We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Newer Chemical Diagnostic Tests

Maurice Bell, MSc, FRIG
JAMA. 1968;205(3):155-156. doi:10.1001/jama.1968.03140290047012.
Text Size: A A A
Published online


Undoubtedly, one of the most striking advances in the diagnosis and treatment of tumors in children in the last ten years has been the association of the excretion of catecholamines and metabolites in urine with neuroblastoma. These investigations were initiated by the report of increased excretion of pressor amines by Mason and his co-workers12 in 1957 followed by numerous reports in which a whole spectrum of metabolites was investigated (for summary, see Bell13). The materials of major interest in the diagnosis of neuroblastoma are illustrated in Fig 1, although in normal adrenal tissue, the pathway is extended beyond norepinephrine to epinephrine. In the majority of cases of neuroblastoma, the pathways noradrenaline to VMA and dopamine to HVA appear to be the most important, but in a minority, the transamination pathway from 4-hydroxy-3-methoxy-phenylalanine (HMPA) to 4-hydroxy-3-methoxyphenyl lactic acid (HMPLA) and HVA is of greater significance.14

Problems of Differential 


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.