Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

Interventions in the chest in children

The scope for image-guided intervention in the chest is very wide and encompasses procedures in the heart, pulmonary and systemic vasculature, lungs and pleural cavities, airway, and esophagus. This review describes the most important procedures that are usually performed by radiologists. Percutaneous drainage is now the most common method of treating both empyemas and lung abscesses in children. Although most lung biopsies are carried out by other means, percutaneous biopsy and localization are important alternatives for the diagnosis of focal lung lesions. Esophageal strictures are common in children and are usually best treated by balloon dilatation. The use of retrievable or biodegradable stents has recently been introduced for refractory esophageal strictures. Similarly, balloon dilatation and stenting are now increasingly used in children with stenosis or extrinsic compression of the trachea or bronchi.     

Radiology in chronic constipation in childhood

One hundred thirteen children referred for chronic constipation were examined by means of diagnostic work-up including anal inspection, rectal exploration, weekly bowel frequency evaluation, measurement of total and segmental intestinal transit times (TITT, SITT), contrast enema, anorectal manometry (ARM), suction rectal biopsy for histochemistry. Final diagnosis were: chronic functional "simple" constipation in 53 children; chronic functional constipation and soiling in 32; Hirschsprung's disease in 18. In 10 children, initially referred for constipation, TITT was in the normal range so they underwent no further examination. Conclusions are that bowel frequency identifies a real gastrointestinal problem, but definite diagnosis of constipation is relied on TITT. In the assessment of chronic constipation nature, ARM is more sensitive than radiology. Suction rectal biopsy is reliable in detection of aganglionosis: its accuracy can be improved by histochemical or biochemical determination of Acetylcholinoesterase.     

Skin temperature changes in paradoxical sleep in man in the cold.

Mean skin temperature (Tsk) calculated from seven sites and rectal temperature (Tre) were recorded every minute for a total of 88 man-nights in eight young men sleeping at night in both cold (during the Artic winter) and neutral (laboratory) environments, and were related to the EEG stages of sleep, especially to paradoxical sleep (PS). In the neutral environment, Tre was always above 36 degrees C and Tsk increased during PS. In the cold conditions, during PS, Tsk increased when Tre was high, and decreased when Tre was below 36 degrees C. It was concluded that, although it is not known why a core temperature of about 36 degrees C is the critical point of change in the direction of Tsk variations during PS, the direction in which Tsk will vary during PS is dependent on the core temperature at the time.     

Advances in uroradiologic imaging in children

Diagnostic imaging of pediatric urologic disorders is continuously changing as technologic advances are made. Although the backbone of pediatric urologic imaging has been ultrasound, voiding cystourethrography, and radionuclide scintigraphy, newer and advanced modalities are becoming increasingly important. This article discusses the techniques and clinical applications of three such imaging modalities as they pertain to pediatric urologic disorders: (1) MR urography; (2) advanced ultrasound (harmonic imaging, three-dimensional, and voiding urosonography); and (3) CT angiography.     

Serum zinc in athletes in training

Serum zinc was determined using atomic absorption spectrophotometry in 160 training athletes (57 females) in the morning at rest. In 23.3% of the male and 43% of the female athletes, serum Zn was lower than the limit accepted for the normal range (75 microgram/dl or 11.5 mumol/l). The average serum Zn (96.7 +/- 12.6 microgram/dl) and the range of the values found in a control group of 15 young adult males did not differ from the accepted values in the literature. In 22 randomly selected male athletes, serum Zn fractions were determined using polyethylene glycol precipitation at pH 7.1; 22.2% of total Zn was bóund to alpha2-macroglobulin, the ratio being very close to 1 atom of metal per molecule of globulin. The possible reasons that may influence the serum Zn level in athletes are discussed with regard to the present knowledge in both exercise physiology and metabolism of zinc in man.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Two lymphoscintigraphic agents compared in vitro and in vivo in rabbit knees

Two 99mTc-labelled colloidal radiopharmaceuticals [99mTc-albumin colloid (A) and 99mTc-rhenium sulfide colloid (B)] were compared in vitro in saline, plasma, and synovial fluid with regard to particle size, radiochemical purity, protein binding level, and stability at varying acidity. The purpose was to compare the two compounds in studies of lymphatic drainage from the knee joint of rabbits. Particle size for A was uniform at about 10 nm, but for B it varied between 40 and 80 nm. The radiochemical purity was lowest for B (90%-95%), with a small fraction of minor particles. B was protein bound, which was only the case for A in joint fluid from synovitic knees. A faster disappearance of A than B was observed from the knee joint, with lesser retention in the regional lymph nodes. A negligible uptake of colloid was seen in the liver. The major fraction of radioactivity absorbed from the knee was excreted in the urine. The differences between in vitro and in vivo stability are probably due to phagocytosis in the synovial membrane.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Technical considerations in in vivo thyroid studies

Radionuclide thyroid studies, although among the oldest of clinical nuclear medicine procedures, continue to show growth and change. In the 7 years since thyroid studies were last reviewed in the Seminars, there have been marked changes in the preferred ways of doing these studies. In the areas of radiopharmaceuticals, 131I remains a useful agent in selected circumstances, but 99mTc-pertechnetate has become the agent of choice for imaging applications. Iodine-123 represents an exciting possibility for the future if problems in cost and radiopurity can be solved. New data on the dosimetry of the various agents allow for more rational choices among them, and useful guidelines can now be given for the use of these radiopharmaceuticals in problem areas such as pregnancy, nursing, and the pediatric age group. The scintillation camera with a pinhole collimator has become the instrument of choice for thyroid imaging, and the use of computers and the availability of systems for fluorescent scanning have added new possibilities for thyroid evaluation. Ancillary techniques such as ultrasound scanning also offer the possibility of improved diagnostic accuracy. These developments are reviewed in the context of clinical studies, together with a discussion of specific clinical applications and a brief look to the future.     

