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Characterization of acute and chronic myocardial infarcts by multidetector computed tomography: comparison with contrast-enhanced magnetic resonance.

BACKGROUND: We evaluated whether contrast-enhanced multidetector computed tomography (CE-MDCT) might characterize myocardial infarct (MI) with patterns similar to those obtained by contrast-enhanced magnetic resonance (CE-MR) and studied the underlying mechanisms. METHODS AND RESULTS: In vivo infarct characterization by CE-MDCT was shown to be feasible between 4 and 20 minutes after contrast injection in 7 pigs with MI. Subsequently, in 16 patients with acute MI and 21 patients with chronic MI, contrast patterns by CE-MDCT were related to CE-MR. Eighteen patients had hypoenhanced regions on early CE-MDCT images at the time of coronary imaging, and 34 patients had hyperenhanced regions on images acquired 10 minutes later. On a segmental basis, there was moderately good concordance of early hypoenhanced regions (92%, kappa=0.54, P<0.001) and late hyperenhanced regions (82%, kappa=0.61, P<0.001) between CE-MDCT and CE-MR. Absolute sizes of early hypoenhanced (6+/-16 versus 7+/-16 g, P=0.25) and late hyperenhanced (36+/-34 versus 31+/-40 g, P=0.14) regions were similar on CE-MDCT and CE-MR and were highly correlated (r=0.93, P<0.001 and r=0.89, P<0.001 respectively). In 8 retrogradely perfused infarcted rabbit hearts, contrast kinetics of iomeprol were similar to gadodiamide, ie, slow wash in (8.7+/-6.7 versus 1.2+/-0.3 minutes, P<0.001) in infarct core and slow washout (20+/-12 versus 2.5+/-0.5 minutes, P<0.001) in both infarct core and rim compared with the remote region. CONCLUSIONS: Because iodated contrast agents have similar kinetics in infarcted and noninfarcted myocardium as gadolinium DPTA, CE-MDCT can characterize acute and chronic MI with contrast patterns similar to CE-MR. CE-MDCT may thus provide important information on infarct size and viability at the time of noninvasive coronary imaging.

Acute Disease↗

A new method for the determination of plasma phenylalanine.

Two hundred microlitres of plasma is deproteinised, and chloride is removed with TCA/silver iodate. After centrifugation of the phenylalanine in the protein-free extract is oxidised to benzaldehyde with buffered sodium metaperiodate. The benzaldehyde is extracted into iso-octane, and the absorbance of the organic layer is measured at 240 nm. The method gives good agreement with a paper chromatographic method at normal and elevated levels of phenylalanine. All the reagents are stable indefinitely, and a single determination can be completed in 15 minutes.

Benzaldehydes↗

Iodine stability in salt double-fortified with iron and iodine.

Deficiencies in small quantities of micronutrients, especially iodine and iron, severely affect more than a third of the world's population, resulting in serious public health consequences, especially for women and young children. Salt is an ideal carrier of micronutrients. The double fortification of salt with both iodine and iron is an attractive approach to the reduction of both anemia and iodine-deficiency disorders. Because iodine is unstable under the storage conditions found during the manufacturing, distribution, and sale of salt in most developing countries, the effects of packaging materials and environmental conditions on the stability of salt double-fortified with iron and iodine were investigated. Salt was double-fortified with potassium iodide or potassium iodate and with ferrous sulfate or ferrous fumarate. The effects of stabilizers on the stability of iodine and iron were followed by storing the salt under three conditions that represent the extremes of normal distribution and sale for salt in developing countries: room temperature (25 degrees C) with 50%-70% relative humidity, 40 degrees C with 60% relative humidity, and 40 degrees C with 100% relative humidity. The effects of stabilizers, such as sodium hexametaphosphate (SHMP), calcium carbonate, calcium silicate, and dextrose were investigated. None of the combinations of iron and iodine compounds was stable at elevated temperatures. Essentially all of the iodine was lost over a period of six months. SHMP effectively slowed down the iodine loss, whereas magnesium chloride, a typical hygroscopic impurity, greatly accelerated this process. Calcium carbonate did not have a sparing effect on iodine, despite contrary indications in the literature. Ferrous sulfate-fortified salts generally turned yellow and developed an unpleasant rusty flavor. Salt fortified with ferrous fumarate and potassium, iodide was reasonably stable and maintained its organoleptic properties, making it more likely to be acceptable to consumers. We confirmed that application of the iodine compounds as solutions resulted in a more even distribution of the iodine throughout the sample. The effect of the packaging materials was overshadowed by the other variables. None of the packaging materials was clearly better than any other. This may have been due to the fact that the polymer bags were not heat sealed, and thus some moisture penetration was possible. The results indicate that with careful control of processing, packaging, and storage conditions, a double-fortified salt could be stabilized for the six-month period required for distribution and consumption. Unfortunately, the processing and storage required are difficult to attain under typical conditions in developing countries.

