Assessment of suspected insulinoma by 48-hour fasting test: a retrospective monocentric study of 23 cases.

OBJECTIVE: Insulinoma causes fasting hypoglycaemia due to inappropriate insulin secretion. The diagnosis of insulinoma is based on Whipple's triad during a supervised fasting test. The aim of our study was to evaluate retrospectively the percentage of positive 48-hour fasting tests in a large series of patients with insulinoma. DESIGN, PATIENTS AND METHODS: In a retrospective study, we identified 39 patients (24 females, 15 men; average age 47 years [range 12-78 years]) with insulinoma. Sixteen patients were diagnosed by spontaneous hypoglycaemia. Twenty-three patients with insulinoma were tested with a 48-hour fasting test and compared to 31 healthy controls who had a negative fasting test and were followed up for at least two years. RESULTS: The fast was terminated due to neuroglycopenic symptoms in 4 patients (17.4%) at the 12th hour, in 17 patients (73.9%) at the 24th hour, and in 22 patients (95.7%) at the 48th hour. One patient with insulinoma had no neuroglycopenic symptoms, but was diagnosed by glucose and insulin levels during the 48-hour fast. Healthy controls had significantly higher blood glucose and lower insulin levels, and a lower insulin-glucose ratio than patients with insulinoma at the end of the fast. CONCLUSIONS: In conclusion, the 48-hour fasting test was successful in the diagnosis of insulinoma in 95.7% of patients. In this series we did not observe a need for fasting beyond 48 hours.

Kinetics and energetics of redox regulation of ATP synthase from chloroplasts.

The rate of ATP hydrolysis catalyzed by the membrane-bound CF0F1 ATP synthase from chloroplasts served as a probe for the determination of the reduction grade of the enzyme treated with dithiothreitol (DTT) or thioredoxin. Rate constants for reduction were obtained. It turns out that reduction by thioredoxin is about a factor of 6,000 more effective than DTT reduction. The activation profiles with respect to delta pH were obtained for reduced and oxidized ATPases. The activation curve of reduced enzyme turns out to have its half-maximum degree of activation at delta pH = 1.65, which is considerably lower than reported hitherto. The corresponding value of the oxidized enzyme has been obtained from the rate of ATP hydrolysis in the case of incomplete reduced ATPases, taking into account the aforementioned rate constants, and comes to delta pH = 3.35.

Separation of traces and larger amounts of bismuth from gram amounts of thallium, mercury, gold and platinum by cation-exchange chromatography on a macroporous resin.

Traces and larger amounts of bismuth (up to 50 mg) can be separated from gram amounts of thallium, mercury, gold and platinum (up to 5 g) by sorption from a mixture of 0.1M hydrochloric acid and 0.4M nitric acid on a column containing just 3 g (8.1 ml) of AGMP-50, a macroporous cation-exchange resin. This resin retains bismuth much more strongly than does the usual microporous resin (styrene-DVB with 8% cross-linkage). Other elements are eluted with the same acid mixture as that used for sorption, and bismuth is finally eluted with 1.0M hydrochloric acid. Separations of bismuth are sharp and recoveries quantitative. Only microgram amounts of the other elements remain in the bismuth fraction. Amounts of bismuth as little as 5 mug have been separated from 5 g of thallium, and determined (r.s.d. = 2%) by flame atomic-absorption. Only 100-mug amounts of bismuth have been separated from gram amounts of mercury, gold, and platinum, but there is no reason to believe that smaller or larger amounts of bismuth cannot be separated from these elements and recovered with the same accuracy as that for the separation from thallium. The lower limit of the method is determination of 0.4 mug of bismuth in 10 ml of solution (0.004 absorbance). An elution curve, the relevant distribution coefficients and the results of analysis of synthetic mixtures and two practical samples [thallium metal and mercury(II) nitrate] are presented.

Separation of yttrium and neodymium from samarium and the heavier lanthanides by cation-exchange chromatography with hydroxyethylenediaminetriacetate in monochloroacetate buffer.

Trace and mg amounts of yttrium and neodymium are separated from samarium and the heavier lanthanides by elution of the latter with hydroxyethylenediaminetriacetate (HEDTA) in a chloroacetate buffer of pH 2.85 from a column containing 68 ml (20 g) of AG 50W-X4 resin of 200-400 mesh particle size. Yttrium and neodymium (and also praeseodymium, cerium and lanthanum) are retained and can be eluted with 0.01M HEDTA in 0.20M ammonium acetate (pH 6). The separations are reasonably sharp and quantitative: only 3-15 microg of samarium was found in the yttrium fraction and 0.8-3.4 microg of yttrium in the samarium fraction when 4.41 mg of yttrium and 7.12 mg of samarium were present originally. Control of the pH during the column operations is essential because the peak positions are very sensitive to change in pH. The relevant distribution coefficients, elution curves of pairs of elements and results for the analysis of synthetic mixtures are presented. Also included is a method for separating yttrium and the lanthanides from HEDTA and sodium and ammonium ions.

