小剂量高渗氯化钠羟乙基淀粉40注射液用于妊高征剖宫产术中的探讨

目的 研究比较高渗氯化钠羟乙基淀粉40注射液(HSH)与羟乙基淀粉注射液(HS)在妊高征剖宫产术中的临床疗效.方法 拟行剖宫产的妊高征产妇60例.随机分成HSH组(n=20例)HS组(n=20例)及对照组(n=20例),患者入室后均在硬膜外麻醉下行剖宫产术,穿刺点为L2～3问隙,在硬膜外腔开始推注局麻药的同时HSH组先输入高渗氯化钠羟乙基淀粉40注射液250ml、HS组先输入羟乙基淀粉注射液250ml,之后两组再输乳酸钠林格液,对照组则一直输乳酸钠林格液.记录麻醉后5、10、30分钟及术毕MAP,术中麻黄素用量;术前和术后患者血清电解质以及新生儿1分钟Apgar评分.结果 三组患者MAP在麻醉后5、10、30分钟及术毕较术前均有明显降低(p<0.05);对照组在麻醉后5、10、30分钟较HSH和HS组有明显降低p<0.05);HSH组在麻醉后5,10分钟时段时高于HS组而术毕时差异已无显著性.麻黄素的应用对照组明显多于HSH和HS组.手术前后患者血清电解质及新生儿1分钟Apgar评分三组间无显著性差异.结论 妊高征患者训宫产术中应用高渗氯化钠羟乙基淀粉40注射液预防术中低血压是较好的选择.     

高渗氯化钠羟乙基淀粉40对联合硬膜外-腰麻下子宫全切术中恶心呕吐的防治

目的观察高渗氯化钠羟乙基淀粉40、6%中分子羟乙基淀粉130/04急性高容量血液稀释对联合硬膜外-腰麻下子宫全切术中恶心呕吐的防治效果。方法选择择期行子宫全切术,ASAⅠ~Ⅱ级的病人45例,随机分成三组,每组15例。Ⅰ组为高渗氯化钠羟乙基淀粉40;Ⅱ组万汶;Ⅲ组乳酸格林氏液。三组患者分别于腰麻前20min内静脉输注高渗氯化钠羟乙基淀粉40、万汶、乳酸格林氏液250ml,均采用丁卡因(1%丁卡因1ml 10%GS1ml 3%麻黄素1ml)重比重液2.5ml行腰麻.腰麻后低血压持续超过3min者,静注麻黄素10mg,比较三组腰麻后低血压、恶心、呕吐等的发生率及麻黄素应用率。结果Ⅰ、Ⅱ组低血压、恶心、呕吐的发生率、麻黄素应用率均明显低于Ⅲ组(P<0.05),经快速补液后低血压的自动复升率I,Ⅱ组明显高于Ⅲ组(P<0.01),Ⅰ组低血压、恶心、呕吐的发生率、麻黄素应用率略低于Ⅱ组,但无统计学意义(P(0.05)。结论以高渗氯化钠羟乙基淀粉40、万汶急性高容量血液稀释可有效防治联合硬膜外-腰麻下子宫全切术中恶心呕吐的发生,且高渗氯化钠羟乙基淀粉40的效果略优于万汶。     

早期复苏对感染性休克患者血流动力学参数的影响

目的 早期液体复苏对感染性休克患者血流动力学参数的影响.方法 将40例感染性休克患者随机分为对照组和观察组,每组20例.两组患者均采用PICCO监测,并根据早期复苏目标导向(Early goal directed therapy,EGDT)进行早期液体复苏治疗.对照组和观察组复苏液分别为林格液和6％羟乙基淀粉130/0.4氯化钠溶液.分别于复苏开始时(0h)、8h和24h收集患者的血流动力学参数.结果 两组CVP、CI、ITBVI及GEDVI水平在复苏后8h和24h差异有统计学意义(p＜0.05).结论 感染性休克患者根据EGDT方案使用6％羟乙基淀粉130/0.4氯化钠溶液进行复苏,能更好的改善患者的血流动力学指标.     

两种液体复苏对失血性休克大鼠血气的影响

目的:观察复方氯化钠溶液(RS)和6%中分子羟乙基淀粉溶液(HES)对失血性休克大鼠血气的影响。方法:40只健康雄性SD大鼠随机分为RS组(n=20)和HES组(n=20),建立失血性休克模型,分别在放血前、休克期和复苏期经股动脉回抽0.2ml血液用于血气分析。结果:组内比较,PaO2、pH、BE值放血前显著高于休克期和复苏期;PaO2休克期显著高于复苏期;PCO2、BE休克期低于复苏期;休克期pH值RS组低于复苏期,HES组高于复苏期。组间比较,放血前和休克期pH、PaCO2、PaO2、BE值没有明显差别。HES组复苏期pH、PaO2、BE值明显低于RS组,PaCO2值明显高于RS组。结论:本实验条件下,与6%中分子HES溶液比较,RS复苏能明显减轻酸中毒的严重程度。     

