Comparison of spectrophotometric, fluorimetric, high-performance liquid-chromatographic and radioimmunological methods for the determination of theophylline concentrations in biological material

Uvedene su spektrofotometrijska, fluorimetrijska, tekućinskokromatografska i radioimunokemijska metoda za određivanje teofilina u biološkom materijalu. Kod fotometrijskih tehnika i tekućinske kromatografije visoke djelotvornosti teofilin je izoliran adsorpcijom na aktivni ugljen. Kod uvođenja radioimunokemijske metode vezano je antitijelo kemijski na cijanobromiranu Sepharozu. Sve analitičke metode zadovoljavale su s obzirom na osjetljivost (0,5-1,0 mg. L-1) i preciznost (CV unutar odnosno između određivanja ispod 10% u terapijskom području koncentracija), ali su s obzirom na selektivnost fotometrijske metode bile nepouzdane pri rutinskom određivanju koncentracija teofilina. Korelacija između pojedinih metoda je bila dobra i koeficijenti korelacije imali su vrijednosti više od 0,95.Spectrophotometric, fluorimetric, high-performance liquid chromatographic (HPLC) and radioimmunological (RIA) methods have been introduced for the determination of theophylline levels in the serum. The extraction on charcoal was used for drug isolation from biological fluids before spectrophotometric, fluorimetric and HPLC measurements. For the solid-phase RIA theophylline antibody was covalently bound to CNBr-activated Sepharose. For all introduced methods the inter- and intra-assay coefficients of variation were below 10 per cent in the therapeutic range of concentrations, and the sensitivity was below 1.0 mg. L-1. With the photometric methods high interferences of structurally similar drugs and other materials were observed. The correlations between different methods were good (r = 0.97 and 0.98)

Correlation between Fluorimetric and Microbiological Methods for Determination of Cephalexin in Urine and Serum

Peer Reviewe

Poisoning with phenobarbital and phenytoin treated by haemodialysis

Prikazan je tijek bolesti 48-godišnjeg bolesnika, alkoholičara, koji je imao epilepsiju i koji je u suicidalnoj namjeri uzeo nepoznatu količinu fenobarbitona i fenitoina. Primljen je u stanju duboke kome, arefleksije, sa pneumonijom obostrano bazalna, respiratornom insuficijencijom. Imao je koncentraciju fenobarbitona u serumu 810 mg/L, što je mnogo viša koncentracija nego se u literaturi opisuje, a imao je koncentraciju fenitoina također u toksičnom području: 68 mg L, s nistagmusom i produženim 0-T-intervalom u elektrokardiogramu. Primijenjen je postupak ekstrakorporalne hemodijalize u trajanju od 6 sati, uz protok krvi u aparatu 150 ml/min i površinu aparata od 1,4 m2. Nakon završetka postupka bolesnik je prostorno i vremenski orijentiran. Prosječna vrijednost koncentracije fenobarbitona na kraju hemo-dijalize iznosi 109 mg/L. Bolesnik je sedmog dana bolesti premješten u psihijatrijsku ustanovu.The paper deals with the course of illness in a 48-year-old man who attempted to commit suicide by taking an undefined amount of phenobarbital and phenytoin. He was admitted to hospital in a comatous state with pneumonia of both sides resulting in acute respiratory failure. He had a serum phenobarbital level of 810 mg/L, and a phenytoin level of 68 mg/L. After the treatment by haemodialysis for six hours, he regained consciousness, and serum phenobarbital concentration was 109 mg/L. On the seventh day after the beginning of illness he was transferred to a psychiatric institution