Biological Availability↗

Standardized evaluation of iodine nutrition in West Africa: the African phase of the thyromobil program.

Extensive programs of iodine supplementation by iodated salt have been implemented in Africa during the last decade. The present work evaluated their effectiveness in Benin, Burkina Faso, Mali, and Togo. A van equipped with a sonographic device visited 39 sites in the four countries. The prevalence of goiter was evaluated on the basis of the determination of thyroid volume by ultrasonography in 4,011 randomly selected 6- to 12-year-old schoolchildren of both sexes in the 39 sites. The concentration of urinary iodine was measured in 1,545 of these children. The iodine content of table salt collected at home by the children was measured by test kits in 3,202 salt samples, 415 of which were also analyzed by titration. Based on the results obtained by the kits, 83.7% to 97.9% of the salt samples contained iodine. However, the test kits had a low sensitivity and specificity in comparison with titration. The median urinary iodine was within an acceptable range (100-300 14 g/L) in the four countries, but almost one-third of the values were still below normal. The prevalence of goiter was normal (< 5%) in Benin and Togo, and it was 22.4% and 13.4%, respectively, in Burkina Faso and Mali. These results indicate marked improvement of the status of iodine nutrition in comparison with the situation reported only a few years ago in the same countries, but quality control of the iodine content of salt and monitoring of the iodine status of the populations need to be improved.

Africa, Western↗

Fast and reliable salt iodine measurement: evaluation of the WYD Iodine Checker in comparison with iodometric titration.

Iodine deficiency persists as the leading cause of preventable brain damage and reduced intellectual capacity in the world. The most effective method for the elimination of iodine deficiency is the consumption of adequately iodized salt. Ensuring that a population receives adequately iodized salt demands careful monitoring of the salt iodine content. We evaluated the WYD Iodine Checker, a hand-held instrument that quantitatively measures the salt iodine content on the basis of a colorimetric method, and compared its performance with iodometric titration. Performance testing results indicated that the WYD Iodine Checker is a highly precise, accurate, and sensitive tool for measuring salt iodine content. It is a user-friendly instrument that is based on a simple methodology and a straightforward salt sample preparation and testing procedure. We recommend further testing to examine the field performance of the WYD Iodine Checker when measuring iodate salt samples.

Colorimetry↗

Urinary iodine concentration of pregnant women and female adolescents as an indicator of excessive iodine intake in Sri Lanka.

BACKGROUND: Mild deficiencies and excesses of iodine have deleterious effects in both females and males. The iodine status of the population after implementation of the universal salt iodization program in Sri Lanka is not known. OBJECTIVE: This cross-sectional study was carried out to assess the iodine status of pregnant women and female adolescents, with urinary iodine concentration used as the measure of outcome. METHODS: The participants were 100 women in the first trimester of pregnancy and 99 female adolescents in Kuliyapitiya, Kurunegala District, North-Western Province, Sri Lanka. The urinary iodine concentration was measured in a casual urine sample from each subject. The iodate contents of salt samples collected from households of the adolescents participating in the study were also measured. RESULTS: The median urinary iodine concentration of 185.0 microg/L and the prevalence of values under 50 microg/L of only 1% among the pregnant women indicate adequate iodine intake and optimal iodine nutrition. The median urinary iodine concentration (213.1 microg/L) among female adolescents indicates a more than adequate iodine intake and a risk of iodine-induced hyperthyroidism. Approximately 8% and 4% of the adolescents and pregnant women, respectively, had urinary iodine concentrations in the range of mild iodine deficiency (51 to 100 microg/L). More than half of the adolescents (56%) and 39% of the pregnant women had urinary iodine concentrations higher than optimal. The median iodine content in salt samples was 12.7 ppm. Only 20.2% of the samples were adequately iodized, and 10.1% of the samples had very high iodine levels. CONCLUSIONS: Female adolescents and pregnant women had no iodine deficiency, but a considerable proportion of them, especially female adolescents, were at risk for iodine-induced hyperthyroidism. There is thus a need for proper monitoring of the salt iodization program to achieve acceptable iodine status.

Adolescent↗

Kinetic spectrophotometric method for the determination of ramipril in pharmaceutical formulations.

