monobasic (CK-MB) (28.6 +/- 11.3 microg/l; range 11.9-86.0 microg/l) peaked at the 8 h recording after unclamping the aorta. CONCLUSION: Substantial early elevations of plasma CK-MB and troponin-T occurred in patients with no or minimal permanent myocardial injury after CABG. Unspecific release was most pronounced during the timeframe that is usually studied to evaluate myocardial protective strategies or to compare revascularization procedures.


Subject(s)
Coronary Artery Bypass , Creatine Kinase/blood , Isoenzymes/blood , Troponin T/blood , Aged , Creatine Kinase, MB Form , Female , Humans , Male , Middle Aged , Postoperative Period
5.
Mult Scler ; 9(3): 239-45, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12814169

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate if multiple sclerosis (MS) is associated with vitamin B12 (cobalamin) deficiency. METHODS: We measured serum vitamin B12, plasma folate, serum methylmalonic acid (MMA), plasma homocysteine (tHcy) and also cerebrospinal fluid (CSF) MMA and tHcy in 72 patients with MS and 23 controls. RESULTS: The mean plasma tHcy level was significantly increased in MS patients (11.6 micromol/L) compared with controls (7.4 micromol/L) (P = 0.002). Seven patients showed low serum vitamin B12 levels but only one of them had concomitant high plasma tHcy. None of them showed high serum MMA. Plasma or blood folate levels did not differ between MS patients and controls. We found no significant differences in mean values or frequency of pathological tests of serum B12, serum MMA, mean corpuscular volume (MCV), haemoglobin concentration, CSF tHcy or CSF MMA between patients and healthy subjects. There were no correlations between CSF and serum/plasma levels of MMA or tHcy. Serum vitamin B12, serum MMA, plasma tHcy, CSF Hcy or CSF MMA were not correlated to disability status, activity of disease, duration of disease or age. CONCLUSIONS: The relevance of the increased mean value of plasma tHcy thus seems uncertain and does not indicate functional vitamin B12 deficiency. We can not, however, exclude the possibility of a genetically induced dysfunction of the homocysteine metabolism relevant for the development of neuroinflammation/degeneration. Our findings indicate that, regardless of a significant increase in plasma tHcy in MS patients, the MS disease is not generally associated with vitamin B12 deficiency since we did not find any other factors indicating vitamin B12 deficiency. Analysis of CSF MMA and CSF tHcy, which probably reflects the brain vitamin B12 status better than serum, are not warranted in MS. We conclude that B12 deficiency, in general, is not associated with MS.


Subject(s)
Homocysteine/blood , Multiple Sclerosis/blood , Vitamin B 12/blood , Adult , Aged , Aged, 80 and over , Female , Homocysteine/cerebrospinal fluid , Humans , Male , Methylmalonic Acid/blood , Methylmalonic Acid/cerebrospinal fluid , Middle Aged , Multiple Sclerosis/cerebrospinal fluid , Multiple Sclerosis/complications , Vitamin B 12 Deficiency/complications
6.
Melanoma Res ; 12(3): 193-200, 2002 Jun.
Article in English | MEDLINE | ID: mdl-12140375

ABSTRACT

The use of reverse transcription polymerase chain reaction (RT-PCR) analysis of melanoma-specific transcripts for the identification of circulating melanoma cells has shown very variable results in different studies on melanoma patients. We have therefore developed quantitative methods to study both analytical and biological variations as possible causes of this phenomenon. Pigment-related and S-100 beta transcripts were quantified in 12 different melanoma cell lines and related to the amounts of 5-S-cysteinyldopa, pigment and S-100B protein. A real-time PCR method was used and the results were expressed as absolute number of transcripts per cell. Tyrosinase, tyrosinase-related protein (TRP)-1, TRP-2 and MART-1/Melan-A mRNA varied from undetectable (< 10(-4) transcripts/cell) to 10(3) transcripts/cell, i.e. by a factor > 10(7) in the different cell lines. S-100 beta mRNA varied from 2.8 to 165 transcripts/cell, i.e. by a factor of 60. Tyrosinase, TRP-1 and TRP-2 mRNA correlated significantly with the amount of 5-S-cysteinyldopa, an intermediate pigment metabolite (P < 0.001, P < 0.001 and P < 0.01, respectively). The amount of S-100 beta mRNA correlated significantly with the amount of S-100B protein (P < 0.001). No cross-correlations were seen between the pigment-related and S-100-related analytes. We conclude that one reason behind the negative results of RT-PCR measurement of pigment-related mRNA may be that these transcripts are not always expressed in the particular cells present in the patient's blood. Furthermore, variation in the expression of the order of 10(7) must have great impact on the diagnostic sensitivity. Measurement of S-100 beta mRNA would be more sensitive, but the use of this transcript is hampered by its presence in the blood cells.


