[Clinical usefulness of the acetaminophen detection kit in treating acute poisoning--data from a survey of 28 cases treated at Niigata City general hospital].

In acute poisoning caused by acetaminophen (N-acetyl-p-aminophenol, APAP), it is critical to predict the onset of delayed liver injury based on the prompt measurement of serum APAP level and to administer the antidote N-acetylcysteine (NAC) without delay as needed. However, all emergency medical facilities are not necessarily equipped with an expensive analytical instrument that allows prompt determination of APAP. Here, we tested the clinical usefulness of the Acetaminophen Detection Kit (Kanto Chemical Co., Ltd.), which claims to rapidly detect APAP in serum using a simple procedure, by spectrophotometrically measuring the APAP concentration in 34 serum samples collected from 28 patients with acute APAP poisoning. The results showed that the correlation coefficient between the APAP value measured by the Acetaminophen Detection Kit and that determined by the HPLC method was, at 0.888, not very high, but that the decision on whether to administer NAC based on the measured APAP level was consistent between the two analytical methods in 23 out of 25 patients. Also, the value obtained by the Acetaminophen Detection Kit was equal to, or larger than, that obtained by the HPLC method, suggesting that it is unlikely that patients requiring NAC would be left untreated. These results indicate that the Acetaminophen Detection Kit, with its ease and simplicity of use, is clinically useful in emergency medical facilities for which an expensive analytical instrument is not affordable.

Rapid analysis method for paraquat and diquat in the serum using ion-pair high-performance liquid chromatography.

In the present study, by using IPCC-MS3 (GL Sciences Inc. Tokyo, Japan) as the counter-ion in the mobile phase, we established a simple, quick method of analysis that separated and quantified paraquat and diquat on an ODS column by introducing the deproteinized serum sample directly into HPLC. The calibration curve of paraquat and diquat detected at UV 290 nm showed good linearity when the concentration of the injected sample was in the range 0.1-10.0 microg/ml. The detection limit was 0.05 microg/ml, and the mean recoveries (n=5) added 1.0 microg/ml each of paraquat and diquat to standard serum were 87.5% and 89.1%, respectively, while the RSD were 4.52% and 3.85%. All of these were good results, and the time taken for one analysis was less than 30 min. As a result of employing this analytical method for the analyses in four cases of acute poisoning, it was possible to decide promptly on treatment approaches for all of the present cases.

Rapid analysis of 4-O-methylpyridoxine in the serum of patients with Ginkgo biloba seed poisoning by ion-pair high-performance liquid chromatography.

We have established a new method of HPLC analysis for the rapid separation from human serum and the quantification of 4-O-methylpyridoxine (MPN), which is contained in Ginkgo biloba seeds, and which, when consumed in large amounts, causes vomiting and convulsions. As a result of using IPCC-MS3 (GL Science, Tokyo, Japan), an ion-pair reagent, in the mobile phase, we succeeded in separating MPN in the deproteinized serum sample which was introduced directly onto the reverse-phase HPLC column. For the calibration curve of MPN standard solution, prepared with fluorescence detection at an excitation wavelength of 290 nm and an emission wavelength of 400 nm, a good linear relationship was obtained within the HPLC injection range of 10 ng-10 pg (in terms of the injected sample concentration, range: 1.0 microg/ml-1 ng/ml), allowing the detection of minute amounts, with the limit of detection (concentration of injected sample: 500 pg/ml) being 5 pg. In addition, when MPN solution was added to human reference serum to give a concentration of 0.002 microg/ml, the mean recovery rate was 92.5%, with RSD=7.09% (n=5). The time required for one analysis using this method is approximately 30 min, and thus it offers the advantages of greater speed and superior analytical sensitivity over the conventional methods, which require solid-phase extraction. We employed our new method to determine both the serum levels of MPN in 5 patients with Ginkgo biloba seed poisoning and the levels of free-form MPN in such seeds obtained in 8 regions of Japan.