The objective of this research was to develop a kinetic spectrophotometric method for determination of ramipril in pure form and pharmaceutical formulations. The method was based on the reaction of carboxylic acid group of the drug with a mixture of potassium iodate (KIO3) and potassium iodide (KI) in aqueous medium at room temperature. The reaction is followed spectrophotometrically by measuring the increase in absorbance at 352 nm as a function of time. The initial-rate and fixed-time methods were adopted for constructing the calibration curves. Both the calibration curves were linear in the concentration range of 10.0-70.0 microg mL(-1). The detection limits were 0.02 microg mL(-1) and 0.15-microg mL(-1) for initial rate and fixed time methods, respectively. The proposed methods are validated statistically and through recovery studies. The point and interval hypothesis tests have been performed confirming that there is no significant difference between the proposed methods and the reference method. The experimental true bias of all samples is less than +/- 2%. The methods have been successfully applied to the determination of ramipril in tablets and capsules.

Chemistry, Pharmaceutical↗

Hyperthyroidism in Tasmania following iodide supplementation: measurements of thyroid-stimulating autoantibodies and thyrotropin.

Serum thyroid-stimulating autoantibodies (LATS and LATS protector) and thyrotropin (TSH) concentrations were measured in the serum of 30 patients with hyperthyroidism living in Tasmania who developed their disease following correction of iodine deficiency by addition of iodate to the bread. Patients were grouped according to thyroid scan results. None of 8 patients with autonomous thyroid nodules had thyroid-stimulating autoantibodies. These were present in both of the patients with uniform thyroid scans and 14 of 20 patients (70%) with irregular scans without demonstrated localized autonomy. Serum TSH, measured by immunoassay of concentrated serum extracts, was 0.15 muU/ml or less in all patients, below the range of 0.35 to 2.60 muU/ml found in normal subjects. Only 6 (20%) of the 30 patients failed to show either localized autonomy or thyroid-stimulating autoantibodies. In most regards these patients resembled those with antonomous nodules. The findings support the conclusion that the increased incidence of phyerthyroidism in Tasmania was due to an increased supply of iodine to patients with latent hyperthyroidism whose thyroid glands, due to the presence of toxid nodule(s) or thyroid-stimulating autoantibodies, were unresponsive to control by TSH deprivation. There was no evidence for additional pathogenic mechanisms

Adult↗

Spectrophotometric and potentiometric determination of piroxicam and tenoxicam in pharmaceutical preparations.

Two simple and accurate methods are described for the determination of piroxicam and tenoxicam in their pharmaceutical preparations. The spectrophotometric method involves the oxidation of these drugs with potassium iodate in acid medium with the liberation of iodine and subsequent extraction with cyclohexane followed by measuring the absorbance at lambda=522 nm. Beer's law is obeyed in the concentration range of 0.05-1.1 and 0.05-0.6 mg x ml(-1) for piroxicam and tenoxicam, respectively. The apparent molar absorptivities of the resulting coloured products are found to be 2.7 x 10(3) and 2.5 x 10(3) l mol(-1) x cm(-1), whereas Sandell sensitivities are 0.012 and 0.013 g x cm(-2) for piroxicam and tenoxicam, respectively. The potentiometric method involves the direct titration of both drugs with N-bromosuccinimide in acid medium and the end point is determined potentiometrically using platinum indicator electrode. Piroxicam and tenoxicam can be determined quantitatively in the concentration range of 0.33-3.37 and 0.33-4.08 mg x ml(-1) for tenoxicam and piroxicam, respectively. The standard deviation and relative standard deviation values are found to be ranged from 0.05-0.07 and 0.37-0.98% and 0.025-0.078 and 0.25-1.2% for tenoxicam and piroxicam, respectively. The two methods are accurate within +/-1.0%. Optimum conditions affecting both methods are studied. The proposed methods are applied for the determination of the drugs in pure form and in commercial pharmaceutical preparations.

Pharmaceutical Preparations↗

The reaction of butylated hydroxyanisole and its metabolites with some arylamines: investigations of product mutagenicity.

We examined t-butylhydroquinone (t-BHQ) and t-butylquinone (t-BuQ), two of the major microsomal metabolites of the synthetic antioxidant butylated hydroxyanisole (BHA), for their ability to react with the xenobiotic arylamines aniline and N-methylaniline. A number of substances were isolated by thin-layer chromatography. The main products were quantitatively evaluated and their structures assigned. BHA and t-BHQ yielded reaction products with anilines only in the presence of an oxidant such as iodate (KIO3). We used the Salmonella/microsome mutagenicity assay to test the new compounds for mutagenic activity. The reaction products gave no evidence of mutagenicity in the S. typhimurium strains TA98 and TA100, with or without metabolic activation. In some instances the substituted quinone products are less toxic than t-BuQ alone.