Subject(s)
Biomarkers, Tumor/analysis , Melanoma/pathology , Membrane Glycoproteins , Oxidoreductases , RNA, Messenger/analysis , RNA, Neoplasm/analysis , Tyrosine/analogs & derivatives , Antigens, Neoplasm , Gene Expression Profiling , Humans , Intramolecular Oxidoreductases/genetics , MART-1 Antigen , Melanins/analysis , Melanins/biosynthesis , Melanoma/blood , Melanoma/chemistry , Melanoma/genetics , Monophenol Monooxygenase/genetics , Neoplasm Proteins/genetics , Neoplastic Cells, Circulating , Nerve Growth Factors , Pigmentation , Polymerase Chain Reaction , Proteins/genetics , Pyrroles/analysis , S100 Calcium Binding Protein beta Subunit , S100 Proteins/analysis , S100 Proteins/genetics , Tumor Cells, Cultured/chemistry , Tyrosine/analysis
7.
Scand Cardiovasc J ; 36(1): 35-40, 2002 Feb.
Article in English | MEDLINE | ID: mdl-12018764

ABSTRACT

OBJECTIVE: ECG diagnosis of myocardial infarction after cardiac surgery is associated with major pitfalls and enzyme diagnosis is interfered by unspecific elevation unrelated to permanent myocardial injury. Sustained release of troponin-T is a marker of permanent myocardial injury if renal function is maintained. However, early identification of perioperative myocardial infarction is desirable and therefore the usefulness of creatine kinase monobasic (CK-MB) kinetics to detect myocardial injury early after coronary surgery was investigated. DESIGN: Two hundred and eighty-six patients undergoing coronary surgery were studied with respect to release of enzymes and troponin-T preoperatively and postoperatively 3 and 8 h after unclamping the aorta, and every morning postoperative days 1-4. RESULTS: CK-MB peak was found at 3 h (n = 145), 8 h (n = 103) and 16-20 h after unclamping (n = 38). Depending on when the CK-MB peak was recorded different demographic and perioperative characteristics were found. A sustained release of troponin-T was characteristic for the group with the CK-MB peak at 16-20 h after unclamping. CONCLUSION: If CK-MB is measured only once it may be advisable to do it on the first postoperative morning as these measurements provided the best discrimination between patients with and without sustained elevation of troponin-T. However, repeated sampling provides additional information that aids in the early identification of permanent myocardial injury particularly in patients with borderline elevations of CK-MB.


Subject(s)
Biomarkers/analysis , Coronary Artery Bypass/methods , Creatine Kinase/metabolism , Myocardial Infarction/pathology , Myocardial Infarction/surgery , Troponin T/metabolism , Aged , Cohort Studies , Coronary Artery Bypass/adverse effects , Creatine Kinase/analysis , Electrocardiography , Female , Humans , Macromolecular Substances , Male , Middle Aged , Monitoring, Intraoperative/methods , Myocardial Infarction/blood , Postoperative Period , Preoperative Care , Prospective Studies , Sensitivity and Specificity , Severity of Illness Index , Time Factors , Troponin T/analysis
8.
Melanoma Res ; 10(4): 363-9, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10985671

