The effect of various stain carriers on the quality and quantity of DNA extracted from dried bloodstains

Summary Bloodstains were made with 200 l blood on each of 11 different common substrates to examine the effect of the stain carrier on the amount and quality of DNA recoverable. High-molecular-weight DNA was extracted from all samples after 2 days. The yield of DNA from each sample varied considerably, not only between the different stain carriers but also within a given category. With a DNA yield of up to 10 g, paper, glass, nylon, wood, smooth leather and wool gave the best results, followed by blue denim and wallpaper (up to 6 g), cotton fabric and carpeting (up to 4 g), and suede (up to 2 g), For several stain carriers the DNA-containing solution was contaminated by chemical substances, which in the case of the blue denim, suede, and carpet samples inhibited the digestion of the DNA with restriction enzymes and prevented DNA typing. The different textures of the stain carriers tested and (as for varying yields on the same carrier) the differing degree of loss of DNA during extraction and the physiological variation in the number of leukocytes in human blood are discussed as possible reasons for the wide range of variation in the amounts of DNA it was possible to extract.Presented in part at the meeting of the North/West German Section of the German Society for Legal Medicine (Essen, May 88) and at the Liège meeting of the English Speaking Group of the Society for Forensic Haemogenetics (Oct 88)     

ROC analysis in radioimmunoassay: An application to the interpretation of thyroglobulin measurement in the follow-up of thyroid carcinoma

This study is an application of the ROC technique to the determination of threshold values (TV) for the interpretation of serum thyroglobulin (Tg) measurements in the follow-up of differentiated thyroid cancer. Serum Tg was assayed using the Henning kit in 1466 samples from 245 individuals. A local or distant recurrence was assessed by clinical examination, radiological and scintigraphic investigations, and was present in 23 patients. The measurements were divided into four groups: 1) measurements performed less than 6 months after thyroidectomy; 2) measurements performed more than 6 months after thyroidectomy; 3) measurements performed during the suppression of pituitary secretion; 4) measurements performed during withdrawal of the substitutive therapy. An ROC curve was calculated for each group and for each curve three TVs were determined: TV1, TV2, and TV3 corresponding to a high sensitivity, a high specificity and a high sum of sensitivity and specificity respectively. TV1 is 3.12 g/l in the four groups. TV2 is 44 g/l, 19 g/l and 30 g/l, in the first, second, third and fourth groups respectively. TV3 is 35 g/l in the first group, 3.12 g/l in both the second and third groups and 30 g/l in the fourth group. When the classical method allows the determination of only one threshold value, the ROC technique allows us to determine threshold values adapted to both the patient clinical status and the chosen sensitivity or specificity.     

Usefulness of a latex agglutination assay for FDP D-dimer to demonstrate the presence of postmortem blood

D-dimer, a specific fragment resulting from degradation of cross-linked fibrin, is an essential marker for the diagnosis of disseminated intravascular coagulation (DIC). Rapid assay for D-dimer using monoclonal antibody coated-latex particles might be useful for discriminating between postmortem and antemortem blood in bloodstains. We tried to detect D-dimer in nine postmortem blood samples by the rapid latex agglutination assay and to quantify them automatically using the latex photometric immunoassay system. The results showed that all samples were positive and that their amounts of D-dimer were 335–2,800 g/ml (the normal blood level, <1 g/ml; the pathogenic blood level with DIC, 1–100 g/ml). Next, nine stains made of postmortem blood were examined by the rapid latex agglutination assay. The result showed that only one case (D-dimer 335 g/ml blood) showed weak positive while the others (D-dimer 600–2,800 g/ml blood) were positive. The present study indicates that the latex agglutination assay for D-dimer can be useful to demonstrate the presence of postmortem blood.     

