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Urine Vanillylmandelic Acid

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101. Management of a catecholamine-secreting tympanicum glomus tumour: case report. (PubMed)

and a partial osteolytic lesion in the internal carotid artery. Angiographic examination revealed a densely contrasting tumour with feeding vessels from the ascending pharyngeal artery. Concentrations of serum noradrenalin and urine vanillylmandelic acid (VMA) were high. The tumour was completely resected using a potassium titanyl phosphate laser, the feeding vessels having been embolised the previous day. Concentrations of serum noradrenalin and urine VMA normalised following the operation.Pre-operative

2008 Journal of Laryngology & Otology

102. Phaeochromocytoma

collection is required for creatinine (to assure full 24-hour specimen), total catecholamines, vanillylmandelic acid (VMA) and metanephrines. The bottle for collection should be dark and acidified and should be kept cold to avoid degradation of the catecholamines. Preferably collect urine immediately after a crisis. Physical stress and a number of drugs may interfere with the assay and cause false elevation of metanephrines. Drugs include tricyclic antidepressants, alcohol, levodopa, labetalol, sotalol (...) bradycardia. Neurofibromas may be felt and café au lait patches may be seen. Investigations Blood tests Blood glucose is often raised. Calcium may be elevated. Haemoglobin is elevated due to haemoconcentration from reduction in circulating volume. Plasma catecholamines and plasma metanephrines (the o-methylated metabolites of catecholamines) have both been used in diagnosis [ ] . A recent consensus guideline stated that plasma free metanephrines were the blood test of choice [ ] . Urine 24-hour urine

2008 Mentor

103. Neuroblastomas

be detected in the urine of patients with neuroblastoma. These include: Homovanillic acid (HVA) and vanillylmandelic acid (VMA). A low VMA-to-HVA ratio is consistent with a poorly differentiated tumour and indicative of a poor prognosis. Neuron-specific enolase (NSE) - elevated levels can be demonstrated in most patients with metastases, indicating a poor prognosis. Radio-imaging Computed tomography (CT) is the preferred method for assessment of tumours in the abdomen, pelvis, or mediastinum. Magnetic

2008 Mentor

104. Accelerated Hypertension

sugar measurement. ± Cardiac enzymes and fasting blood lipids. ± Ambulatory blood pressure monitoring. Urine dip testing for protein and blood. CXR: cardiac size, cardiac failure, etc. ECG: left ventricular hypertrophy or left atrial enlargement. Subsequent investigations may include: CT/MRI scan of the head or kidneys. Plasma renin activity. Plasma aldosterone level. 24-hour urine for vanillylmandelic acid (VMA) and metanephrine levels. Auto-antibody levels - eg, antinuclear factor. Management

2008 Mentor

105. Abbreviations

renal agenesis VATS video-assisted thoracoscopic surgery VCA viral capsid antigen VEP visual evoked potential VF ventricular fibrillation VGCC voltage-gated calcium channel VH visible haematuria VIP vasoactive intestinal polypeptide VLCFA very long chain fatty acids VLDL very low-density lipoprotein VMA vanillylmandelic acid VPI velopharyngeal insufficiency VT ventricular tachycardia VTEC O157 verocytotoxin-producing Escherichia coli O157 WASP Wiskott-Aldrich syndrome protein WATCH Working Group (...) use a number of abbreviations in our medical reference articles. The following table, which will be updated regularly, provides the abbreviation in full. % abv percentage alcohol by volume ac ante cibum (before food) AIIRA angiotensin-II receptor antagonist AAFB acid-alcohol fast bacilli AAS atomic absorbance spectrophotometry Ab antibody ABC abacavir ABG arterial blood gasses ABPI ankle brachial pressure index ABR auditory brainstem response ACBS Advisory Committee on Borderline Substances ACDP

2008 Mentor

106. hu14.18-Interleukin-2 Fusion Protein in Treating Young Patients With Recurrent or Refractory Neuroblastoma

IV Other Names: IMMUNOCYTOKINE HU14.18-IL2 FUSION PROTEIN humanized anti GD2 antibody fused with human IL-2 BB-IND-9798 Outcome Measures Go to Primary Outcome Measures : Number of Responders (Response Rate) [ Time Frame: Up to 30 weeks ] Response rate to hu14.18-Interleukin-2 in 3 separate strata of patients with recurrent or refractory neuroblastoma. Patients will have radiologic (CT/MRI) tumor and urine homovanillic acid (HVA)/vanillylmandelic acid (VMA) measurements. Patients with prior marrow