ABSTRACT

In a series of 92 patients with malignant melanoma, clinical stage III or IV, both 5-S-cysteinyldopa (5SCD) and 6-hydroxy-5-methoxyindole-2-carboxylic acid (6H5MI2C) were measured in urine during chemotherapy. A total of 434 urine specimens were analysed. The sensitivity of 5SCD for the detection of stage III-IV melanoma was 83%, while the corresponding sensitivity of 6H5MI2C was 52%. Fifty per cent of patients with one metastatic site had increased 5SCD excretion, while all patients with four or more metastatic sites had increased excretion. A significant correlation was found between 5SCD decrease and clinical regression (P<0.001) and between 5SCD increase and clinical progression (P<0.001). Corresponding correlations were not found for 6H5MI2C. Increments in 5SCD excretion (median 269 micromol/mol creatinine) were seen for 83% of the occasions when clinical progression was recorded, and decrements in 5SCD excretion (median 145 micromol/mol creatinine) were seen for 85% of the occasions when clinical regression was seen. During clinical 'stable disease' increases in 5SCD excretion were seen in 59% and decreases in 41%. The median value of 5SCD changes for stable disease was 7.0 micromol/mol creatinine, indicating a chemical marker stability in many cases. We recommend the use of 5SCD in urine as a valuable, reliable and simple biochemical marker to use in the clinical follow-up of melanoma patients with advanced disease.


Subject(s)
Biomarkers, Tumor/urine , Cysteinyldopa/urine , Melanoma/urine , Skin Neoplasms/urine , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Disease Progression , Female , Follow-Up Studies , Humans , Indoles/urine , Male , Melanoma/drug therapy , Melanoma/secondary , Middle Aged , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology
9.
Clin Chem ; 46(7): 921-7, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10894834

ABSTRACT

BACKGROUND: Tyrosinase is an enzyme unique to pigment-forming cells. Methods using this transcript for detection of melanoma cells in blood have given divergent results. Quantitative analytical procedures are therefore needed to study the analytical performance of the methods. METHODS: Mononucleated cells were isolated by Percoll centrifugation. RNA was isolated by each of three methods: Ultraspec(TM)-II RNA isolation system, FastRNA(TM) GREEN Kit, and QIAamp RNA Blood Mini Kit. cDNA was synthesized using random hexamer primers. A tyrosinase-specific product of 207 bp was amplified by PCR. As an internal standard (and competitor) we used a 207-bp cDNA with a base sequence identical to the tyrosinase target except for a 20-bp probe-binding region. The PCR products were identified by 2, 4-dinitrophenol (DNP)-labeled probes specific for tyrosinase (5'DNP-GGGGAGCCTTGGGGTTCTGG-3') and internal standard (5'DNP-CGGAGCCCCGAAACCACATC-3') and quantified by ELISA. RESULTS: The calibration curves were linear and had a broad dynamic measuring range. A detection limit (2 SD above zero) of 48 transcripts/mL of blood was obtained from a low control. The analytical imprecision was 50% and 48% at concentrations of 1775 and 17 929 transcripts/mL (n = 12 and 14, respectively). With the cell line SK-Mel 28 added to blood and RNA extracted with the Ultraspec, Fast RNA, and QIAamp RNA methods, we found (mean +/- SD) 1716+/-1341, 2670+/-3174, and 24 320+/-5332 transcripts/mL of blood. Corresponding values were 527+/-497, 2497+/-1033, 14 930+/-1927 transcripts/mL of blood when the cell line JKM86-4 was added. One high-risk patient was followed by repeated analysis of tyrosinase transcripts in blood. The melanoma marker 5-S-cysteinyldopa in serum and urine was within reference values, but tyrosinase mRNA was slightly increased (120-168 transcripts/mL of blood). The tyrosinase mRNA increased to 1860 transcripts/mL concomitant with the increase in 5-S-cysteinyldopa; later a spleen metastasis was found. CONCLUSIONS: The results obtained with different RNA extraction methods illustrate the importance of quantitative methods for validation of methods. The use of QIAamp RNA improved the extraction efficiency considerably. Data from a case study suggest the assay is suitable in the follow-up of patients with high risk of developing metastases.


