Fatal strychnine poisoning: application of gas chromatography and tandem mass spectrometry.

The history and toxicological findings in a case of suicidal fatal strychnine poisoning are presented along with a description of the analytical methods. Detection and quantitation of strychnine in body fluids and tissues was performed by gas chromatography (GC) with nitrogen-phosphorus detection, using organic extraction and calibration by a standard addition method. Strychnine concentrations in subclavian blood (1.82 mg/mL), inferior vena cava blood (3.32 mg/mL), urine (3.35 mg/mL), bile (11.4 mg/mL), liver (98.6 mg/kg), lung (12.3 mg/kg), spleen (11.8 mg/kg), brain (2.42 mg/kg), and skeletal muscle (2.32 mg/kg) were determined. Confirmation of strychnine in blood and tissue was performed by GC with detection by tandem ion-trap mass spectrometry (MS). GC-MS-MS analysis, employing electron ionization followed by unit mass resolution and collision-induced dissociation of strychnine, resulted in confirmatory ions with mass-to-charge ratios of 334 (parent ion), 319, 306, 277, 261, 246, 233, and 220. Additional confirmation was provided by GC-MS-MS-MS analysis of each confirmatory ion, revealing an ion fragmentation pathway consistent with the molecular structure of strychnine. The case demonstrates body tissue and fluid distribution of strychnine in a fatal poisoning and the application of tandem MS in medical examiner casework.

Advances in catecholamine and metabolite measurements for diagnosis of pheochromocytoma.

Assessment of catecholamine production and excretion is important in the laboratory detection of pheochromocytoma, a rare but curable cause of hypertension. Advances in catecholamine and metabolite methodologies have enhanced the diagnostic acumen by increasing analytical sensitivity and eliminating many of the interferences observed with earlier methods. Estimation of urinary catecholamines metanephrine and vanillylmandelic acid is routinely used in the biochemical detection of pheochromocytoma and in monitoring the completeness of tumor excision as well as the possibility of recurrence. Traditional spectrophotometric and fluorometric methods for urinary catecholamines and their metabolites are being replaced by highly sensitive and selective chromatographic methods. The ability to quantify individual catecholamines and metanephrines by high-performance liquid chromatography is of particular value for detecting familial forms of the tumor that may secrete epinephrine. Plasma norepinephrine and epinephrine measurements are of additional diagnostic value in determining recent catecholamine release and response to clonidine suppression. For either urine or plasma measurements, appropriate patient preparation, sample collection, and method validation along with an understanding of the variable pattern of catecholamine secretion and metabolism in pheochromocytoma are essential. Advances in laboratory methodology and reference intervals for catecholamines for clinical interpretation are reviewed.

Candidate reference method for determining creatinine in serum: method development and interlaboratory validation.

We describe a "high-performance" liquid chromatographic (HPLC) method for accurately determining creatinine in serum. After prechromatographic precipitation of protein, we performed isocratic ion-exchange chromatography with ultraviolet detection (234 nm). Analytical results showed linearity up to 1770 mumol/L, a detection limit of 22 mumol/L, an average analytical recovery of 101%, and a CV ranging from 3% to 11%. We used certified human serum (National Institute of Standards and Technology), and additional lyophilized serum pools also assayed by definitive isotope-dilution mass spectrometry, to validate the accuracy of the HPLC method. In addition, the isocratic HPLC results showed close agreement with those obtained with a step-gradient HPLC method. We also compared the isocratic HPLC method with alkaline picrate and enzymatic methods. Our findings with samples from nonuremic, uremic, and diabetic ketoacidotic patients confirmed the positive bias previously reported with the alkaline picrate method. Interlaboratory transferability of the method was demonstrated with various commercial instruments and analytical columns. We evaluated column stability and possible interference from endogenous or exogenous compounds. On the basis of our analytical findings, we recommend the isocratic HPLC method as a candidate Reference Method for determining creatinine in serum.

Testosterone suppression of ornithine decarboxylase activity in rat Sertoli cells.

The effect of testosterone on the induction of Sertoli cell ornithine decarboxylase (ODC) activity was investigated in highly purified cultures derived from testes of 20-day-old rats. Sertoli cell cultures were maintained in serum-free Ham's F-10 medium, with refeeding on days 2 and 4. Before refeeding on day 4, ODC activity was 7.4 U (1 U = 1 pmol 14CO2 released/mg protein.60 min at 37 C). After a medium change, ODC activity increased (41.6 U at 10 h; 180.0 U at 24 h) and then returned to near-basal activity (26.3 U) after 48 h. Simultaneous addition of testosterone (150 ng/ml; 5.2 X 10(-7) M) with the day 4 medium change suppressed the increase in ODC induction (7.53 U at 10 h, 91.6 U at 24 h). Addition of testosterone 24 h before refeeding resulted in greater inhibition of ODC induction (6.9 U at 10 h; 45.4 U at 24 h) than when added simultaneously. Other androgens, 5 alpha-dihydrotestosterone, androsterone, and 5 alpha-androstane-3 alpha,17 beta-diol, also suppressed induction of ODC, whereas 17 beta-estradiol was ineffective, illustrating the steroid specificity of the effect. Coadministration of the antiandrogens hydroxyflutamide or cyproterone acetate partially blocked the testosterone effect. Induction of ODC activity by ovine FSH (10 ng/ml) was also suppressed when Sertoli cells were cultured in the presence of testosterone (150 ng/ml) from the time of isolation. However, induction of ODC activity by (BU)2cAMP was uncompromised by testosterone. These results suggest that testosterone may repress ODC activity and, hence, polyamine biosynthesis in the Sertoli cell, but that cAMP, acting through the trophic hormone FSH, can overcome this suppression of putrescine biosynthesis. Intratesticular and hypophyseal modulation of polyamine biosynthesis may influence not only cellular processes in the Sertoli cell itself but also its role in spermatogenesis.