67Ga/Zn separation with an organic adsorbent.

A 67Ga/Zn separation method is presented which uses an organic polymer containing no ion exchange groups, instead of an ion exchange resin. With the apparatus described, high quality 67Ga citrate can be obtained in good yield with little effort. Values for distribution coefficients for Ga on various resins and at different HCl concentrations are presented.

Distribution coefficients and ion-exchange selectivities for 46 elements with a macroporous cation-exchange resin in hydrochloric acid-acetone medium.

Distribution coefficients with the macroporous cation-exchange resin AG MP-50 in HCl-acetone mixtures ranging from 0.2 to 4.0M HCl and from 0 to 95% acetone have been determined for 46 elements. The ion-exchange behaviour of the elements is discussed, some possible separations are indicated, and elution curves demonstrating separations of the combinations Au(III)BiZnPbSr; Rh(III)InGaCuNi and CdFe(III)LiAlYb are presented.

Separation of trace amounts of indium, gallium and aluminium from each other by cation-exchange chromatography on AG50-X4 resin.

Traces and minor amounts of indium, gallium and aluminium can be separated from gram amounts of thallium and from each other by cation-exchange chromatography on a column containing as little as 2 g of AG50W-X4, a cation-exchange resin with low cross-linking. An elution sequence of 0.1 M HBr in 40% acetone [for Tl(III)], 0.2M HBr in 80% acetone for In, 0.3M HCl in 90% acetone for Ga and 3M aqueous HCl for Al is used. The separations are very sharp and even 10-mug amounts of In, Ga and Al in synthetic mixtures are recovered quantitatively, with a standard deviation of 0.3 mug. The separation factors between neighbouring ions are extremely large (> 5000).

Separation of bismuth from gram amounts of thallium and silver by cation-exchange chromatography in nitric acid.

Traces and small amounts of bismuth can be separated from gram amounts of thallium and silver by successively eluting these elements with 0.3M and 0.6M nitric acid from a column containing 13 ml (3 g) of AG50W-X4, a cation-exchanger (100-200 mesh particle size) with low cross-linking. Bismuth is retained and can be eluted with 0.2M hydrobromic acid containing 20% v/v acetone, leaving many other trace elements absorbed. Elution of thallium is quite sharp, but silver shows a small amount of tailing (less than 1 gmg/ml silver in the eluate) when gram amounts are present, between 20 and 80 mug of silver appearing in the bismuth fraction. Relevant elution curves and results for the analysis of synthetic mixtures containing between 50 mug and 10 mg of bismuth and up to more than 1 g of thallium and silver are presented, as well as results for bismuth in a sample of thallium metal and in Merck thallium(I) carbonate. As little as 0.01 ppm of bismuth can be determined when the separation is combined with electrothermal atomic-absorption spectrometry.

The influence of thiourea on the cation-exchange behaviour of various elements in dilute nitric and hydrochloric acids.

Cation-exchange distribution coefficients for 21 elements between the cation-exchange resin AG50W-X4 and dilute nitric and hydrochloric acid containing up to 2.0M concentration of thiourea are presented. The ion-exchange behaviour of the elements and some possible separations are discussed. Four multi-element elution curves are presented, demonstrating the separation of the combinations Ga(Ag, Cu)Zn(Cd, Pb, In, Sn[IV]), CoPbSbTe, ZnCdBiHg, and AgCdInAu.

Separation of silver from zinc, cadmium, copper, nickel and other elements in nitric acid with a macroporous resin.

Traces of silver and amounts up to 50 mg can be separated from up to gram amounts of Zn, Cu(II), Ni, Co(II), Mg, Be, Ti(IV), V(IV), Li and Na by eluting these with 2.0M nitric acid from a column containing 54 ml (20 g) of macroporous AG MP-50 cation-exchange resin of 100-200 mesh particle size, in the H(+)-form. Silver is retained and can be eluted with 0.5M hydrobromic acid in 9:1 v v acetone-water. Separations are sharp and quantitative and only a few microg of the other elements are found in the silver fraction. Cadmium and manganese (II) can also be separated quantitatively but show tailing and require larger elution volumes. Some typical elution curves and results of analyses of synthetic mixtures are presented.