小剂量高渗氯化钠羟乙基淀粉40预扩容对全髋关节置换中凝血功能的影响

背景：髋关节置换前应用小剂量高渗氯化钠羟乙基淀粉40预扩容对患者凝血功能的影响缺乏系统性研究。 目的：对比观察小剂量高渗氯化钠羟乙基淀粉40与琥珀酰明胶预扩容影响全髋关节置换患者凝血功能的差异。 方法：纳入46例ASAⅠ~Ⅱ级择期行全髋关节置换的患者,随机分为高渗氯化钠羟乙基淀粉40(HSH40)预扩容组和琥珀酰明胶预扩容组,毎组23例。麻醉前HSH40预扩容组以6 mL/min的速度输注HSH40注射液3 mL/kg行预扩容,琥珀酰明胶预扩容组以20 mL/min的速度输注琥珀酰明胶10 mL/kg行预扩容。输注完毕后开始行蛛网膜下腔-硬膜外腔联合阻滞。分别在预扩容输液前、预扩容输液后60 min、置换后2 h应用血栓弹力描记仪测定纤维蛋白形成时间、血凝块生成时间、最大振幅、凝血综合指数。取2 mL静脉血,枸橼酸钠抗凝后1 500 r/min离心10 min,取血浆测定凝血酶原时间和部分激活凝血酶时间。 结果与结论：与预扩容输液前相比,预扩容输液后60 min两组患者纤维蛋白形成时间、血凝块生成时间、凝血酶原时间和部分激活凝血酶时间均延长(P < 0.05)。预扩容输液后60 min,HSH40预扩容组血凝块生成时间、部分激活凝血酶时间短于琥珀酰明胶预扩容组(P < 0.05);置换后2 h两组患者各项凝血指标均恢复到预扩容前水平。提示3 mL/kg HSH40预扩容对全髋关节置换患者凝血功能呈短暂抑制作用,但其影响小于琥珀酰明胶,凝血功能指标均在正常范围内,可以安全应用于全髋关节置换患者。     

高渗氯化钠羟乙基淀粉40注射液在剖宫产手术中的应用

目的 探讨高渗氯化钠羟乙基淀粉40注射液在剖宫产患者中的应用疗效.方法 将60例行剖宫产的患者随机分位两组,A组:高渗氯化钠羟乙基淀粉40注射液(以下称高渗晶胶液)组;B组:复方氯化钠组.两组患者均于麻醉前输入液体,A组输入高渗晶胶液4ml/kg,B组输入复方氯化钠液体8ml/kg.监测患者入室血压、注药10min、20min的血压以及术前、术后的电解质变化.结果 A组在注药后10min及20min的血压与麻醉前比较无统计学意义.B组在注药后10min及20min血压下降明显,与麻醉前比较有统计学意义(P< 0.05),与A组比较差异有统计学意义(P<0.05).结论 高渗晶胶液可安全有效的应用于剖宫产的患者,对于低血压的预防有一定的作用,对电解质的影响较小.     

八肽胆囊收缩素改善内毒素休克大鼠心肌损伤的实验研究

目的观察八肽胆囊收缩素(CCK-8)改善内毒素休克(ES)大鼠心肌损伤的变化,探讨CCK-8逆转ES心功能衰竭及顽固性低血压的作用机制.方法实验分4组(1)对照组,静脉注射生理盐水0.2mL;(2)LPS组,静脉注射8mg*kg-1LPS;(3)CCK组,静脉注射40μg*kg-1CCK-8;(4)CCK+LPS组,静脉注射40μg*kg-1CCK-8,10min后再注入LPS(8mg*kg-1).股动脉插管监测平均动脉压(MAP),尾静脉穿刺注射药物.分别测定2h、6h心肌组织匀浆中超氧化物歧化酶(SOD)活性、丙二醛(MDA)和一氧化氮(NO)含量变化,用ELISA法测定肿瘤坏死因子-α(TNF-α)和白介素-1β(IL-1β)含量.结果(1)MAP变化对照组MAP为(14.20±1.38)kPa,静脉注射LPS后MAP快速持续下降,75min降至低谷为(7.16±0.59)kPa;CCK+LPS在CCK注入20min时MAP下降幅度与LPS组无差异,20min后即迅速回升,至120min仍持续在较高水平(10.71±0.45)kPa,仍未恢复至正常水平.(2)SOD活性变化2h、6h对照组SOD为(60.51±2.23)×103U/L和(55.97±4.96)×103U/L,LPS组心肌组织匀浆中SOD活性则明显下降为(48.69±2.30)×103U/L和(34.49±4.69)×103U/L,CCK+LPS组较LPS组SOD活性则明显回升为(56.19±1.83)×103U/L和(41.95±7.44)×103U/L.(3)MDA含量变化2h、6h对照组MDA为(3.43±1.76)μmol/L和(3.68±1.58)μmol/L,LPS组心肌组织匀浆中MDA含量明显上升(19.71±3.02)μmol/L和(36.18±5.26)μmol/L,CCK+LPS组较LPS组MDA含量显著下降为(0.39±2.43)μmol/L和(15.10±2.12)μmol/L.(4)NO含量变化2h、6h对照组NO为(37.96±1.85)mmol/L和(41.98±6.59)mmol/L,LPS组心肌组织匀浆中NO含量明显上升(73.45±8.93)mmol/L和(105.4±3.61)mmol/L,CCK+LPS组较LPS组NO含量显著下降为(60.91±3.15)mmol/L和(70.37±7.68)mmol/L.(5)TNF-α含量变化2h对照组心肌组织匀浆中为(320.81±110.63)ng/L,LPS组TNF-α含量明显上升为(1599.08±227.03)ng/L,CCK+LPS组较LPS组TNF-α含量显著下降为(863.54±123.19)ng/L.(6)IL-1β含量变化6h对照组心肌组织匀浆中为(163.10±80.20)ng/L,LPS组IL-1β含量明显上升为(620.66±144.57)ng/L,CCK+LPS组较LPS组IL-1β含量显著下降为(282.07±92.68)ng/L.结论预先注射CCK-8可以减轻ES大鼠心肌氧化损伤,抑制炎性细胞因子TNF-α及IL-1β产生,影响NOS活性,使NO合成下降,发挥心肌细胞保护作用,恢复心肌收缩力,是其逆转ES心功能衰竭及顽固性低血压的主要机制.     