Trends in myocardial infarction in Middle Dalmatia during the war in Croatia

The aim of this study was to determine the pattern of myocardial infarction (MI) incidence with regard to age, gender, infarction site, and the most important risk factors. All 3,454 patients hospitalized in coronary care units of Clinical Hospital Split between 1989 and 1997 were analyzed. In the 3-year period preceding the war, from 1989 to 1991, 1,024 patients were hospitalized because of MI. During the 3 years of full war activities, from 1992 to 1994, there were 1,257 patients (significantly more; p < 0.05). And in the 3-year period after the war, from 1995 to 1997, there were 1,173 patients. In the war period, there were 151 (12%) patients younger than 45 years of age (p < 0.05); of that number, 143 (95%) were men (significantly more than in the other two periods; p < 0.05) and 8 (5%) were women. In the period preceding the war, there were 66 (6.5%) patients younger than 45 years: 60 (91%) men and 6 (9%) women. In the period after the war, those numbers were 88 (7.5%), 81 (92%), and 7 (8%), respectively. The patients younger than 45 years (305) more often had MI of an inferior than an anterior site (49% vs. 28%; p < 0.001), whereas there was no difference in patients older than 45 years (36% vs. 37%; p > 0.05). The patients older than 45 years had significantly greater hospital mortality (21% vs. 4%; p < 0.001) and were more likely to have hypertension (51% vs. 15%; p < 0.001) as well as hypercholesterolemia (54% vs. 14%; p < 0.001). Smokers prevailed among those younger than 45 years (75% vs. 51%; p < 0.001). The number of hospitalized patients with MI was greatest during the war period. It included a significant increase in the incidence in men younger than 45 years (12% vs. 7%; p < 0.05), with smoking as the most important risk factor, especially for infarctions of inferior sites.     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

Dynamic KINE-MRI in patellofemoral instability in adolescents

Purpose

The impact of kinematic MRI (KINE-MRI) in the patellofemoral instability and anterior knee pain of the adolescents is rarely reported. Our special interest was to evaluate the patellofemoral joint biomechanics with KINE-MRI in adolescents with affected and unaffected knees in a case–control study.

Methods

KINE-MRI was performed in 29 adolescents (affected knee group, n = 29 and unaffected knee group, n = 26) aged 11–16 years with unilateral patellofemoral instability. For the control group, we enrolled ten healthy age- and sex-matched volunteers (healthy knee group, n = 19). The study parameters, bisect offset, lateral patellar displacement, patellar tilt angle, sulcus angle and Insall–Salvati ratio at 0, 10, 20 and 30° of flexion–extension, were measured for the affected knee patients (n = 29), unaffected knee patients (n = 26) and the healthy knee subjects (n = 19).

Results

The affected knee and the healthy knee subjects had a significant difference in the bisect offset ratio, lateral patellar displacement test and patellar tilt angle test. In these parameters, the difference between the affected knee patients and the healthy knee subjects progressively increased towards the full extension of the knee. In the affected knee and unaffected knee patients, bisect offset ratio at 0° ranged between 0.50 and 1.20 in both groups, whereas the bisect offset ratio in the healthy knee subjects ranged between 0.33 and 0.75 (p < 0.001). At the 0°, the lateral patellar displacement test ranged between 0 and 10 mm in the affected knee patients and between 0 and 35 mm in the unaffected knee patients, whereas the lateral displacement test ranged between 0 and 5 mm in the healthy knee subjects (p = 0.003). Patellar tilt angle test ranged between ?30 and 20° in the affected knee patients and between ?30 and 24° in the unaffected knee patients, and in the healthy knee subjects, the patellar tilt angle test ranged between 10 and 24° (p < 0.001).

Conclusions

The KINE-MRI was able to detect significant differences in patellofemoral joint kinematics between the patients and the healthy subjects. A new finding with clinical relevance in our work is that the unaffected knee is very similar to the dislocated knee in adolescents and this should be taken in account in rehabilitation of patients.

Level of evidence

II.     

Trends in nuclear medicine in developing countries

This article describes trends in nuclear medicine in the developing world as noted by nuclear medicine professionals at the International Atomic Energy Agency (IAEA). The trends identified are based on data gathered from several sources, including information gathered through a database maintained by the IAEA; evaluation of country program frameworks of various IAEA Member States; personal interactions with representatives in the nuclear medicine field from different regions of the world; official proceedings and meeting reports of the IAEA; participation in numerous national, regional, and international conferences; discussions with the leadership of major professional societies; and relevant literature. The information presented in this article relied on both objective and subjective observations. The aims of this article were to reflect on recent developments in the specialty of nuclear medicine and to envision the directions in which it is progressing. These issues are examined in terms of dimensions of practice, growth, and educational and training needs in the field of nuclear medicine. This article will enable readers to gain perspective on the status of nuclear medicine practice, with a specific focus on the developing world, and to examine needs and trends arising from the observations.