Sensitive stereospecific determination of acenocoumarol and phenprocoumon in plasma by high-performance liquid chromatography.

We describe a normal-phase HPLC method for the stereospecific determination of R- and S-acenocoumarol and R- and S-phenprocoumon with S-warfarin as internal standard. The compounds were separated using a Whelk-O1 chiral stationary phase, detected by UV at 310 nm and quantified in the internal standard mode. Linearity was verified for acenocoumarol in the range of 15-2000 microg/l and for phenprocoumon from 15 to 2200 microg/l, respectively. The detection limits were 5 microg/l for all compounds. The recovery was >84% for R- and S-acenocoumarol and >74% for R- and S-phenprocoumon. The imprecision (C.V.) (50-1800 microg/l) for R- and S-acenocoumarol was <4.7% within-day and <7.8% between-day. For R- and S-phenprocoumon the respective values were <5.6% and <5.9%. The accuracy for all compounds was 96.5-110%.

Extracranial vertebral artery dissection causing cervical root lesion.

The authors report an unusual manifestation of extracranial vertebral artery dissection (VAD), presenting with a predominantly motor radicular manifestation. Cervical magnetic resonance imaging (MRI) revealed the intramural hematoma in the dissected vessel wall, compressing mainly the segmental motor root and, to a lesser degree, the sensory ganglion. In the digital subtraction angiography (DSA), a circumscribed narrowing of the incriminated vessel was demonstrated. Color-coded Duplex imaging (CDDI) revealed complete recanalization after a few days of anticoagulation treatment. Complete neurologic recovery was seen after 3 months. Considering the MRI data, the likely pathogenetic mechanism was compression of the nerve root by the intramural hematoma. The synopsis with similar cases in the literature points to the characteristic features, i.e., the association of neck pain with radicular motor deficit and the absence of degenerative disk disease. The respective syndrome should raise the suspicion of vertebral artery dissection, especially in young individuals.

S-nitrosoglutathione in rat cerebellum: identification and quantification by liquid chromatography-mass spectrometry.

Given the extreme lability and the facile inactivation of the messenger nitric oxide (NO) by many reactive biochemical species, it has been suggested that some intermediate compounds, for example, S-nitrosothiols, may act to stabilize NO and at the same time to preserve its biological activity. To test this hypothesis, we investigated if the S-nitrosothiol of glutathione, which is the predominant low molecular weight thiol in CNS, is present in the rat brain. The HPLC analysis of cerebellar extract from [35S]cysteine-prelabeled slices suggested that S-nitrosoglutathione (GSNO) was indeed present in rat brain. To detect endogenous GSNO, a methodology based on liquid chromatography-mass spectrometry was developed. Besides an unequivocal identification of the endogenous GSNO, this method also permitted its precise quantification using 15N-labeled GSNO ([15N]GSNO) as internal standard. GSNO level in adult cerebellum amounts to 15.4 +/- 1.4 pmol/mg of protein. This is the first direct demonstration of the presence of endogenous GSNO in CNS. The packaging of NO in the form of GSNO might serve to facilitate its transport, prolong its life, and target its delivery to specific effectors.

[Bronchogenic cyst. A rare benign esophageal tumor]. / Die bronchogene Zyste. Eine seltener benigner Osophagustumor.

A case of confirmed esophageal bronchogenic cyst is reported. We review the clinical and pathologic features of this rare congenital foregut anomaly, and emphasize its radiographic appearances with special reference to differential diagnosis.

Nitric oxide precursor arginine and S-nitrosoglutathione in synaptic and glial function.

In the last few years, there has been an important increase in interest in nitric oxide (NO) as an intercellular messenger, and its putative role in numerous CNS functions is being continually updated. Arginine, the nitric oxide precursor, has been found in our laboratory to be released following stimulation of the white matter in the cerebellum and of sensory afferents in the thalamus. Since arginine is localized in glial cells while the nitric oxide synthesizing enzyme is localized in different cells (predominantly in neurons), these findings may represent a transfer of arginine from glia to neurons in order to supply the nitric oxide synthase with its substrate. The mechanism underlying this glial-neuronal interaction seems to involve the activation of excitatory amino acid receptors present on glial cells. Our results speak for an intense crosstalk between neurons and glia (activation of glial receptors by neurotransmitter released from neurons) and between glia and neurons (supply of the nitric precursor arginine from glia to neurons). The form in which NO is released from cells has been much debated. The chemical identity of the endothelial-derived relaxing factor in particular is still a matter of dispute, the major contender being NO. and a S-nitrosothiol compound. Based on the strong reactivity of NO for thiols and on the presence of cysteine and glutathione at the mM level intracellularly and microM level extracellularly, we have investigated whether S-nitrosothiols, i.e. S-nitrosoglutathione, may be the potential "package" form in which NO could be stored. We demonstrated, with HPLC coupled to mass spectrometry techniques, the presence of endogenous nitrosoglutathione in rat brain tissue. This packaging of NO in the form of nitrosothiols might serve to facilitate its transfer, prolong its life, and target its delivery to specific effectors. That could confer a specificity of action to the widely diffusable messenger NO, may determine the range of effectiveness of NO and mitigate its adverse cytotoxic effects.

gamma-Glutamylglutamine and taurine concentrations are decreased in the cerebrospinal fluid of drug-naive patients with schizophrenic disorders.