小剂量羟乙基淀粉对脓毒症大鼠的肺保护作用研究

目的研究小剂量羟乙基淀粉130/0.4(HES)对脓毒症模型大鼠肺毛细血管通透性以及全身及局部炎症细胞因子水平的影响。方法 40只雄性SD大鼠,随机分为小剂量组(S组)、大剂量组(L组)、脓毒症对照组(SC组)及假手术对照组(C组)4组,每组10只。S组、L组及SC组均采用盲肠结扎穿孔的方法建立脓毒症大鼠模型;分别于CLP后4h时静脉输注HES 5ml/kg+生理盐水25ml/kg、HES 30ml/kg,SC组于相应时点输注生理盐水30ml/kg。CLP后6h处死大鼠,取肺组织计算含水量,测定毛细血管通透性、炎症细胞因子肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平及外周血炎症细胞因子水平。结果与C组比较,S组、L组及SC组肺含水量、毛细血管通透性均明显增高,肺组织及外周血TNF-α、IL-1β、IL-6水平增高(P0.05)。与SC组比较,S组与L组肺含水量、毛细血管通透性均有降低,肺组织及外周血TNF-α、IL-1β、IL-6水平降低(P0.05);与S组比较,L组TNF-α、IL-1β、IL-6水平有所降低,但无统计学差异。结论小剂量羟乙基淀粉130/0.4具有一定肺保护作用。     

乳酸林格氏液和羟乙基淀粉对失血性休克大鼠血气的影响

目的乳酸林格氏液、羟乙基淀粉单用与合用对失血性休克大鼠血压与血气指标的影响。方法SD大鼠放血45％复制重度失血性休克模型，分别观察不同量的乳酸林格氏液（LR），羟乙基淀粉（HES）单用与合用对失血性休克大鼠血气指标的影响，同时观察动物的存活时间。结果3倍失血量的LR，HES20输注后的pH值优于LR，HES其他剂量组；1倍失血量的LR＋HES输注后PCO2明显低于其2倍和3倍剂量组。3倍失血量的LR，20mL／kgHES，及1倍失血量的LR＋HES组输注PO2优于其他各剂量组。动物存活时间以1倍失血量的LR＋HES组较好，其他各剂量组间无显著差异。结论不同剂量LR、HES单用及合用对失血性休克大鼠血气指标和存活时间具有一定影响，其中以1倍失血量的LR＋HES复苏血气指标和动物存活情况改善较好。     

不同初始补液速率对内毒素休克猪肺损伤的影响

目的:观察不同初始补液速率对内毒素休克猪肺损伤的影响。方法:健康巴马香猪24头,采用静脉注射内毒素(LPS,20μg/kg)建立内毒素休克模型后,随机分为4组:内毒素休克组、慢速补液组(10ml/kg/h)、中速补液组(30ml/kg/h)和快速补液组(120ml/kg/h),每组各6头。观察注射LPS前、液体复苏即刻、复苏3h、复苏6h、复苏9h和复苏12h血乳酸水平变化。复苏12h后处死动物,取肺组织,HE染色观察肺组织病理变化,免疫荧光法观察肺组织髓过氧化物酶(MPO)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平,Tunnel染色观察肺细胞凋亡情况。结果:与内毒素休克组相比,各补液组乳酸值、肺组织MPO、IL-6、IL-1β及细胞凋亡指数均显著降低(P<0.05);在各补液组中,中速补液组和快速补液组血乳酸值显著低于慢速补液组(P<0.05),乳酸清除率显著高于慢速补液组(P<0.05);中速补液组肺组织MPO、IL-6、IL-1β及细胞凋亡指数较其余两补液组明显降低(P<0.05)。结论:初始进行液体复苏能够降低内毒素休克时肺损伤程度,但不同复苏策略减轻肺损伤的程度不同,中速补液减轻肺损伤效果最佳。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.