2004 Clinical Trials

107. Decitabine, Doxorubicin, and Cyclophosphamide in Treating Children With Relapsed or Refractory Solid Tumors or Neuroblastoma

table for eligibility information Ages Eligible for Study: 1 Year to 21 Years (Child, Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Histologically confirmed diagnosis of either of the following: Solid tumor (part A) No lymphoma Neuroblastoma (part B) Original diagnosis may be based on elevated urine vanillylmandelic acid (VMA) and homovanillic acid (HVA) and bone marrow examination Accessible disease by bone marrow aspirate or tumor biopsy

2004 Clinical Trials

108. Observation, Combination Chemotherapy, Radiation Therapy, and/or Autologous Stem Cell Transplant in Treating Young Patients With Neuroblastoma

by the presence of distinct neuroblastoma cells in the bone marrow AND elevated catecholamine metabolites (i.e., homovanillic acid [HVA] and vanillylmandelic acid [VMA]) in blood or urine Newly diagnosed disease (for patients in the low-risk group) Diagnosis from tumor tissue (for patients in the medium-risk group) Meets criteria for 1 of the following risk groups: Low-risk group No MYCN amplification AND meets 1 of the following criteria: Stage 1 disease Stage 2 disease with no chromosome 1p deletion (...) to Outcome Measures Go to Primary Outcome Measures : Event-free survival (EFS) Locoregional EFS Secondary Outcome Measures : Time from diagnosis to transition to stage 4 disease, to death from disease, or to the last follow-up (if no transition to stage 4 disease is observed) Overall survival Time to the beginning of primary tumor regression (in patients in the low-risk group [LRG]) Time to the normalization of tumor markers HVA and VMA in urine Time to no evidence of disease (in patients in the LRG

2006 Clinical Trials

109. Ganglioneuroma : primary tumor or maturation of a suspected neuroblastoma? (PubMed)

and weight loss. Eleven years before presentation, an incidental urine test showed an elevation of vanillylmandelic acid (VMA) and homovanillic acid (HMA) and a neuroblastoma was suspected. However, further investigations showed no tumor and the test results turned out to be normal within 1 year. Now, a malignant neurogenic tumor was again suspected, but a CT-guided biopsy revealed a benign tumor. The mass was originating from the left sacral nerve roots. A tumor resection via a dorsal approach (...) was performed. Final histology showed a differentiated ganglioneuroma. This is, to our knowledge, the first report describing a patient with elevated VMA/HMA and suspected neuroblastoma who developed a ganglioneuroma 11 years later. The association of ganglioneuroma and neuroblastoma and the abnormal urine tests pointing toward a neuroblastoma 11 years ago remains unclear and the possible answers are discussed in our report.

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2006 European Spine Journal

110. Urinary catecholamines and metabolites in the immediate postoperative period following major surgery. (PubMed)

postoperative course. Reference ranges were established from 33 healthy normotensive volunteers.Excretion of adrenaline, noradrenaline, dopamine, vanillylmandelic acid, and metadrenaline was within normal limits. Normetadrenaline excretion was mildly raised in four patients, but did not exceed 1.5 times the upper reference limit, and returned to normality by the fourth postoperative day.It is feasible to perform simple urinary screening for possible phaeochromocytoma in the immediate postoperative period. (...) be carried out.To study patterns of urinary catecholamine excretion and the feasibility of biochemical screening for phaeochromocytomas in the immediate postoperative period in otherwise healthy subjects undergoing a single type of major surgical procedure.Catecholamines and metabolites were measured for each mole of creatinine in single voided urine on one preoperative and four postoperative days in five subjects who underwent elective coronary artery bypass graft surgery with an uncomplicated

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2004 Journal of Clinical Pathology