Radioimmunoassay of serum thyroglobulin

A radioimmunoassay technique using a double antibody procedure for human serum thyroglobulin (HTg) is described. Only antigen labeling with iodine-125 is performed extemporaneously, the other reagents being purchased commercially. Quality criteria were: sensitivity (2 g/l), interassay reproducibility (coefficient of variance, C.V.=11%) and specificity are comparable with those of previously published techniques. Normal limits for serum HTg concentrations were established on the basis of 65 assays (33.0±21.20 g/l). In 69 subjects exhibiting goiters and cold nodules, the values observed were considerably higher and more dispersed (81±57 g/l); the same observation was made for the cases of Basedow's disease studied. Patients who had undergone thyroid ablation for thyroid cancer exhibited a low or nondemonstrable HTg concentration, except for seven subjects showing osseous and/or pulmonary functionally active metastases of a differentiated cancer whose HTg levels were significantly higher (300–400 g/l). These results concur with several previous reports in emphasizing the interest of assaying serum HTg during the surveillance of differentiated cancers of the thyroid.     

Verluste bei der Bestimmung kleinster Arsenmengen und ihre radiochemische Überprüfung

Zusammenfassung Überprüfung der Analysenmethode vonVaák-edivec zur Arsen-bestimmung im biologischen Material mit As⁷⁴. Bei genauer Einhaltung bestimmter Analysenbedingungen, die in zahlreichen Versuchen ermittelt wurden, belaufen sich die Arsen Verluste, auch bei Anwesenheit sehr kleiner As-Mengen (ca. 0,1 g und weniger) auf annähernd 5–6%. Vergleichende Versuche mit anderen entsprechenden Analysenmethoden (Gutzeit, Marsh, Testflecken usw.) führen zu wesentlich schlechteren Ergebnissen.

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Summary The methods ofVaák-edivec for the measurement of As in biological samples is controlled by addition of As⁷⁴. Under meticulous observation of certain analytic conditions, which had been found out in many experiments, the loss of As in this modified analytic method amounts to about 4–6%; even when only 0,1 g As is present. Comparative tests of other corresponding methods (Gutzeit, Marsh, Testspot) lead to less exact results.

     

Radiation doses to those accompanying nuclear medicine department patients: a waiting room survey

In a multi-centre European trial we have assessed the radiation dose to those accompanying patients undergoing nuclear medicine investigations. Dosemeters were first calibrated against each other and then used to measure the radiation dose to the nurse or relative while they were in the waiting room. In departments where there was one waiting room the median radiation dose was 13 LSv, and the corresponding figures for where there were two waiting rooms and where the patients were allowed to leave the department with their nurse or relative were 12 and 11 Sv, respectively. These figures are not significantly different. However, we found that the median radiation dose to relatives was 13 Sv while that to nurses was 3 Sv (P<0.01), although the waiting times were not significantly different. The reasons for these differences are discussed. Our data do not support the need for a second waiting room for injected patients in a nuclear medicine department. Correspondence to: L.K. Harding     

A newly developed intra-operative gamma camera: performance characteristics in a laboratory phantom study

Purpose Radioguided surgery depends on the intra-operative detection of radiolabelled tissues. This is currently accomplished with hand tools capable of providing a tone signal, depending on the proximity and direction of a radioactive source in relation to the probe. The advantages of visual images of radiolabelled tissues are well recognised, but satisfactory means of acquiring such images intra-operatively are not yet available. The goal of this study was to examine the performance of a newly developed intra-operative gamma camera, compact enough to be a hand tool and capable of yielding a visual image of the source field.Methods The study was performed in the laboratory with a phantom consisting of a water bath and small hollow spheres (1–2 cm in internal diameter) filled with ^99mTc (1–5 Ci/cc), placed in different configurations within the bath. For comparison, studies were also performed using a standard intra-operative gamma probe, and others using a standard single-head high-resolution gamma camera.Results Compared with the gamma probe, the intra-operative camera was found to possess a superior ability to distinguish small, deep and weakly localised radioactivity sources from background. By acquiring images from different angles, it allowed a 3D understanding of multiple radioactive sources. It detected cold defects within a hot radiolabelled sphere. It discriminated a weak source located near a much hotter radioactivity source, similar to discrimination with the standard gamma camera, and discerned localised sources against a background of radioactivity.Conclusion It is anticipated that the high imaging potential of the camera tested in this study will offer clinical advantages.     