Subject(s)
Monophenol Monooxygenase/genetics , Cell Line , Cysteinyldopa/blood , Cysteinyldopa/urine , Humans , Lymphatic Metastasis , Melanoma/blood , Melanoma/enzymology , Melanoma/pathology , Monophenol Monooxygenase/blood , Polymerase Chain Reaction , RNA, Messenger/blood , Reagent Kits, Diagnostic , Reproducibility of Results , Splenic Neoplasms/diagnosis , Splenic Neoplasms/secondary
10.
Melanoma Res ; 10(3): 213-22, 2000 Jun.
Article in English | MEDLINE | ID: mdl-10890374

ABSTRACT

Several studies have evaluated the use of polymerase chain reaction (PCR) amplification of tyrosinase mRNA to detect melanoma cells in blood. However, contradictory results have been obtained from different groups. We therefore have developed and validated a quantitative PCR method for tyrosinase and tyrosinase-related protein-2 (TRP-2) mRNA. An important methodological finding was that high concentrations of reverse transcriptase or RNA sample inhibited the following PCR. This could be abolished by dilution of the cDNA sample before the PCR. Standard curves with a linear range over at least five logs were obtained with dilutions of melanoma cell cDNA. Controls (RNA and cDNA) consisting of melanoma cells (1000/ml) added to blood were analysed repeatedly over 3 months, resulting in means between 880 and 1074 AU/ml. The RNA controls were stable, whereas the cDNA controls, as well as the calibrators, showed a tendency to change over time. The variation in the RNA controls was 25% for tyrosinase and 22% for TRP-2. Seven stage III-IV melanoma patients were tested for tyrosinase and TRP-2 transcripts in blood drawn from a peripheral vein and from a Port-a-cath. Tyrosinase mRNA was found in three patients (0.8-12.4 AU/ml). For TRP-2, the same amount was found in the patients as in healthy donors. No differences were seen between blood from a peripheral vein and from the Port-a-cath. We here present fast and sensitive methods for the quantification of tyrosinase and TRP-2 mRNA in blood.


Subject(s)
Intramolecular Oxidoreductases/genetics , Melanoma/enzymology , Monophenol Monooxygenase/genetics , Neoplasm Proteins/genetics , Neoplastic Cells, Circulating/metabolism , RNA, Messenger/blood , Skin Neoplasms/enzymology , Evaluation Studies as Topic , Humans , Melanoma/diagnosis , Neoplasm Staging , Quality Control , Reverse Transcriptase Polymerase Chain Reaction , S100 Proteins/genetics , Sensitivity and Specificity , Skin Neoplasms/diagnosis , Time Factors , Tumor Cells, Cultured
11.
Cancer Chemother Pharmacol ; 45(3): 192-8, 2000.
Article in English | MEDLINE | ID: mdl-10663636

ABSTRACT

PURPOSE: Glutathione is an important cellular compound which affects detoxification of electrophiles and may have direct or indirect effects on pigment formation. It is therefore of importance to study interstitial concentrations in melanoma tissue while decreasing its formation with an enzyme inhibitor and increasing its amount with cysteine deliverers. METHOD: Glutathione formation was inhibited by intraperitoneal (i.p.) injection of BSO. N-Acetylcysteine (NAC) and l-2-oxothiazolidine-4-carboxylate (OTC) were then given i.p. to subgroups of the animals. Intratumoral microdialysis was performed during BSO treatment, during BSO treatment combined with NAC or OTC and after discontinuation of BSO but ongoing NAC or OTC treatment. RESULTS: Glutathione formation was inhibited during BSO treatment. The dialysate concentrations of both glutathione and cysteine decreased during concomitant treatment with BSO and NAC or OTC. Recovery of the amounts of the two compounds was seen in both groups after discontinuation of BSO treatment. In the NAC group we also observed an acute increase in dialysate concentrations of cysteine after NAC injection. The 5-S-cysteinyldopa concentrations were unaffected by variations in glutathione and cysteine concentrations. CONCLUSIONS: 5-S-Cysteinyldopa in melanoma is not formed from glutathione in vivo to any appreciable extent. The intracellular amount of cysteine is probably not a limiting factor for cysteinyldopa formation. It seems that both NAC and OTC can be used as cysteine deliverers to melanoma cells in vivo to produce recovery of glutathione levels after synthesis inhibition by BSO treatment.