Aniline Compounds↗

Comparison of two methods for the detection of urinary iodine used in epidemiological studies.

Two methods for the determination of iodine in urine or serum based on the Sandell-Kolthoff reaction were compared. The first was an autoanalyser method (AAII, Technicon) where the mineralisation takes place in a continuous flow manner. This procedure was used at the Department of Clinical Chemistry of the University Hospital of Berne (Switzerland) from 1968 until 1993. The second method was evaluated and adapted in our own laboratory. Each sample and the iodate-standards are mineralised in a Pyrex glass tube and the decolorisation reaction takes place in a 96-well-microtiter plate which was read by a PC-controlled photometer at 405 nm. This method, with a detection limit of 0.1 micromol/l showed good analytical recovery (90 to 110%) and a low imprecision (intra-assay coefficient of variation (CV) of 5% and an inter-assay CV of 7.5%). In contrast to the autoanalyser method, the microtiter plate-method is suitable both for series up to 24 samples (3-fold) and for single samples. A comparison of 87 samples in the range of 0.1 to 60 micromol/l which were measured with both Sandell-Kolthoff based methods showed no obvious discrepancy. These two methods showed a good agreement for the determination of urinary iodine. This guarantees that the results of earlier epidemiological studies can be compared with recent studies performed in our and many other laboratories.

Humans↗

Correction of iodine deficiency in Macedonia.

A national survey conducted in 1995-96 showed that mild to moderate iodine deficiency existed in Macedonia (median urinary iodine [UI] concentration 117 microg/l). It was concluded that a new legal regulation should be introduced concerning the iodination of table salt for human consumption. The iodine level was recommended to be 20-30 mg/kg salt, exclusively in the form of the more stable potassium iodate. The new regulations were instituted and became effective in October, 1999. National surveys performed in 2000 and 2001 showed increased median UI concentrations (154.1 microg/l in 2000 and 164.5 microg/l in 2001). In 2001, UI excretion was assessed in 490 pregnant and lactating women (median UI concentration 140 microg/l). During the last three surveys, household salt specimens were assessed for iodine content. The findings showed an increase of the percentage of the optimal iodine content in household salt (42-69%), which correlated with the higher IU excretion results. The new regime of salt iodination was proved to be highly effective in correcting the iodine deficiency in Macedonia.

Adolescent↗

The iodide/iodate actinometer in UV disinfection: determination of the fluence rate distribution in UV reactors.

Thirty-seven Suprasil quartz spheres, each approximately 1 cm in diameter and containing an iodide-iodate actinometric solution, were attached to a metal rack and inserted into a bench-scale UV reactor filled with water. The spheres were located at various distances and heights around a 12.4 W low-pressure Hg lamp housed inside a 3.2 cm-radius quartz sleeve in the middle of an annular batch reactor. UV light exposure at 254 nm was performed with the percent transmittance of the water present in the reactor at either 73% or 100% defined over a 1 cm path length. The spheres were simultaneously exposed to the UV light for a given period of time, after which the solutions were removed from the spheres and the yield of triiodide determined from the increase in absorbance at 352 nm. The resulting fluence rate at each site was then calculated on basis of the yield of triiodide. These results were compared with the predictions of a mathematical model based on the multiple point source summation approximation, including reflection and refraction at the air-quartz-water interface. Initially, the agreement was not satisfactory, especially in regions at an oblique angle to the lamp. The model was modified from a multiple point source model to a multiple cylindrical segment model by incorporating a cosine factor. The agreement between the new model and the experimental data was excellent and these experiments provide a strong validation of the model, even under conditions in which the fluence rate varied by >1000-fold between extreme sites in the reactor.

Journal Article↗

Determination of hydroxylysine in urine.

A new method for colorimetric determination of urinary hydroxylysine is described. Approximately one-hundredth of human urine collected for 24 hr was diluted to 25 ml and titrated to pH 2.0 with 2 hcl, and then subjected to column chromatography on Dowex 50 X 4 (H+ form). Amino acids were eluted from the column with 1.5 N NH4OH. Hydroxylysine in the elute with 1.5 N NH4OH was separated from the other amino acids, especially from serine and threonine, by preparative paper chromatography. The paper corresponding to hydroxylysine was cut and eluted with water. An aliquot of the eluate with water was oxidized by sodium metaperiodate, and formaldehyde liberated from hydroxylysine was assayed by chromotropic acid reagents, after removing periodate and iodate with Dowex 1 X 8 (formate form). Excretion rate of hydroxylysine in urine of adults was shown to be approximately 110 mumoles per day.