Poisoning with ethylene glycol treated by haemodialysis

Prikazan je tijek bolesti 56-godišnjeg bolesnika koji je poto nepoznatu količinu alkoholnog pića i zabunom je usto popio 150 ml 95%-tne otopine etilen glikola. Primljen je u Kliniku 28 sati nakon incidenta, a izmjerena koncentracija etilen glikola iznosila je 14 mg/100 ml seruma. Relativno spora eliminacija etilen glikola tijekom 28 sati prije početka hemodijalize možda se može objasniti zaštitnim djelovanjem etilnog alkohola koji je bolesnik popio prije etilen glikola. Nakon prijema, proveden je postupak izvantjelesne hemodijalize u trajanju od četiri sata, s protokom krvi u aparatu od 200 ml/min i s površinom membrane za dijalizu od 1,3 m2. Klirens etilen glikola i njegovih metabolita iznosio je 110- 150 ml/min. Ukupna izlučena količina etilen glikola tijekom 4-satne hemodijalize iznosila je oko 5 g, s time da je između prvog i drugog sata hemodijalize iznosila 1,5 g. Zbog razvoja akutnog zatajenja bubrega u još dva navrata preveden je postupak hemodijalize. Bolesnik je otpušten kući 13 dana nakon prijema, u zadovoljavajućem kliničkom stanju u fazi oporavka bubrežne funkcije.The paper deals with the course of illness in a patient aged 56 years who had ingested accidentally an unknown amount of alcoholic drink followed by 150 ml of 95 percent solution of ethylene glycol. The patient was admitted to the intensive care unit 28 hours after the accident. The serum ethylene glycol concentration reached 14 mg/100 ml. The slow elimination of ethylene glycol during 28 hours before haemodialysis could be explained by the protective effect of ethanol which the patient had consumed before ethylene glycol. The method of extracorporeal haemodialysis was applied for four hours; the membrane surface was 1.3 m2 and blood velocity 200 ml/min. The rate of clearance of ethylene glycol and its metabolites was 110-150 ml/min. The total amount of ethylene glycol eliminated during four hours of haemodialysis came to about 5 g. Four hours from the beginning of the treatment the serum ethylene glycol concentration was not measurable. As the patient developed signs of acute renal failure the haemodialysis method was applied two more times. The patient was dismissed from hospital in good clinical condition, with normal diuresis and repaired renal function on the 13th day from admission

Poisoning with a large dose of digoxin

Prikazan je tijek bolesti 63-godišnje bolesnice koja je u suicidalnoj namjeri uzela per os oko 10 mg medigoksina. Imala je znakove intoksikacije digitalisom: mučninu i povraćanje, u elektrokardiogramu atrioventrikularnu disocijaciju s fibrilacijom atrija·i koncenrraciju digoksina u plazmi od 19,9 nmol/L. Imala je znakove akutnog zatajenja bubrega i, u povezanosti s renalnom insuficijencijom, poluživot digoksina u plazmi iznosio je od 30 do 90 sati. EKG promjene korigiranog 0-T-intervala i P-T-Q-indeksa bile su u korelaciji s ostalim znakovima intoksikacije digitalisom. Sedmog dana bolesti koncentracija digoksina u plazmi iznosila je 2,5 nmol/L.The paper describes the course of ilness in a 63-year-old woman who ingested 10 mg of medigoxin with suicidal intent. The first signs of poisoning were nausea and vomiting. The electrocardiogram showed sings of atrioventricular dissociation and atrial fibrillation, and serum digoxin concentration was 19.9 nmol/L, The partien1: also had sings of acute renal failure with a renal failure index of 3.9. Digoxin half-life was between 30 and 90 hours, depending on renal damage. ECG signs of digitalis intoxication were in correlation with the corrected 0-T-interva! and P-T-0 index. On the seventh day of the ilness the serum digoxin concentration was 2.5 nmol/L

Oleander intoxication

Prikazan je tijek bolesti 17-godišnje bolesnice koja je u suicidalnoj namjeni uzela per os 5 listova oleandera. Imala je kliničku sliku intoksikacije digitalisom. Postupak je započet s hemodijalizom, a nakon jednog sata uključen je i postupak hemoperfuzije jantarnom smolom kroz iduća 3 sata. Postupno su aritmije srca nestale kao i gastrointestinalne tegobe. Izmjerena lažna koncentracija digoksina prije postupka iznosila je 1,7 nmol/L, što preračunato iznosi oko 170 nmol/L oleandrina. U daljem tijeku klinička se slika popravila, no lažna koncentracija digoksina i dalje je bila prisutna - povišena preračunata koncentracija oleandrina, najvjerojatnije zbog interferencije metabolita. Ukupna količina oleandnina uzeta per os iznosila je oko 60 mg. Volumen distribucije iznosio je oko 260 L. Bolesnica je otpuštena kući sedmog dana od početka bolesti.A 17-year old girl attempted to commit suicide by eating five leaves of oleander. The symptoms and signs of poisoning were nausea, vomiting, diarrhoea and disturbances in the rhythm and conduction of the heart: nodal tachycardia, first degree atrioventricular block, ventricular premature beats, intermittent atrial fibrillation, incomplete right bundle branch block, intermittent left bundle branch block, and S-T segment depression. All the symptoms disappeared after the treatment with the resin hemoperfusion method for three hours. The apparent digoxin concentration at the beginning of treatment was 1.7 nmol/L, that is 170 nmol/L of oleandrin. The volume of distribution was 260 L. The patient was dismissed on the seventh day