Subject(s)
Acetylcysteine/pharmacology , Cysteine/metabolism , Glutathione/metabolism , Melanoma/metabolism , Thiazoles/pharmacology , Acetylcysteine/metabolism , Animals , Buthionine Sulfoximine/pharmacology , Cysteine/drug effects , Cysteinyldopa/drug effects , Cysteinyldopa/metabolism , Enzyme Inhibitors/pharmacology , Glutathione/drug effects , Humans , Melanoma/pathology , Melanoma, Experimental/metabolism , Melanoma, Experimental/pathology , Mice , Mice, Nude , Microdialysis , Neoplasm Transplantation , Protein Precursors/metabolism , Pyrrolidonecarboxylic Acid , Thiazoles/metabolism , Thiazolidines , Transplantation, Heterologous , Tumor Cells, Cultured
12.
Clin Chem ; 45(10): 1813-20, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10508450

ABSTRACT

BACKGROUND: Intravenous and subcutaneous microdialysis was performed to compare the free concentrations and pharmacokinetics of L-3, 4-dihyroxyphenylalanine (L-dopa) in blood and tissue in healthy subjects and in patients with Parkinson disease. METHODS: Nine healthy volunteers and 10 patients with Parkinson disease, stage 1. 5-2 according to the Hoehn-Yahr rating scale, took part of the study. In the patient group subcutaneous microdialysis and ordinary blood sampling were performed, whereas in the control group intravenous microdialysis was also performed. Microdialysis samples were collected in fractions of 15 min. The first two fractions were collected for analysis of basal concentrations. A blood sample was also taken. The patients were then given one tablet of Madopar((R)) (100 mg of L-dopa and 25 mg of benserazide), and the microdialysis was continued for another 210 min. Blood samples were obtained at 30-min intervals. RESULTS: The serum samples gave a significantly higher mean area under the curve (AUC; 491 +/- 139 micromol. min/L) than that for intravenous dialysates (235 +/- 55.3 micromol. min/L), suggesting a protein binding of 50%. The L-dopa concentrations from the subcutaneous dialysates matched those from the intravenous dialysates, indicating rapid distribution of L-dopa to the tissues. CONCLUSIONS: Parkinsonian patients in early stages of the disease have a pharmacokinetic pattern of free L-dopa similar to that of healthy subjects. Comparison of AUCs from microdialysis with ordinary serum analysis revealed data indicating significant protein binding. Microdialysis is a suitable and easily applied tool in pharmacokinetic studies.


Subject(s)
Dihydroxyphenylalanine/pharmacokinetics , Dopamine Agents/pharmacokinetics , Adult , Aged , Chromatography, High Pressure Liquid , Dialysis Solutions/metabolism , Dihydroxyphenylalanine/blood , Dihydroxyphenylalanine/therapeutic use , Dopamine Agents/blood , Dopamine Agents/therapeutic use , Female , Humans , Male , Microdialysis/methods , Middle Aged
13.
Acta Neurol Scand ; 100(4): 231-7, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10510682

ABSTRACT

OBJECTIVES: The pharmacokinetics of free L-dopa in blood and tissue of five parkinsonian patients with malignant melanoma was studied with microdialysis. In one case the effect of L-dopa treatment on 5-S-cysteinyldopa and the melanoma was studied. Gastric emptying and its effects on free L-dopa in blood were also investigated in one of the patients. METHODS: Five patients were given 100 mg L-dopa with 25 mg benserazide. Blood and dialysates from the circulation and fatty tissue were collected for analysis. [13C]-Octanoic breath test was used for analyzing gastric half-emptying time. RESULTS: Four of the patients had similar pharmacokinetic patterns for L-dopa and a significant (P < 0.05) increase of serum 5-S-cysteinyldopa occurring 30 min after L-dopa intake. Delayed L-dopa peaks and slow gastric half-emptying time were found in 1 patient. A dose-dependent increase of 5-S-cysteinyldopa occurred but no melanoma metastases were seen during long-term L-dopa therapy. CONCLUSION: L-dopa therapy increases 5-S-cysteinyldopa levels but does not seem to cause progress of melanomas. Gastric emptying impacts L-dopa pharmacokinetics.