Stimulation of polyamine biosynthesis by follicle-stimulating hormone in serum-free cultures of rat Sertoli cells.

Sertoli cells derived from 21-day-old rats were cultured in serum-free Ham's F-10 medium to allow a direct investigation of the effects of FSH on polyamine (PA) biosynthesis in a defined culture system. After 48 h in culture, the basal cellular content consisted predominantly of spermine (1.1 nmol/mg protein) with substantially lower amounts of spermidine (0.1 nmol/mg protein) and undetectable amounts of putrescine. Upon the addition of ovine FSH (3 X 10(-9) M), cellular spermine content became significantly elevated above the control value as early as 1 h after treatment, reaching a 2.5-fold stimulation by 4 h. Spermidine was also elevated by 4 h after FSH treatment, but remained less than 20% of the spermine concentration. At no time did the cellular content of putrescine increase to measurable levels. Extended time-course studies demonstrated that the FSH-induced cellular increase in spermine and spermidine content persisted up to 24 h during the continuous presence of FSH. Bu2cAMP (5 mM) invoked similar changes in PA levels when measured at 4, 8, and 24 h. Ornithine decarboxylase (ODC) activity, which catalyzes the production of putrescine, was increased by FSH in a temporal fashion similar to that of spermine production. Addition of alpha-difluoromethylornithine, an irreversible inhibitor of ODC, blocked increases in both ODC activity and PA in cells stimulated with FSH or Bu2cAMP. Pulse-chase experiments using [3H]ornithine demonstrate that putrescine is initially synthesized, and is subsequently converted to spermidine and spermine. These studies suggest that regulation of PA biosynthesis by FSH is largely expressed as increases in spermine, and to a lesser extent spermidine, suggesting that the more complex PAs may be involved in the regulation of Sertoli cell function.

Effects of the polyamine spermine on binding of follicle-stimulating hormone to membrane-bound immature bovine testis receptors.

The effect of the polyamine, spermine, on the interaction of human 125I-labeled FSH with membrane-bound receptors derived from bovine calf testes has been examined. Concentrations of spermine less than 0.01 M resulted in a slight but insignificant (P greater than 0.10) enhancement of FSH concentrations of 0.01 M and above caused a progressive reduction of FSH binding. Membrane receptors incubated in the presence of spermine at concentrations inhibitory to human 125I-FSH binding (0.01-0.04 M) resulted in an 8-50% decrease in the apparent FSH receptor concentration and a 10-65% decrease in the affinity constant as determined by computerized analysis of the isothermic ligand-binding data. Within the temperature range 4-20 degrees C, simultaneous addition of spermine (0.025 M) increased the reversibility of human 125I-FSH binding approx. 10% (P less than 0.005). Delayed addition of spermine (0.01-0.04 M) resulted in a dose-related dissociation of human 125I-FSH already bound to its receptor (P less than 0.05). However, preincubation of membrane receptors with spermine (0.002-0.04 M) at 4 degrees C or 34 degrees C followed by washing and addition of human 125I-FSH, resulted in an increase in hormone binding (P less than 0.05) over that of controls. If membrane receptor was incubated at 34 degrees C with spermine in the absence of radioligand, the usual loss of hormone binding was reduced (P less than 0.05), while membrane receptor incubated with spermine at 4 degrees C exhibited hormone binding greater (P less than 0.05) than that observed before treatment. Thus, the mechanism of inhibition of human 125I-FSH binding to membrane receptors appears to be correlated with an increase in reversibility of the membrane receptor-human 125I-FSH complex and is expressed as a decrease in the calculated receptor concentration and affinity constant of that interaction. Second, spermine appears to stabilize the membrane receptor in the absence of ligand, presumably through a membrane effect. These data suggest that spermine, and possibly other polyamines, which are endogenous to eukaryotic cells and undergo increases in concentration following stimulation by trophic hormone may play a role in the modulation of the ligand-membrane receptor interaction, in part, through direct effects on the membrane and/or the receptor.

Liquid-chromatographic determination of urinary 5-hydroxy-3-indoleacetic acid, with fluorescence detection.

We describe and evaluate a procedure for measuring urinary 5-hydroxy-3-indoleacetic acid by "high-performance" liquid chromatography. After a simple organic extraction, the analyte and internal standard are chromatographed on a reversed-phase column and are detected by native fluorescence. The detection limit (3 ng per injection), between-day precision (CV 5.2%), absolute recovery (70%), analytical recovery (99%), and working linear range (up to 15 mg/L) have been determined. Compared with colorimetric results with nitrosonaphthol, values obtained with the chromatographic method are significantly lower. Reference values and clinical experience with the method are reported. The method is simple, free from interferences, and suitable for use in routine analysis in the clinical laboratory.

Fluorometry of ethylene glycol in serum.

We describe an assay for ethylene glycol in serum, which is based on the Hantzsch condensation reaction. Ethylene glycol is dehydrogenated by sodium periodate to form two molecules of formaldehyde, which is then combined with ammonium ion and acetylacetone to form a fluorescent diacetyllutidine derivative. The detection limit of this method is 50 mg/L. The procedure is sensitive, requires only 100 micro L of serum, and the standard curve is linear over a working range of 50 to 250 mg/L. Average analytical recovery ranged from 99 to 102% and within-run precision studies showed CVs of < 5%. Reagents are easily prepared and available.