Separation of iron-52 from chromium cyclotron targets on the 2% cross-linked anion-exchange resin AG1-X2 in hydrochloric acid.

Iron-52 can be separated from solutions of chromium cyclotron targets by eluting chromium, copper and radioactive impurities with 9.0M hydrochloric acid from a column containing 1.0 g of AG1-X2 anion-exchange resin. Iron-52 is retained and can then be eluted with 6.0M hydrochloric acid containing 0.05M hydrogen iodide or 0.05M sodium iodide. The separations are sharp and quantitative. Less than 2 microg of chromium will remain with the iron-52, from 2.0 g originally present.

Cation-exchange behaviour of the platinum group and some other rare elements in hydrobromic acid-thiourea-acetone media.

Ion-exchange distribution coefficients and elution curves are presented for copper(I), silver, gold(I), palladium, platinum(II), rhodium(III), iridium(III), ruthenium(III), osmium(III), mercury(II), thallium(I), tellurium(II), lead and bismuth in mixtures of thiourea, hydrobromic acid, acetone and water, with the cation-exchange resin AGW50W-X4. The system affords excellent separations of rhodium, mercury, silver (or copper), tellurium, gold, and palladium (or platinum) from each other.

Cation-exchange in thiourea-hydrochloric acid solutions.

Ion-exchange distribution coefficients are reported for several transition and post-transition elements in solutions of hydrochloric acid (0.1-3.0M) and thiourea on AG50W resins. Some typical elution curves illustrate use of the systems with special reference to the separation of small amounts of gold, palladium, platinum, rhodium and iridium from large amounts of numerous base metals by using 1.5M hydrochloric acid-0.1M thiourea as eluent. Also illustrated is the use of a bromine-containing solution to strip thiourea complexes from a cation-exchange column.

Separation of lead-203 from cyclotron-bombarded thallium targets by ion-exchange chromatography.

A simple method is presented for the separation of lead-203 from copper-backed thallium cyclotron targets. The procedure involves cation-exchange chromatography in hydrochloric acid and hydrochloric acid-acetone mixtures. Further purification involves anion-exchange chromatography in nitric acid-hydrobromic acid mixtures. A cation-exchange column containing 3.0 g of resin can handle as much as 15 g of thallium and 160 mg of copper. An anion-exchange column containing 3.0 g of resin can separate lead from up to 200 mg of thallium and 10 mg of copper. Separations are extremely sharp and less than 0.1 mug of thallium and less than 0.1 mug of copper remain in the lead-203 fraction.

Selective and quantitative separation of zinc and lead from other elements by cation-exchange chromatography in hydrohalic acid-acetone solutions.

Zinc and lead can be separated from Cd, Bi(III), In and V(V) by eluting these elements with 0.2M hydrochloric acid in 60% acetone from a column of AG50W-X8 cation-exchange resin, zinc and lead being retained. Mercury(II), Tl(III), As(III), Au(III), Sn(IV), Mo(VI), W(VI) and the platinum metals have not been investigated quantitatively, but from their distribution coefficients, should also be eluted. Vanadium(V), Mo(VI) and W(VI) require the presence of hydrogen peroxide. Zinc and lead can be eluted with 0.5M hydrochloric acid in 60% acetone or 0.5M hydrobromic acid in 65% acetone and determined by AAS; the alkali and alkaline-earth metal ions, Mn(II), Co, Ni, Cu(II), Fe(III), Al, Ga, Cr(III), Ti(IV), Zr, Hf, Th, Sc, Y, La and the lanthanides are retained on the column, except for a small fraction of copper eluted with zinc and lead. Separations are sharp and quantitative. The method has successfully been applied to determination of zinc and lead in three silicate rocks and a sediment.

Improved separation of iron from copper and other elements by anion-exchange chromatography on a 4% cross-linked resin with high concentrations of hydrochloric acid.

Iron(III) can be separated from copper(II) and many other elements by eluting these from a column of AG1-X4 anion-exchange resin with 8M hydrochloric acid, while iron(III) is retained and can be eluted with 0.1M hydrochloric acid. The separation is much better than the customary one with 3.5M hydrochloric acid. Columns containing only 8.8 ml (3 g) of resin can separate traces or up to more than 1 mmole of iron(III) from more than 1 g of copper. Mn(II), Ni, Al, Mg and Ca are quantitatively eluted together with copper(II). Lead, the alkali metals, Be, Sr, Ba, Ra, Sc, Y and the lanthanides, Ti(IV), Zr, Hf, Th and Cr(III) have not been investigated in detail but should be separated according to their known distribution coefficients. Separations are sharp and quantitative, less than 1 mug of copper remaining in the iron fraction when more than 1 g was present originally. Relevant elution curves and results of the quantitative analysis of synthetic mixtures are presented.