Effects of tumour mass and circulating antigen on the biodistribution of111In-labelled F(ab′)2 fragments of human prostatic acid phosphatase monoclonal antibody in nude mice bearing PC-82 human prostatic tumour xenografts

We have evaluated the effects of tumour mass and circulating antigen (prostatic acid phosphatase, PAP) on the biodistribution and the incorporation of¹¹¹In-labelled F(ab)2 monoclonal antibody (MoAb) fragments directed against human PAP into human prostatic tumours (PC-82; 0.1–8.9 g) growing in nude mice. The radioactivities in the blood, liver, spleen, kidney and tumour were compared at 1, 3, 4 and 6 days after the intravenous administration of the antibody fragments. There was a significant correlation between the tumour size and the serum PAP concentration in the model employed. Even tissue of a small tumour (< 0.1 g) had a high concentration of PAP, but it was not secreted into the circulation in detectable amounts when measured by radioimmunoassay (the lowest standard was 0.5 g/l). The percentage uptake by tumours of the injected dose per gram of tissue (%ID/g) was inversely proportional to the tumour size at 24 h after the administration of¹¹¹In-labelled F(ab)₂ fragments. This relationship had levelled off by 72 h and most likely reflected a better vascularisation of the smaller tumours. Our results show that the increase in tumour size and in the concentration of circulating antigen in the blood led to decreased tumour-to-blood ratios, since there was a tendency for higher blood activities in mice with larger tumours and higher serum PAP concentrations. There was no correlation between tumour size and label uptake by the liver during the follow-up over 144 h, although serum PAP concentrations ranged from 3.1 g/l to 352 g/l. On the other hand, when compared with our previous data obtained with non-tumour-bearing mice, there was a significant increase in the uptake by the liver and spleen. These results indicate that even a small concentration of circulating antigen was able to trigger an abnormal change in the biodistribution of MoAbs.     

Zur Interpretation von postmortalen Digoxinspiegeln: Überprüfung eines „Korrekturfaktors“ für postmortal gemessene Digoxinkonzentrationen im Blut

Zusammenfassung Die Interpretation von postmortalen Serumdigoxinspiegeln wird vor allem dadurch erschwert, daß mit einem präfinalen and postmortalen Anstieg der Digoxinkonzentration im Blut zu rechnen ist. Eriksson et al. (1984) dividierten die postmortal gemessenen Digoxinspiegel im Femoralvenenblut durch 1,5, um den postmortalen Anstieg des Serumdigoxinspiegels zu berüicksichtigen; nach Meinung dieser Autoren weisen postmortale Serumdigoxinspiegel, die nach Division durch 1,5 noch über dem therapeutischen Bereich liegen, auf eine Digoxinüberdosierung hin. Der diagnostische Wert des von Eriksson et al. (1984) vorgeschlagenen Korrekturfaktors wurde überprüft. In 56 Fällen mit dokumentierter Digoxin-Medikation wurde postmortal Femoralvenenblut asserviert und eine Serumdigoxinspiegelbestimmung durchgeführt. In keinem der untersuchten Fälle war klinisch eine Digoxin-Intoxikation diagnostiziert worden. 50% der gemessenen Werte lager oberhalb des therapeutischen Bereichs (0,7 ng/ml bis 2,2 ng/ml). Nach Division der gemessenen Werte durch 1,5 lagen noch immer ca. 20% über 2,2 ng/ml, der höchste korrigierte Wert betrug 4,44 ng/ml. Unter Berücksichtigung des Zeitraums zwischen letzter Gabe und Tod, der individuell unterschiedlichen Digitalisglykosidempfindlichkeit sowie der Komplexität präfinaler und postmortaler Verteilungsvorgänge wurde für unser Untersuchungskollektiv festgestellt, daß eine (unerkannte) Digoxinüberdosierung auch darn nicht wahrscheinlich war, wenn der postmortale Wert nach Division durch 1,5 noch über dem therapeutischen Bereich lag. Der vor Eriksson et al. (1984) vorgeschlagene Korrekturfaktor ist nur vor begrenztem diagnostischem Wert; die korrigierten Werte können allenfalls einen Hinweis darauf geben, in welchem Bereich sich die entsprechende antemortale Serumdigoxinkonzentration bewegt haben könnte. Vor allem korrigierte Werte, die nur wenig über dem therapeutischen Bereich liegen, können den Verdacht auf eine Digoxinüberdosierung nicht mit ausreichender Sicherheit stützen.Ausführliche Darstellung siehe Dissertation St. Ritz, Kiel, Dissertation eingereicht Sonderdruckanfragen an: S. Ritz     