Methyprylon intoxication

Prikazan je tok bolesti 60-godišnje bolesnice koja je zbog akutne psihoze liječena u psihijatrijskoj ustanovi, a na dan transporta u mjesto stanovanja bila je u komi IV. stupnja. Toxi-lab analizom seruma nisu nađeni psihofarmaci koji se rabe u našoj zemlji, već tvar s karakteristikama metiprilona. Bolesnica je bila u stanju kome gotovo puna četki dana: razvila se slika hipotenzije, edema pluća, respiratorna insuficijencija, obostrana pneumonija. Primjenom reanimacijske terapije, pospješivanjem diureze furosemidom, lanatozidom C primijenjenim uz dopamin i ampicilin, nakon 90 sati probudila se iz kome. Otpuštena je iz bolnice 5,5 mjeseci nakon prijema.The paper deals with the course of illness in a 60-yeair-old woman who had taken several drugs simultaneously. She was treated in a psychiatric hospital for 67 days for acute psychosis. On the day when she was supposed to leave hospital she was found in a state of deep coma. A substance with the characteristics of methyprylon was identified by toxicologicai laboratory analysis. The state of coma lasted 90 hours and was complicated with hypotension, pneumonia and pulmonary oedema. The patient regained consciousness without any neurological disturbances, and was discharged from hospital after 22 weeks of treatment

Ethanol intoxication treated by haemodialysis

Prikazan je tijek bolesti 68-godišnjeg bolesnika koji je u suicidalnoj namjeri popio 1,5 litara žestokog alkoholnog pića (570 mL etanola). Primljen je u komi III. stupnja, s koncentracijom etanola u serumu 5,09 g/L. Primijenjen je postupak ekstrakorporalne hemodijalize, tijekom kojega je postao kontaktibilan. Koncentracija etanola u serumu snizila se na 3,46 g/L nakon 2 sata, a nakon iduća 2 sata na 0,82 g/L. Klirens etanola iznosio je 260 mL/min. Bolesnik je otpušten kući četvrtog dana nakon prijema.The paper deals with the course of illness in a 68-year-old man who attempted to commit suicide by drinking 1.5 L of a concentrated alcoholic drink (570 ml of ethanol). He was admitted to hospital in a state of the III degree coma, with a serum ethanol concentration of 5.09 g/L. He was treated by the method of extracorporeal haemodialysis for four hours. At the end of two hours ethanol concentration in the serum decreased to 3.46 g/L and at the end of the treatment it was 0.82 g/L. The rate of ethanol clearance reached 260 ml/min. The patients was dismissed from hospital on the fourth day of admittance

Bridge deck runoff control trough drainage, treatment and irrigation system: The case study of the bridge Ostruznica over the Sava river

The paper presents main design project of the bridge Ostruznica deck drainage and runoff treatment. An integral solution of drainage and irrigation and/or discharge water into the Sava river of pre - treated runoff from the portion of highway Dobanovci – Bubanj Potok and the bridge The treated water is taken for irrigation into the groundwater as a recharge, along the series of wells for potable water within sanitary protection zone of the Belgrade Water supply system. The first flush of the criteria rainfall runoff volume is to be pre - treated using a StormwaterR barrels. Such a solution is considered as an additional water source at the aquifer by the rivers’ banks. Also, it is a measure of water cycle improvement. The project is completed by a SwermR preventing system for accidental situation, such as leakage or accidents of vehicles and potential pollution and risks of vulnerability for the potablewater wells

Bridge deck runoff control trough drainage, treatment and irrigation system: The case study of the bridge Ostruznica over the Sava river

The paper presents main design project of the bridge Ostruznica deck drainage and runoff treatment. An integral solution of drainage and irrigation and/or discharge water into the Sava river of pre - treated runoff from the portion of highway Dobanovci – Bubanj Potok and the bridge The treated water is taken for irrigation into the groundwater as a recharge, along the series of wells for potable water within sanitary protection zone of the Belgrade Water supply system. The first flush of the criteria rainfall runoff volume is to be pre - treated using a StormwaterR barrels. Such a solution is considered as an additional water source at the aquifer by the rivers’ banks. Also, it is a measure of water cycle improvement. The project is completed by a SwermR preventing system for accidental situation, such as leakage or accidents of vehicles and potential pollution and risks of vulnerability for the potablewater wells