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A procedure for the simultaneous analysis of brain pipecolic acid, proline, gamma-aminobutyric acid and glycine--amino acids with potent inhibitory actions on the central nervous system--was developed. The identification and quantification of the amino acids were performed with a gas chromatographic--mass spectrometric--computer system using deuterium-labelled amino acids as the internal standards. After separation of the amino acids by high-performance liquid chromatography, the methyl ester heptafluorobutyryl derivatives were prepared. The lower limit of quantification for this method is at the picomole level. The usefulness of this chromatographic procedure has been demonstrated by measurement of trace amounts of pipecolic acid in rat brain.

Imino acid and related alicyclic amine concentrations in blood and urine of mammals including humans were concurrently determined by a selected ion monitoring technique. Nanomole levels of proline and pipecolic acid, and pyrrolidine and piperidine as well, were found in human urine. Proline levels but not pipecolic acid levels were higher in blood of humans than in urine. Pyrrolidine and piperidine levels in blood of humans were picomole levels and much lower than those in urine. Similar tendencies were also recognized when these 4 compounds were analyzed using animal blood and urine, although the levels were generally higher in animals than in humans. Significantly high concentrations of the imino acids and the amines were found also in animal semen.

It is very important to have a standard neurological grading system and CT classification for "putaminal hemorrhage" to compare, contrast and discuss the results and the surgical indications of various workers. We evaluated 355 cases of putaminal hemorrhage for their long-term outcome by using neurological grading and CT classification of Kanaya et al and compared it with our new classification based on the mode of hematoma extension. The long-term outcome (ADL) showed a better correlation with our new classification. While by using the earlier method (Kanaya et al), there was no significant statistical difference in the ADL between the patients of neurological grade IVb & grade V and also between the patients of CT class II and IIIa. In this classification, the definition of CT class V is not clear as the putaminal hemorrhage does not penetrate into the thalamus. It also ignores the upward or downward extension of the hematoma. Therefore, we emphasize the need for the modification of the presently existing neurological grading system and the CT classification for a better correlation with the long-term outcome.