In acute poisoning by herbicides containing paraquat, or paraquat and diquat, it is possible to infer from the concentration of paraquat in the serum whether the patient will or will not survive, and this is of importance as a basis for deciding what approach to take in emergency treatment. In Japan, the main emergency medical centers where acute poisoning is a specialty have HPLC-photodiode array systems installed for the purpose of toxin analysis. However, in the conventional HPLC method, since it is necessary as a preliminary procedure to extract the paraquat and diquat from serum samples, analysis is time-consuming, and the establishment of a faster analytical technique is a significant step.To the knowledge of the authors, a wide variety of methods have been reported for determining the serum level of paraquat or diquat, for example, thin-layer chromatography, 1) spectrochemical analysis, 2-8) HPLC, 9-21) LC/MS, 11) GC 22) and GC/MS. 23) In 1998, the Japanese Ministry of Health, Labor and Welfare distributed HPLC-photodiode array systems to 73 emergency centers throughout the country in order to facilitate the diagnosis of acute poisoning by drugs and poisons. The application of these HPLC systems was a highly practical step. However, since the task of extraction from samples has to be carried out for the conventional methods reported for HPLC analysis of paraquat, the establishment of a faster technique of analysis would be useful in order to minimize delay in reaching a diagnosis of poisoning by a paraquat preparation.In the present study, after simply deproteinizing serum samples and introducing them directly to the HPLC column using an ion pair reagent as the mobile phase, we obtained good results with a new method that rapidly isolated and quantitated paraquat and diquat in an ODS column, and we report this and a number of cases in which analysis was actually performed.
MATERIALS AND METHODS
Reagents and Materials(1,1Ј-ethylene-2,2Ј-bipyridylium dibromide monohydrate) were purchased from Wako Pure Chemicals (Osaka, Japan), and ethyl viologen dibromide (1,1Ј-diethyl-4,4Ј-bipyridinium dibromide) was from Aldrich Chem. Co. (Milwaukee, WI, U.S.A.). These substances were dissolved in distilled water and were used as standard preparations. The ion-pair reagent IPCC-MS3 was purchased from GL Sciences Inc. (Tokyo, Japan). The distilled water was prepared by Wako Pure Chemicals (Osaka, Japan) for HPLC use, the acetone used was of special grade, and was manufactured by the same company, and the acetonitrile was a specially prepared reagent for HPLC produced by Nacalai Tesque, Inc. (Kyoto, Japan).Biological Specimen Collection Standard human serum for recovery tests was purchased from Sigma Chemical Co. (St. Louis, MO, U.S.A.), and was stored at Ϫ40°C until the time of analysis. The serum samples were derived from blood samples drawn from four patients poisoned by herbicides containing paraquat who ingested them with the aim of committing suicide and who were treated at the Emergency and Critical Care Center wher...