Subject(s)
Levodopa/pharmacokinetics , Melanoma/complications , Parkinson Disease/drug therapy , Skin Neoplasms/complications , Aged , Antiparkinson Agents/pharmacokinetics , Antiparkinson Agents/therapeutic use , Benserazide/pharmacokinetics , Benserazide/therapeutic use , Female , Humans , Levodopa/therapeutic use , Male , Microdialysis , Middle Aged , Parkinson Disease/complications
14.
Clin Chem ; 45(9): 1485-94, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10471651

ABSTRACT

BACKGROUND: Analysis of drugs in hair has been used on a qualitative basis to estimate earlier exposure to drugs. Clinical applications are rare because of the lack of dose-response relationships in the studies performed to date, and questions remain regarding the mechanisms of drug incorporation into hair. Several human studies have shown differences in drug accumulation between pigmented and nonpigmented hair. However, the melanin concentration in hair was not determined and correlated to the amount of drug incorporated. METHODS: Nine human subjects were given codeine as a single oral dose, and plasma codeine concentrations were determined for 24 h, using gas chromatography-mass spectrometry. Hair samples were obtained weekly for a month. Total melanin, eumelanin, and codeine were measured quantitatively in hair samples by spectrophotometry, HPLC, and gas chromatography-mass spectrometry, respectively. RESULTS: There was an exponential relationship between codeine and melanin concentrations in hair, (r(2) = 0.95 with total melanin and r(2) = 0.83 with eumelanin). After normalizing the results by the area under the curve for codeine in plasma, we obtained r(2) = 0.86 for codeine vs total melanin and r(2) = 0.90 vs eumelanin. CONCLUSIONS: Our results stress the importance of melanin determination when measuring drugs in hair. We postulate that analysis of drug concentration in hair may be worthwhile in the monitoring of drug compliance if the results are normalized for melanin content.


Subject(s)
Codeine/analysis , Hair/chemistry , Melanins/metabolism , Narcotics/analysis , Substance Abuse Detection/methods , Chromatography, High Pressure Liquid , Codeine/blood , Female , Gas Chromatography-Mass Spectrometry , Hair/metabolism , Humans , Male , Morphine/analysis , Narcotics/blood , Pyrroles/analysis
16.
Eur J Cardiothorac Surg ; 13(6): 655-61, 1998 Jun.
Article in English | MEDLINE | ID: mdl-9686796

ABSTRACT

OBJECTIVE: A major assumption in cardiovascular medicine is that Q-waves on the electrocardiogram indicate major myocardial tissue damage. The appearance of a new Q-wave has therefore been considered the most reliable criterion for diagnosis of perioperative myocardial infarction (PMI) in cardiac surgery. In a study, originally intended to evaluate troponin-T as a marker of PMI, analysis of our data aroused the need to address the reliability of Q-wave criteria for diagnosis of PMI. METHODS: In 302 consecutive patients undergoing coronary surgery, Q-wave and other electrocardiogram (ECG) criteria were compared with biochemical markers of myocardial injury and the postoperative course. All ECGs were analysed by a cardiologist blinded to the biochemical analyses and the clinical course. RESULTS: The incidence of positive Q-wave criteria was 8.1%. Combined biochemical (CK-MB > or = 70 microg/l) and Q-wave criteria were found in 1.0%. Patients with new Q-waves did not have CK-MB or troponin-T levels significantly different from those without Q-waves. More than 25% of the Q-waves were associated with plasma troponin-T below the reference level (< 0.2 microg/l) on the fourth postoperative day. Q-wave criteria alone did not influence the postoperative course. In contrast, biochemical markers correlated with clinical outcome. CONCLUSIONS: The majority of Q-waves appearing after coronary surgery were not associated with major myocardial tissue damage, and according to troponin-T one-fourth of the Q-waves were not associated with myocardial necrosis. Furthermore, the appearance of Q-waves had little influence on short term clinical outcome. Therefore, the use of Q-wave criteria as the gold standard for diagnosis of PMI may have to be questioned.