Untersuchungen zum dünnschichtchromatographischen Nachweis eines neuartigen Tranquilizers aus der Trioxazin-Reihe (Versuchspräparat Nr. 518 der Firma Knoll AG.)

Summary The tranquilizer-substance Trioxazine is described and investigations were made for detecting the substance and its metabolites in the urine after intake. It was found, that the unchanged tranquilizer as well as 3 metabolites were excreted. The substance could easily be extracted out of urine with chloroforme after acidifying with hydro-chloric acid. The extract was separated on silica-gel GF₂₅₄-thinlayer-plate in the solvent CHCl₃-n-Heptan-Ethanol (111). For the detection of the substances on the plate it was found, that spraying them with a modified reagent ofSonnenschein, consisting of Cer(IV)sulphate, trichloraceticacid and conc. sulfuric. acid give red spots. An amount of 5 g of Trioxazine can thus be detected. Trioxazine also reacts with conc. nitric acid to a deep red colour.

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Vorgetragen auf der Tagung der Deutschen Gesellschaft für Gerichtliche und Soziale Medizin in Freiburg i. Br. im Oktober 1966.     

125I-β-iodo-D-alanine-synthesis,biodistribution and antimicrobial activity

Methyl N-carbobenzoxy--iodo-D-alaninate (1) served as an intermediate to synthesize methyl -iodo-D-alaninate (2) and -iodo-D-alanine (3). The ¹²⁵I-labeled compound 1 was synthesized by the melt method and used to synthesize ¹²⁵I-labeled compounds 2 and 3. Compound 3 was shown to be substrate for D-amino acid oxidase. It was also shown that compounds 2 and 3 were rapidly eliminated from normal mammalian tissues and that compound 3 inhibited the Escherichia coli growth in a dose-dependent manner at 100–500 g/ml while compound 2 showed no effect at 500 g/ml level. Therefore, it was suggested that compound 3 may serve as an abscess localizing agent.Research carried out at Brookhaven National Laboratory under contract with the U.S. Department of Energy (No. DE-AC-02-76CH00016) and supported by its Office of Health and Environmental Research     

Evaluation of 111In labelled white blood cells by in vitro functional tests and electron microscopy

We have studied the influence of granulocyte labelling with commercially available ¹¹¹In-oxine, tropolone (trop) or home made ¹¹¹In-Mercapto pyridine (Merc) prepared by the method of Thakur (1985) on the cell structure by electron microscopy and on the cell function by enzymatic tests, random migration, chemotaxis, phagocytosis and bactericidal activity. The granulocytes were labelled with 400 Ci ¹¹¹In-oxine in saline or ¹¹¹In-trop or Merc in plasma. The effect of the chelating agents with and without addition of the tracer was studied (n=4) with varying concentrations: 5–10 g/ml oxine, 10–160 g/ml trop and 1–4 g/ml Merc. Chemotaxis and random migration were not affected by ¹¹¹In-trop and clearly supressed by ¹¹¹In-oxine and Merc; the other tests were normal. The cell structure was disturbed by Merc. The labelling efficiency was excellent with oxine (90%), acceptable with trop (30%–80%) and poor with Merc (10%–25%). Without ¹¹¹In, chemotaxis and random migration were normal up to a concentration of 80 g/ml trop, 8.5 g/ml oxine and 1 g/ml Merc. With addition of ¹¹¹In, chemotaxis and random migration were unaffected up to 80 gmg/ml by trop and markedly supressed by Merc and oxine. It is concluded that labelling with ¹¹¹In-trop assures intact cells.     