Quantitative separation of gallium from zinc, copper, indium, iron(III) and other elements by cation-exchange chromatography in hydrobromic acid-acetone medium.

Gallium can be separated from Zn, Cu(II), In, Cd, Pb(II), Bi(III), Au(III), Pt(IV), Pd(II), Tl(III), Sn(IV) and Fe(III) by elution of these elements with 0.50M hydrobromic acid in 80% acetone medium, from a column of AG50W-X4 cation-exchange resin. Gallium is retained and can be eluted with 3M hydrochloric acid. Separations are sharp and quantitative except for iron(III) which shows extensive tailing. With 0.20M hydrobromic acid in 80% acetone as eluting agent, all the species above except iron(III) and copper(II) can be separated from gallium with very large separation factors. Only a 1-g resin column and small elution volumes are required to separate trace amounts and up to 0.5 mmole of gallium from more than 1 g of zinc or the other elements. Hg(II), Rh(III), Ir(IV), Se(IV), Ge(IV), As(III) and Sb(III) have not been investigated, but should be separated together with zinc according to their known distribution coefficients. Relevant elution curves, results for the analysis of synthetic mixtures and for amounts of some elements remaining in the gallium fraction are presented.

Comparative study of the masking effect of various complexans in the spectrophotometric determination of uranium with arsenazo III and chlorophosphonazo III.

Results are presented for the masking of 35 elements with the complexans DTPA, EGTA and TTHA in the spectrophotometric determination of uranium(VI) with Arsenazo III at pH 1.8 +/- 0.2 and with Chlorophosphonazo III at pH 1.1 +/- 0.2. The complexans EDTA and DCTA were found to be less suitable because at low pH they tended to precipitate. DTPA is shown to be especially attractive for masking other elements in the determination of uranium(VI) at low pH.

Quantitative separation of gold from cadmium, indium, zinc and other elements by cation-exchange chromatography in hydrochloric acid-acetone medium.

Gold(III) can be separated from Cd, In. Zn, Ni, Cu(II), Mn(II), Co(II), Mg, Ca, Al, Fe(III), Ga and U(VI) by adsorbing these elements on a column of AG50W-X8 sulphonated polystyrene cation-exchange resin from 0.1M HCl containing 60% v v acetone, while Au(III) passes through and can be eluted with the same reagent. Separations are sharp and quantitative. The amounts of gold retained by the resin are between 1 and 2 orders of magnitude lower than encountered during adsorption from aqueous 0.1M HCl. Recoveries for mg amounts of gold are 99.9% or better and for ng amounts are still better than 99%, as shown by radioactive tracer methods. Hg(II), Bi, Sn(IV), the platinum metals and some elements which tend to form oxy-anions in dilute acid accompany gold. All other elements, though not investigated in detail, should be retained, according to their known distribution coefficients. Relevant elution curves, results of quantitative separations of binary mixtures and of recovery tests are presented.

Selective separation of indium from zinc, lead, gallium and many other elements by cation-exchange chromatography in hydrohalic acid-acetone medium.

Indium can be separated from Zn, Pb(II), Ga, Ca, Be, Mg, Ti(IV), Mn(II), Fe(III), Al, U(VI), Na, Ni(II) and Co(II) by selective elution with 0.50M hydrochloric acid in 30% aqueous acetone from a column of AG50W-X8 cation-exchange resin, all the other elements being retained by the column. Lithium is included in the elements retained by the column when 0.35M hydrochloric acid in 45% aqueous acetone is used for eluting indium, but the elution of indium is slightly retarded. Ba, Sr, Zr, Hf, Th, Sc, Y, La and the lanthanides, Rb and Cs should also be retained according to their distribution coefficients. Cd, Bi(III), Au(III), Pt(IV), Pd(II), Rh(III), Mo(VI) and W(VI) can be eluted with 0.20M hydrobromic acid in 50% aqueous acetone before the elution of indium, and Ir(III), Ir(IV), As(III), As(V), Se(IV), Tl(III), Hg(II), Ge(IV), Sb(III) and Sb(V), though not investigated in detail, should accompany these elements. Relevant distribution coefficients and elution curves and results for analyses of synthetic mixtures of indium with other elements are presented.