Subject(s)
Cardiac Surgical Procedures , Electrocardiography , Myocardial Infarction/diagnosis , Postoperative Complications/diagnosis , Aged , Creatine Kinase/blood , Female , Humans , Intraoperative Complications , Isoenzymes , Male , Middle Aged , Myocardial Infarction/blood , Predictive Value of Tests , Reproducibility of Results , Troponin/blood , Troponin T
17.
Clin Chem ; 44(4): 894-5, 1998 Apr.
Article in English | MEDLINE | ID: mdl-9554512
19.
Acta Derm Venereol ; 78(1): 31-5, 1998 Jan.
Article in English | MEDLINE | ID: mdl-9498023

ABSTRACT

5-S-Cysteinyldopa (5SCD) and 6-hydroxy-5-methoxyindole-2-carboxylic acid (6H5MI2C) are formed during biosynthesis of melanins. They are used as indicators of pigment formation and markers of melanoma progression in adults and could possibly be used as markers of activity, growth and even malignant transformation in large pigmented naevi in children. We investigated the urinary excretion of these pigment precursor metabolites from 136 children, 5 to 15 years of age. The mean 5SCD excretion was 38.1 mumol/mol creatinine. A significant age-related decrease from a mean of 60.4 mumol/mol creatinine at 5 years of age to 28.0 mumol/mol creatinine at age 15 was found. In a reference group (29 adults, 20-33 years of age) the mean excretion was 48.9 mumol/mol creatinine. The mean excretion of 6H5MI2C was 42.8 mumol/mol creatinine at 5 years of age and 26.1 mumol/mol creatinine at the age of 15. The mean value for the young adults was 33.4 mumol/mol creatinine. No correlation between the mean excretion of 5SCD and 6H5MI2C was demonstrated. We suggest an upper reference level of 90 mumol/mol creatinine for the excretion of 5SCD in the age group 5-11 years and of 60 mumol/mol creatinine in the age group 13-15 years. Corresponding figures for the indole 6H5MI2C are 70 and 60 mumol/mol creatinine. The establishment of reference values in children will make it possible to use 5SCD and 6H5MI2C measurements as diagnostic tools, indicating growth or malignant transformation in giant melanocytic naevi during childhood.


Subject(s)
Cysteinyldopa/urine , Indoles/urine , Melanins/biosynthesis , Adolescent , Adult , Age Factors , Biomarkers, Tumor/urine , Child , Child, Preschool , Female , Humans , Male , Melanins/urine , Nevus, Pigmented/diagnosis , Sex Factors , Skin Neoplasms/diagnosis
20.
Melanoma Res ; 7(4): 267-74, 1997 Aug.
Article in English | MEDLINE | ID: mdl-9293476

ABSTRACT

Retinoids inhibit proliferation of melanocytes and melanoma cells and affect disorders of hypo- and hyperpigmentation. Such effects might involve retinoid-binding proteins, retinoid metabolites and nuclear retinoid receptors for transcriptional activation. We detected messenger RNA transcripts for the cellular retinol- and retinoic acid-binding proteins (CRBP, CRABP I and II) in cultured epidermal melanocytes. In the melanoma cell lines the major transcript was CRABP II. Nuclear retinoic acid (RA) receptor transcripts and the 9-cis-retinoic acid receptor transcript were detected in all cells. The endogenous concentrations of retinol (ROH) and its metabolite 3,4-didehydroretinol (ddROH) in melanocytes were five times those in melanoma cells. When cells were incubated with [3H]ROH the main metabolites in the melanocytes were [3H]ddROH (4%) and [3H]RA (0.4%). Formation of [3H]RA was only detected in one melanoma cell line. Both melanocytes and melanoma cells produced an unidentified metabolite when incubated with [3H]ROH and [3H]RA. Dissimilarities in the metabolism and endogenous concentration of retinoids between benign and malignant melanocytes might play a key role in differentiation and growth regulation.


Subject(s)
Melanocytes/metabolism , Melanoma/metabolism , RNA, Messenger/metabolism , Receptors, Cell Surface/biosynthesis , Retinol-Binding Proteins/biosynthesis , Skin/metabolism , Vitamin A/metabolism , Cells, Cultured , Child , Gene Expression , Humans , Infant , Infant, Newborn , Male , Polymerase Chain Reaction , Receptors, Cell Surface/genetics , Retinol-Binding Proteins/genetics , Retinol-Binding Proteins, Cellular , Skin/cytology , Tretinoin/metabolism , Tritium , Tumor Cells, Cultured
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