Zum „Utilitäts“-Prinzip im Rahmen der gerichtlichen Feststellung von Blutsverwandtschaft mittels Serostatistik

Zusammenfassung Die realistische A-priori-Wahrscheinlichkeit bei serologischer Abstammungsbegutachtung — welche stets ein Akten-a-priori bedeutet — stellt eine Teilinformation im gesamten, dem Richter zur Verfügung stehenden Beweiskonvolut dar und nimmt keine eigentliche Sonderstellung ein. — Eine neutrale A-priori-Wahrscheinlichkeit kann es der Sache nach nicht geben. Entweder ist eine solche mit Nichtwissen gleichzusetzen, dann entfällt sie als Information, oder sie steht mit dem Utilitäts-Prinzip in Zusammenhang und stellt damit keine Wahrscheinlichkeit dar. — Das Utilitäts-Prinzip ist rechtspolitisch definiert; es kann zahlenmäßig nicht ausgedrückt werden. — Das Utilitäts-Prinzip wird nur wirksam, wenn der Richter (unter Benutzung aller ihm zur verfügung stehenden Beweise) eine Entscheidung fällt. Es bestimmt dabei die Gewichtung der im Prozeß zur Debatte stehenden Rechtsgüter der Beteiligten. — Der Gutachter hat eine neutrale Utilitäts-Komponente anzuwenden, d.h. er gibt in Zweihypothesenfällen (welche die Regel sind) der Null- wie der Gegenhypothese dasselbe Bedeutungsgewicht. Null- und Gegenhypothese können dabei aus mehreren Einzelhypothesen zusammengefaßt sein; deren Häufigkeiten werden gemittelt. — Die Mitführung eines Akten-a-priori bei der Berechnung eines W-Werts sollte in aller Regel unterbleiben. — Eine Irrtumserwartung soll einen möglichst realistischen Charakter haben; sie sollte daher unter Mitwirkung eines Akten-a-priori zustandekommen.     

In vitro and in vivo characterisation of nor-β-CIT: a potential radioligand for visualisation of the serotonin transporter in the brain

Radiolabelled 2-Cabomethoxy-3-(4-iodophenyl)tropane (-CIT) has been used in clinical studies for the imaging of dopamine and serotonin transporters with single-photon emission tomography (SPET). 2-Carbomethoxy-3-(4-iodophenyl)nortropane (nor--CIT) is a des-methyl analogue of -CIT, which in vitro has tenfold higher affinity (IC₅₀=0.36 nM) to the serotonin transporter than -CIT (IC₅₀=4.2 nM). Nor--CIT may thus be a useful radioligand for imaging of the serotonin transporter. In the present study iodine-125 and carbon-11 labelled nor--CIT were prepared for in vitro autoradiographic studies on post-mortem human brain cryosections and for in vivo positron emission tomography (PET) studies in Cynomolgus monkeys. Whole hemisphere autoradiography with [¹²⁵I]nor--CIT demonstrated high binding in the striatum, the thalamus and cortical regions of the human brain. Addition of a high concentration (1 M) of citalopram inhibited binding in the thalamus and the neocortex, but not in the striatum. In PET studies with [¹¹C]nor--CIT there was rapid uptake of radioactivity in the monkey brain (6% of injected dose at 15 min) and high accumulation of radioactivity in the striatum, thalamus and neocortex. Thalamus to cerebellum and cortex to cerebellum ratios were 2.5 and 1.8 at 60 min, respectively. The ratios obtained with [¹¹C]nor--CIT were 20%–40% higher than those previously obtained with [¹¹C]-CIT. Radioactivity in the thalamus and the neocortex but not in the striatum was displaceable with citalopram (5 mg/kg). In conclusion, nor--CIT binds to the serotonin transporter in the primate brain in vitro and in vivo and has potential for PET and SPET imaging of the serotonin transporter in human brain.     

