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Avian influenza virus was not known to cause systemic infection in humans before. We report a 3-year-old boy with good past health who developed pneumonia caused by H5N1 avian influenza A virus (A/Hong Kong/156/97). The virus was isolated from a tracheal aspirate. There were complications of Reye's syndrome, adult respiratory distress syndrome, and multiple organ system failure. He had a history of receiving aspirin. His adult respiratory distress syndrome did not respond to endotracheal surfactant replacement therapy. He died 6 days after admission. Clinicians should be alert to the importance of a new human influenza strain.

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BACKGROUND: Hyperhomocyst(e)inemia is associated with premature peripheral vascular, cerebrovascular, and coronary artery disease. Because homocysteine has been found to be damaging to endothelial cells in animal and cell culture studies, we evaluated the association between hyperhomocysteinemia and arterial endothelial dysfunction (a marker of early atherosclerosis) in asymptomatic adult subjects. METHODS AND RESULTS: Using high-resolution ultrasound, we measured endothelium-dependent flow-mediated dilation (EDD) and endothelium-independent nitroglycerin-induced dilation (GTN) of the brachial artery in 14 prospectively defined hyperhomocysteinemic (mean plasma homocysteine, 34.8+/-8.5 micromol/L), nonsmoking, healthy subjects aged 53+/-9 years and 14 control subjects with low plasma homocysteine levels (9.9+/-3.2 micromol/L). The two groups were well matched for age; sex; body mass index; blood pressure, blood cholesterol, folate, and vitamin B12 levels; and vessel diameter. EDD was significantly lower in hyperhomocysteinemic subjects (6.5+/-1.7%) than in subjects with low homocysteine levels (10.8+/-1.7%) (P<.001). GTN responses were similar in the two subject groups (P=.90). Multivariate analysis confirmed homocysteine level as the strongest predictor for impaired EDD, independent of age, sex, body mass index, or blood pressure, folate, vitamin B12, and cholesterol levels. CONCLUSIONS: Hyperhomocysteinemia is an independent risk factor for arterial endothelial dysfunction in healthy middle-aged adults.

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Thin-film platinum electrodes have been prepared for use in a system for measurement of glucose. Cyclic voltammetry was used to test the electrodes in phosphate and bicarbonate solutions, and in the dialysate of human serum. The peak current output for glucose concentrations between 50-300 mg/dl in a phosphate buffer, and 100-250 mg/dl in the dialysate of human serum, were linear. Two of the three inflection points occurring in the voltammograms are invariant with changes in scan rate, pH, CO2, O2, and glucose. A method for using these points to compensate for voltage drift and current shift is discussed.

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An electrochemical sensing method was studied, employing cyclic voltammetry at smooth Pt-electrodes in the low potential region. It has certain advantages over methods that employ higher potentials or constant voltage amperometry. There are also advantages over methods employing active enzymes or other unstable elements. In addition to a specific scanning potential we have studied voltage-delay-pulsing techniques for electrode rejuvenation and innovative methods of creating analyte-selective covering membrane. At potentials below -0.6 V vs Ag/AgCl, peaks of adsorbed glucose species have been observed in cyclic voltammograms. These peaks at about -0.7 V (oxidation peak) and -0.8 V (reduction peak) have yielded reproducible current-glucose concentration relationships, linear through the region of clinically important glucose concentrations (50-300 mg/dl) and stable over time. Since these potentials are not in the redox range of many potentially interfering substances, selectivity is enhanced.

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When metoprolol in methanol was analysed by capillary gas chromatography (GC), an additional peak was observed; mass spectrometry (MS) showed this additional peak to have a molecular weight 12 dalton higher than that of the parent compound. A similar phenomenon was observed with other beta-adrenergic blocking aryloxypropanolamines in methanol or dichloromethane. Capillary GC-MS using deuterated solvents as isotopic markers showed that a methylene group from the solvents was incorporated into the parent molecule. The structure of the observed products and the mechanism of their formation are proposed.

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Phosphine was detected in post mortem stomach and contents, blood, and liver specimens of a man who had ingested tablets containing aluminium phosphide. The phosphine was released from the samples after acid treatment and analysed by means of a headspace gas chromatographic technique using a nitrogen phosphorus detector.

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Postmortem samples from two fatalities involving parathion ingestion were examined. Parathion could not be detected in the liver tissue but a significant quantity of a related compound was detected. This was shown to be aminoparathion, a biotransformation product of parathion. The substances were extracted with hexane and analyzed by gas-liquid chromatography on a 3% OV-210 column. Thin-layer chromatography and mass spectrometry were also performed. The transformation of parathion to aminoparathion in human tissue has not been previously reported.

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