A number of laboratory and clinical studies have shown that interleukin-6 is the principal mediator of the acute phase protein response. In this study the relationship between serum concentrations of interleukin-6 and C-reactive protein in acute pancreatitis are examined and the ability of interleukin-6 to discriminate between severe and mild attacks is assessed. We have studied 24 patients (10 severe and 14 mild). Serum samples were collected on admission, six hourly for 48 hours and then 12 hourly for a further three days. 'When the areas under the curves of individual patients were compared there was a strong correlation between the total production of interleukin-6 and C-reactive protein (r=0.73) (Spearman rank correlation) and peak interleukin-6 and C-reactive protein concentrations (r=0-75), suggesting a close relationship between interleukin-6 and C-reactive protein production. Both on admission and peak interleukin-6 concentrations were significantly higher in patients with severe than mild disease. There was no significant difference in on admission C-reactive protein concentrations, although significant differences were seen when peak concentrations were considered. Utilising a peak interleukin-6 concentration of >130 u/ml, we were able to distinguish between severe and mild attacks of acute pancreatitis with a sensitivity of 100% and specificity of 71%. These figures were comparable with those for peak C-reactive protein, a C-reactive protein of

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The pH-dependence of the magnetic moment of a ferri-haem undecapeptide, produced by peptic digestion of cytochrome c, has been measured in aqueous solution using a nuclear magnetic resonance method.Below pH 3 the magnetic moment is consistent with the p.resence of hydroxo-bridged dimers of high-spin iron(II1). Above pH 7 the iron(II1) is low-spin, the spin crossover conforming to a simple titration curve with pK 6.3 (n = 1). This transition is discussed with reference to spectrophotometric studies of ligand binding at the haem.The influence of the protein on the metal ion at the active site of a metalloenzyme is central to the theory of entasis [l]. The influence of globin on haem has been studied using the properties of intact haemoglobin [2], while iron-sulphur proteins have been approached in a complimentary manner by studying the effects of binding small peptides to their chemically synthesized iron-sulphur cores [3]. An intermediate approach, which we are beginning to investigate, is to make use of metal-containing peptide fragments resulting from the enzymic digestion of native enzymes.Of particular interest is a haem-containing undecapeptide ( Fig. 1) derived from peptic hydrolysis of cytochrome c [4]. This provides an opportunity to study the haem group in aqueous solution relatively unshielded by protein, yet soluble over an appreciable pH range. In addition, only a limited number of donor groups may be expected to interact with

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The objective of these clinical trials was to calculate the performance, limit of detection, specificity and sensitivity of a novel, semi-quantitative immunoassay for drugs of abuse in saliva and to determine operator bias when measured blind by four different operators. The test is based on lateral flow gold particle technology coupled with digital photography to provide a semi-quantitative end point. The performance of the test was compared with that of enzyme immunoassays and GC/MS methods. Volunteers consumed marijuana or codeine and their saliva was collected 0.25 to 24 h later with the Cozart RapiScan collection device. The sensitivity and specificity of the opiate test were both 100% ± 10.4% for codeine for 9 h after dosing. The cutoff of the marijuana test at 10 ng/mL THCA was too high to detect marijuana use for more than a few hours after smoking. There was no operator bias because the results were presented in written form either as “positive” or “negative for each of the five drug classes on the screen of the hand-held reader.

This study measured the volume and colour, as weli as concentrations of trypsinogen activation peptides (TAP) in the peritoneal fluid of 22 patients with acute pancreatitis and related these findings to the presence of pancreatic necrosis. Nine patients had a severe attack with histologically confirmed pancreatic necrosis, seven a severe attack without confirmed necrosis, and six a mild attack, also without confirmed necrosis. A free fluid volume >20 ml or free fluid colour >grade 5 on the Leeds chart, or both detected histologically confirmed pancreatic necrosis with a sensitivity of 100% and specificity of 31%. A total peritoneal fluid TAP concentration of ¢96 nmol detected histologically confirmed pancreatic necrosis with a sensitivity of 890/o and specificity of 85%, figures comparable with contrast enhanced computed tomography. These findings suggest that the measurement of peritoneal fluid TAP concentrations can detect effectively histologically confirmed pancreatic necrosis and that such measurements may prove useful in the selection of patients for surgery.