Mikromethode zum Nachweis erythrozytärer Antigene an Blutspuren

Zusammenfassung Um den Absorptions-Elutions-Test auch noch mit sehr kleinen Blutspuren durchführen zu können, wurde ein Verfahren entwickelt, bei dem die Reaktionsschritte während der Absorptions- und Elutionsphase in sogenannten Beckman-Tubes (0,4 ml Inhalt) erfolgen, und die Agglutinationsreaktion in Mikrotestplatten für die HLA-Typisierung durchgeführt wird. Die Zugabe von 2000 Testzellen in 1 l Suspension zu 2–4 l Eluat war ausreichend, um eindeutige mikroskopisch ablesbare Reaktionen zu erzielen. Die Stärke der Agglutinationsreaktion in Mikrotestplatten wurde definiert und mit herkömmlichen Methoden verglichen. Zahlreiche Voruntersuchungen zur Sensitivitätssteigerung der Agglutinationsreaktion und zur Einstellung des Test-Systems wurden durchgeführt und werden ausführlich beschrieben.     

Polarisationsoptische Untersuchungen der elektrischen Strommarke

Zusammenfassung Verfasser haben die polarisationsoptische Analyse der Strommarke durchgeführt; dazu haben sie die anisotropen Anilin-, Phenol- und Rivanol-Färbeverfahren und die anisotropen Präcipitations-Färbeverfahren mit Methylenblau und Toluidinblau angewendet. Der Widerstand der Fasern wurde mittels Elastase-Verdauung untersucht. Die obigen Reaktionen haben die strukturelle Veränderung der kollagenen Fasern, ihre Lösung in Elastase gezeigt. Die ungewöhnlich große strukturelle Diastase wurde durch die Resultate der Messungsdaten bewiesen; gegenüber der +47m, +51 m Doppelbrechung des unversehrten Kollagens betrug der Wert an der Stelle der Strommarke –106 m., –122 m.Zum Schluß bedanken sich Verfasser bei Professor Dr.Ilona Banga für das ihnen liebenswürdigerweise zur Verfügung gestellte benötigte Elastase crudum.     

Local Administration of NF-κ B Decoy Oligonucleotides to Prevent Restenosis after Balloon Angioplasty: An Experimental Study in New Zealand White Rabbits

Purpose To evaluate the efficacy of NF- B oligonucleotides (ODN) administered by local administration with the channeled balloon catheter to prevent restenosis after balloon angioplasty in restenotic iliac arteries of New Zealand white rabbits.Materials and Methods In vitro, 8000 rabbit vascular smooth muscle cells (rVSMC) where transfected with a liposomal carrier (TfX50) with 100 ng of decoy and scrambled ODN. Inhibition of proliferation was measured using a MTT assay after 24 hours in comparison to control. In vivo, 22 male New Zealand White rabbits were fed a 1% cholesterol diet and received denudation of both common iliac arteries with a 3 mm balloon catheter to induce an arterial stenosis. Four weeks after stenosis induction, local application of NF- B in two different concentrations (1 g: n=14; 10 g: n=8) was performed randomly on one common iliac artery. Scrambled oligonucleotides without specific binding capacities were injected into the contralateral side. The channeled balloon catheter allows simultaneous balloon dilation (8 atm) of the stenosis and local application of a drug solution (2 atm). Four weeks after local drug delivery the animals were killed and the vessels were excised and computerized morphometric measurements were performed.Results NF- B decoy ODN but not scrambled ODN inhibited proliferation of rVSMC in vitro. Following local ODN application in the animals, no acute vascular complications were seen. NF- B ODN resulted in a statistically non significant reduction of neointimal area compared to the control group. The neointimal area was 0.97 mm² using 1 g NF- B ODN compared to 0.98 mm² in the control group. The higher dose resulted in a neointimal area of 0.97 mm² compared to 1.07mm² at the control side.Conclusions Local drug delivery of NF- B ODN using the channeled balloon catheter could not reduce neointimal hyperplasia in stenostic rabbit iliac arteries. Application modalities have to be improved to enhance the effect of the local application to prevent restenosis after balloon angioplasty.     