HPLC and gas chromatography-mass spectrometry analyses of 18 amino acids, N-acetylaspartate, N-acetylaspartylglutamate, and 5-hydroxyindoleacetic acid, derived from serotonin, and homovanillic acid, derived from dopamine, were performed in CSF collected from a group of patients with schizophrenia who either had been drug free for at least 1 year (n = 5) or were drug naive for psychotropic drugs (n = 21) and in 15 control subjects. Significant differences were found only for taurine (15% lower in the patients) and isoleucine (7% higher). A number of unidentified substances were detected, one of which proved to be markedly reduced (16%) among the schizophrenic patients. Liquid chromatography-mass spectrometry with continuous flow-fast atom bombardment interface allowed us to identify this substance as gamma-glutamylglutamine. The decreased level of gamma-glutamylglutamine may reflect a deficiency in the gamma-glutamyltransferase system, a system probably involved in glutamate uptake, or a deficiency in glutamine, an important precursor of releasable glutamate. Although glutamate was nonsignificantly reduced in the patients, it was one of the five substances (including gamma-glutamylglutamine) that were necessary for the best discrimination between the schizophrenic patients and the controls. These findings support the notion that the glutamatergic system is affected in schizophrenic disorders. In addition, they underscore the need to apply rigid bioanalytical techniques and use drug-naive patients to gain in-depth information on the pathophysiology of brain disorders such as schizophrenia.

Release of N-acetylaspartylglutamate from slices of rat cerebellum, striatum, and spinal cord, and the effect of climbing fiber deprivation.

The release of endogenous N-acetylaspartylglutamate (NAAG) from slices of rat cerebellum, striatum, and spinal cord upon depolarization with 50 mM K+ was investigated. NAAG in superfusates was prepurified using an ion exchanger, esterified, and then quantified by gas chromatography-mass spectrometry. Deuterated NAAG was used as internal standard. A depolarization-induced release of NAAG was found in all three regions. The release was Ca2+ dependent to over 85% in cerebellum and striatum, but only to approximately 70% in spinal cord. In addition, the effect of lesions of the olivocerebellar pathway on the K(+)-induced release of NAAG was studied: Treatment of the animals with 3-acetylpyridine reduced the release of NAAG from cerebellar hemispheres significantly, by about 40% compared with controls. These results suggest that part of the NAAG released from cerebellar slices on depolarization is related to climbing fibers. Implications of these findings concerning possible physiological roles of NAAG in the three CNS regions are discussed.

A novel hypothesis: specific oncogenes and tumor suppression genes are involved in the expression of the proopiomelanocortin gene by small cell lung cancer.

The endogenous opioid beta-endorphin, a derivative of proopiomelanocortin, stimulates the growth of cloned human small cell lung carcinoma. The present hypothesis states that mutations of the retinoblastoma gene (a tumor suppressor gene) associated to the malignant transformation of bronchial cells would trigger a cascade of biomolecular events leading to 'de novo' proopiomelanocortin expression in small cell lung carcinoma.

Beta-endorphin-like immunoreactivity: assessment of blood levels in patients with tumors of different origin.

Beta-endorphin-like immunoreactivity (beta-ELIR) blood levels in control subjects and in patients with different carcinoma and non-Hodgkin's lymphoma tumor types, were found within the same range, with the exception of one carcinoma type. This pertained to a group of patients with small cell lung cancer who had a significantly higher median beta-ELIR level compared to controls. This finding, and the fact that proopiomelanocortin expression is enhanced in tissues of this cancer type, suggest that the latter might secrete elevated beta-ELIR amounts into the blood of the affected patients.

Quantification of N-acetylaspartylglutamate, an N-terminal blocked dipeptide neurotransmitter candidate, in brain slice superfusates by gas chromatography-mass spectrometry.

N-Acetylaspartylglutamate is a highly promising neurotransmitter candidate. A method for its quantification has been developed that allows to investigate its stimulation-induced release from brain slices. The method is based on ion-exchange prepurification, derivatization with HCl in methanol, separation by capillary gas chromatography and quantification by ammonia chemical ionization mass spectrometry with selected-ion monitoring. Deuterium-labelled N-acetylaspartylglutamate is used as internal standard. The method has been validated, also with respect to possible interfering compounds. A limit of quantification in the low pmol to high fmol range has been achieved, which is clearly sufficient for the intended purpose. A detailed analytical procedure is given, and alternatives for some of the different steps are discussed. Derivatization with diazomethane instead of methanolic HCl turned out to be impracticable. The method may well be applicable to certain other N-terminal blocked di- and tripeptides and to acylated amino acids.