Chromatography↗

Effects of hemicholinium-3 on the pigmented rabbit retina and pigment epithelium.

Hemicholinium-3 effects on the albino rabbit neural retina have been described, but effects on the retinal pigment epithelium (RPE) have not been closely examined. We have studied retinal morphology and function in Dutch belted (pigmented) rabbits after single intravitreal injections of Hemicholinium-3 or saline. DC electroretinogram recordings show a decrease in a, b, and c-wave amplitudes, with the c-wave affected first. Experiments with sodium iodate show that the early decrease in the c-wave results from a loss of the RPE component of the c-wave, rather than the retinal Slow PIII component. After two days, ophthalmoscopic abnormalities of the fundus are severe in a large area with pigmentary changes. A sharp boundary appears between normally pigmented and depigmented fundus, indicative of a critical threshold for damage. The RPE contains clumped melanin. Pigmented cells are seen away from the basement membrane, an early histological observation temporally correlated with a loss of barrier function seen in fluorescein angiograms. After 10 days, apparent proliferation of non-pigmented RPE cells coincides with re-establishment of the barrier. Rod photoreceptor outer segments are lost 4-7 days after injection in the depigmented regions of the fundus, but outer segments are spared in normally pigmented fundus areas. This regional pattern is distinct from that seen in albino rabbit retina where outer segment loss is fairly uniform. We conclude that Hemicholinium-3 affects the RPE in pigmented rabbits in addition to known effects on retinal cholinergic neurons and photoreceptor disc synthesis.

Animals↗

Zirconyl hematoxylin: a new stain for acidic mucins.

Most stains for acidic mucins are time-consuming to prepare and have poor stability. Zirconyl hematoxylin is easily prepared and works for a year or more. It is made by adding 5 ml freshly-made 0.1% aqueous sodium iodate, 400 mg zirconyl chloride octahydrate, and 40 ml 25% aqueous glycerol, in that order, to 100 mg of hematoxylin in 5 ml of absolute ethanol and stirring for 5 min. Stain 10 min and do not "blue" the stain. Chlorazole black or kernechtrot and fast green are good counterstains. Zirconyl hematoxylin stains acidic mucins violet or red violet, regardless of how they are fixed. It stains the same mucins as alcian blue in mouse and sheep salivary glands. It shows goblet cells in mouse rectum as well as alcian blue. It stains the same stomach regions in a lizard as alcian blue. Like alcian blue and colloidal iron, zirconyl hematoxylin stains the mucin of cancerous prostate, but not normal prostate.

Animals↗

A new technique for the rapid screening and selection of large pieces of tissue for ultrastructural evaluation.

A simple and rapid technique is described for the screening of Epon embedded organ slices for the location, isolation, and removal of small specific sites for ultrastructural study with the transmission electron microscope. This procedure consists of perfusion fixation followed by making 1 to 21/2 mm thick slices of relatively large pieces of the organs, control of the degree and evenness of the osmium staining by addition of 3% sodium iodate, and infiltration with a fluorescent dye prior to embedment in Epon. Tissue slices are embedded in wafer-shaped blocks, generally with several slices in one "wafer", and are examined in a controlled manner using a rapid form of serial surface polishing. Each level of the polished wafer is examined using an epi-illuminated fluorescence microscope, and selected sites are chosen at each level for ultrastructural study. Methods are also described for marking each selected site using a conventional slide marker, and for the removal of the selected site in the form of a small disc of Epon, after which the Epon wafer can be further serially polished and the examination continued. Areas to be thin-sectioned are removed using a core drill mounted on a model-maker's drill press. The technique is simple, does not require the destruction of remaining tissues to evaluate more critically a single small site, allows for the easy maintenance of tissue orientation, and the most time-consuming portions of the technique can be quickly taught to a person with no previous histological training.

Animals↗

A new method using a modified Mayer's hemalum at pH 6 for demonstrating mucous neck cells.

The mucous neck cells of gastric glands were stained with a modified Mayer's hemalum adjusted to pH 6 with saturated aqueous lithium carbonate. One gram of hematoxylin was dissolved in 1000 ml distilled water and 200 mg sodium iodate, 3 g potassium alum, 50 g chloral hydrate and 1 g citric acid were added to the solution. Prior to staining, the solution was adjusted to pH 6 with saturated aqueous lithium carbonate. Bromine oxidation and urea abolished the alum hematoxylin reactivity of the mucous neck cells.

Animals↗