111. Exaggerated response to cold stress in a congenic strain for the quantitative trait locus for blood pressure. (PubMed)

liquid chromatography.Under the cold stress, urinary excretion of norepinephrine (NE) and vanillylmandelic acid (VMA), as well as the plasma level of NE, was significantly greater in WKYpch1.0 than in WKY. The increase in blood pressure during the cold stress was also greater in WKYpch1.0 than in WKY. Further, neonatal chemical sympathectomy using guanethidine abolished the exaggerated response in blood pressure and in urinary excretion of NE and VMA in WKYpch1.0.These results suggested that the QTL (...) by 10 generations of backcrossing to transfer the chromosomal fragment between D1Wox29 and D1Arb21 of SHRSP to WKY. This fragment covered the 100:1 confidence interval of the quantitative trait locus (QTL) for blood pressure identified in a previous study. Response to cold stress was studied by exposing rats to 4 degrees C for 4 h. Blood pressure was monitored with telemetry. Urine was collected during the exposure, and urinary concentrations of catecholamines were measured by high-performance

2004 Journal of Hypertension

112. Urinary catecholamine metabolites: Capillary gas chromatography method and experience with 12 cases of neuroblastoma (PubMed)

Urinary catecholamine metabolites: Capillary gas chromatography method and experience with 12 cases of neuroblastoma We propose a rapid, simple metodology for routine analysis of human urine to detect vanillylmandelic and homovanillic acid related to neuroblastoma. The assay were specific capillary gas chromatography with flame ionization detection. In this methodology an internal standard is used and the procedure involves ethyl ester formation without isolation of the compounds of interest (...) . The run time is 36 minutes. We also report quantitative results for urinary vanillylmandelic and homovanillic acid in neuroblastoma patients, demonstrating the diagnostic value of this method.

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2005 Indian Journal of Clinical Biochemistry

113. Composite pheochromocytoma associated with adrenal neuroblastoma in an infant: a case report. (PubMed)

Composite pheochromocytoma associated with adrenal neuroblastoma in an infant: a case report. A 5-year-old boy presented with headache and hypertension. Screening abdominal ultrasonography showed a 6-cm-sized mass in the left adrenal gland. Laboratory data included urine vanillylmandelic acid/creatinine (208.3 microg/mg), urine homovanillic acid/creatinine (114.3 microg/mg), serum epinephrine (237 pg/mL), and serum norepinephrine (1842 pg/mL). Metaiodobenzyl guanidine I 123 scintigram (...) by immunohistochemistry method in patients with neuroblastomatous elements complicated by severe hypertension, and it is important to carefully monitor urine vanillylmandelic acid and urine homovanillic acid in the examination tests and hypertension in the clinical symptoms, and follow up this patient because of some risk of recurrence and metastasis.

2006 Journal of Pediatric Surgery

114. Multiple endocrine neoplasia type 2 (Sipple's syndrome): clinical and cytogenetic analysis of a kindred. (PubMed)

Multiple endocrine neoplasia type 2 (Sipple's syndrome): clinical and cytogenetic analysis of a kindred. This report describes the clinical and cytogenetic analysis of a kindred with multiple endocrine neoplasia type 2 (MEN-2 or Sipple's syndrome) in two generations. Medullary thyroid carcinoma was present in five members either as a large or as an occult tumour. Phaeochromocytoma was demonstrated in one severely hypertensive relative and urine vanillylmandelic acid (VMA) was increased in one

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1984 Journal of Medical Genetics

115. Effects of chronic administration of ephedrine during very-low-calorie diets on energy expenditure, protein metabolism and hormone levels in obese subjects. (PubMed)

, a better nitrogen balance) with respect to placebo, independently of the drug sequence. Daily urinary levels of 3-methylhistidine during ephedrine and placebo treatments were similar. The fasting resting metabolic rate (oxygen consumption, ml STP/min) fell significantly during the very-low-calorie diet in both groups, but this effect was partially and significantly prevented by administration of ephedrine. Diet therapy significantly reduced 24 h urine levels of vanillylmandelic acid and homovanillic (...) acid, which, however, increased to pretreatment values during ephedrine treatment. No significant effects were shown on 24 h urinary concentrations of adrenaline, noradrenaline and dopamine during the very-low-calorie diet and/or ephedrine treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

1992 Clinical science (London, England : 1979) Controlled trial quality: uncertain

116. Salt restriction and increased insulin production in hypertensive patients. (PubMed)

patients and 14 female patients with essential hypertension (mean age 53 years) were randomized to a self monitoring diet group and a diet only group. They were exposed to a moderately salt restricted diet during 12 weeks. Fasting serum insulin C-peptide, glucose, HbA1c, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were measured along with 24 h urine excretion of adrenaline, noradrenaline and vanillylmandelic acid (VMA). As a result, insulin C-peptide increased by 40% (p (...) Salt restriction and increased insulin production in hypertensive patients. The present study was performed to evaluate glucose metabolism, serum lipids and sympathetic activity during 12 weeks of a moderate salt restricted diet in hypertensive patients. The study was designed as a pre-test-post-test study. All patients from a controlled trial evaluating self-monitoring of urine chloride concentration as a remedy for enhancing diet compliance and blood pressure effect were included. Twenty male