Release of N-acetylaspartylglutamate on depolarization of rat brain slices.

In a great number of investigations, evidence in favor of a neurotransmitter role of the N-terminal-blocked, acidic dipeptide N-acetylaspartylglutamate (NAAG) has been accumulating. In fact, in some systems of the mammalian brain, almost all of the classical criteria for neurotransmitters have been fulfilled by NAAG except for the demonstration of its release from nervous tissue on depolarization. For quantification of NAAG in superfusates of brain slices, we have developed an analytical procedure consisting of an ion exchange prepurification, followed by a derivatization procedure and gas chromatography-mass spectrometry with chemical ionization and selected ion monitoring. Deuterated NAAG was used as an internal standard to provide a high degree of reliability for the analytical method. Detection limits of less than 1 pmol were achieved. A statistically highly significant increase of NAAG concentration in superfusates from rat neocortex, piriform cortex/amygdala, and hippocampus on depolarization with 50 mM K+ could be demonstrated and was shown to be largely Ca2+ dependent. These results support the hypothesis that NAAG is a neurotransmitter. Especially with respect to the piriform cortex, the present demonstration of NAAG release is consistent with electrophysiological and immunohistochemical evidence for its neurotransmitter function at terminals of the lateral olfactory tract.

Ventricular cerebrospinal fluid concentrations of putative amino acid transmitters in Parkinson's disease and other disorders.

Concentrations of putative neuroactive substances glutamate, aspartate, gamma-aminobutyric acid, glycine, proline and ethanolamine were determined in ventricular cerebrospinal fluid collected in patients suffering from Parkinson's disease, pain syndromes or cerebellar tremor. Values are similar to those given in the literature for lumbar cerebrospinal fluid. A decrease in gamma-aminobutyric acid in Parkinson patients, as reported in lumbar cerebrospinal fluid, could not be observed. Further evidence for a rostro-caudal gradient for gamma-aminobutyric acid is supplied. New insights into pathophysiological mechanisms in any of the investigated syndromes may not be derived.

Identification of quinolinic acid in rat and human brain tissue.

An analytical technique for the determination of the excitotoxic compound quinolinic acid (2,3-pyridine dicarboxylic acid) in brain tissue has been developed. Following sample prepurification by ion exchange and high pressure liquid chromatography, quinolinic acid is converted to the dihexafluoroisopropyl ester and the derivative is analyzed by mass fragmentography. Using the present technique quinolinic acid has been identified in both rat and human brain tissue.

Gas chromatographic method for the determination of trace amounts of putative amino acid neurotransmitters from brain perfusates collected in vivo.

Glass capillary gas chromatography in combination with thermionic detection has been developed for the measurement of trace amounts of glycine, beta-alanine, aspartic acid, gamma-aminobutyric acid and glutamic acid from brain perfusates collected in vivo by push-pull cannula techniques. Amino acids extracted from the dried perfusate residues are converted to the corresponding N-pentafluoropropionyl hexafluoroisopropyl esters (PFP-HFIP derivatives) and separated by gas chromatography on a glass capillary column coated with methylsiloxane. The detection limit of the amino acids (signal-to-noise ratio 3:1) ranges between 200 fmol and 2.0 pmol. The assay was applied to the measurement of amino acids released in vivo in the pigeon optic tectum into perfusates collected by push-pull techniques.

Mass fragmentographic method for the determination of trace amounts of putative amino acid neurotransmitters and related compounds from brain perfusates collected in vivo.

A mass fragmentographic method for the determination of trace amounts of amino acid neurotransmitter candidates from brain perfusates is described. The analytical procedure includes the measurements of glycine, beta-alanine, gamma-aminobutyric acid, proline, aspartic acid, and glutamic acid; alpha-alanine, leucine, and sarcosine, undergoing gas chromatographic coelution, are detected simultaneously. Amino acids extracted from dried perfusate residues are converted to the corresponding N-pentafluoropropionyl hexafluoroisopropyl esters by a single-step procedure. Gas chromatographic separation of the amino acid derivatives is achieved on a packed glass column filled with trifluoropropylsilicone as stationary phase. The limit of detection for the different derivatives (signal-to-noise, 3:1) ranges from 50 femtomol to 1 picomol. Deuterium-labeled amino acid analogues are used as internal standards for quantitative measurements. The mass spectral characteristics of the derivatives are compared and discussed. The technique has been applied to the assay of amino acids released in vivo within the pigeon optic tectum, demonstrating the capabilities of the present analytical approach.