1994 Scandinavian journal of clinical and laboratory investigation Controlled trial quality: uncertain

117. Clonidine suppresses plasma and cerebrospinal fluid concentrations of TNF-alpha during the perioperative period. (PubMed)

as in the central nervous system. A smaller norepinephrine concentration in plasma and CSF, and less secretion of vanillylmandelic acid (P < 0.01) and methoxy hydroxyl phenyl glycol in the urine, were observed. Larger dose clonidine (0.4 mg) resulted in no detectable TNF-alpha in CSF. These results suggest that an interaction between TNF-alpha and the function of adrenergic neurons in the central nervous system may contribute to the sedative and analgesic effects of adrenergic agonists.Preoperative (...) -pressure liquid chromatography measurement of norepinephrine in plasma and CSF, vanillylmandelic acid and methoxy hydroxyl phenyl glycol in 24-h urinary excretion, respectively. Clonidine 0.2 mg pretreatment decreased TNF-alpha concentrations both in plasma and CSF. Patients receiving clonidine had lower pain visual analog scale scores and required less morphine compared with the Placebo group (P < 0.01). Preoperative administration of clonidine decreased catecholamine release in the periphery, as well

2001 Anesthesia and analgesia Controlled trial quality: uncertain

118. Reduced sympathetic metabolites in urine of obese patients with craniopharyngioma. (PubMed)

Reduced sympathetic metabolites in urine of obese patients with craniopharyngioma. Severe obesity is a major problem in patients suffering from craniopharyngioma (CP), a benign tumor located in pituitary and hypothalamic regions. In this study, the hypothesis that hypothalamic damage leads to a reduction in overall sympathetic tone was tested. Catecholamines, as well as their metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA), markers of catecholamine turnover, were measured (...) in morning voided urine of 109 patients participating in a German pediatric CP study, and their physical activity was analyzed using a questionnaire. HVA and VMA results were compared with age-matched HVA and VMA in urine of patients proven to not have a catecholamine-secreting tumor. Patients with the most severe obesity displayed the lowest urine HVA and VMA values. Patients with hypothalamic CP had 3.2-fold higher BMI values (p<0.0001), lower HVA (0.72-fold, p<0.001), and VMA (0.84-fold, p<0.01

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2007 Pediatric Research

119. Feasibility of chemical screening of urine for neuroblastoma case finding in infancy in Quebec. (PubMed)

for in the Quebec Network of Genetic Medicine. The feasibility of chemical screening of urine for elevated levels of homovanillic acid and vanillylmandelic acid in Quebec was assessed. The cost-effectiveness of screening 100,000 infants per year would be high (cost-benefit ratio 2.4), with a net saving of about $280,000 and eight lives per year. The estimated cost of adding neuroblastoma screening to the existing urine metabolite screening program is $70,700. The apparent sensitivity of the proposed test (...) Feasibility of chemical screening of urine for neuroblastoma case finding in infancy in Quebec. Neuroblastoma is the most common fatal solid tumour of childhood. Studies in Japan suggest that screening urine at 6 months for tumour-derived metabolites greatly improves early case finding and prognosis. The incidence rate of neuroblastoma in Quebec is at least 1 per 10,330 live births, higher than that of all other diseases responding to early treatment except congenital hypothyroidism screened

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1987 CMAJ: Canadian Medical Association Journal

120. Creatinine related reference ranges for urinary homovanillic acid and vanillylmandelic acid at 6 months of age. (PubMed)

Creatinine related reference ranges for urinary homovanillic acid and vanillylmandelic acid at 6 months of age. The relationship between homovanillic acid (HVA), vanillylmandelic acid (VMA), and creatinine in the urine of 6 month old babies has been studied and reference ranges in the form of centiles constructed for HVA and VMA against creatinine. Over 10,000 urine samples were collected from babies in four health districts in the north of England. HVA and VMA concentration, either

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1993 Archives of Disease in Childhood

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