Enlargement of the pancreas in non-alcoholic cirrhosis: a computed tomography and pathological investigation

To evaluate the effect of hepatic dysfunction on pancreatic morphology, the antero-posterior width of the pancreas was measured by CT in 50 non-alcoholic cirrhotic patients without pancreatic disease and 221 age-and sex-matched normal controls. In addition, we reviewed the histology of the pancreas from 13 autopsies of the cirrhotics and 13 controls. The mean width of the pancreatic head in the cirrhotics was 2.94 0.34 cm (mean SD), which was significantly larger than that in the controls (2.17 0.32 cm) (P < 0.001). The width of the pancreatic body in the cirrhotics was also significantly greater than in the controls (1.95 0.24 cm versus 1.50 0.30 cm) (P < 0.001). Histological investigation revealed that lipomatosis and fibrosis increased with age in the controls, while they were seldom observed in the cirrhotics. And enlargement of acinar cells or of the islets of Langerhans was often seen in the cirrhotics. These data suggested that advanced liver dysfunction provoked pancreatic growth, probably through a trophic effect. Offprint requests to: T. Muranaka     

Incidence of stunned, hibernating and scarred myocardium in ischaemic cardiomyopathy

Purpose Different criteria to identify residual viability in chronically dysfunctioning myocardium in patients with coronary artery disease (CAD) can be derived by the combined assessment of myocardial blood flow (MBF) and glucose utilisation (MRG) using positron emission tomography (PET). The aim of this study was to evaluate, in a large number of patients, the prevalence of these different patterns by purely quantitative means.Methods One hundred and sixteen consecutive patients with ischaemic cardiomyopathy (LVEF 40%) underwent resting 2D echocardiography to assess regional contractile function (16-segment model). PET with ¹⁵O-labelled water (H₂¹⁵O) and ¹⁸F-fluorodeoxyglucose (FDG) was used to quantify MBF and MRG during hyperinsulinaemic euglycaemic clamp. Dysfunctional segments with normal MBF (0.6 ml min^–1 g^–1) were classified as stunned, and segments with reduced MBF (<0.6 ml min^–1 g^–1) as hibernating if MRG was 0.25 mol min^–1 g^–1. Segments with reduced MBF and MRG <0.20 mol min^–1 g^–1 were classified as transmural scars and segments with reduced MBF and MRG between 0.20 and 0.25 mol min^–1 g^–1 as non-transmural scars.Results Eight hundred and thirty-four (46%) segments were dysfunctional. Of these, 601 (72%) were chronically stunned, with 368 (61%) having normal MRG (0.47±0.20 mol min^–1 g^–1) and 233 (39%) reduced MRG (0.16±0.05 mol min^–1 g^–1). Seventy-four (9%) segments with reduced MBF had preserved MRG (0.40±0.18 mol min^–1 g^–1) and were classified as hibernating myocardium. In addition, 15% of segments were classified as transmural and 4% as non-transmural scar. The mean MBF was highest in stunned myocardium (0.95±0.32 ml min^–1 g^–1), intermediate in hibernating myocardium and non-transmural scars (0.47±0.09 ml min^–1 g^–1 and 0.48±0.08 ml min^–1 g^–1, respectively), and lowest in transmural scars (0.40±0.14 ml min^–1 g^–1, P<0.01). MRG was comparable in hibernating and stunned myocardium with preserved MRG (0.40±0.19 mol min^–1 g^–1 vs 0.46±0.20 mol min^–1 g^–1, NS), and lowest in stunned myocardium with reduced MRG and transmural scars.Conclusion Chronic stunning is more prevalent than expected. The degree of MRG reduction in stunned myocardium may disclose segments at higher risk of permanent damage.     

Messung des Hämoglobingehalts von frischem Blut durch atomabsorptionsspektralphotometrische Eisenbestimmung

Zusammenfassung Es wird eine atomabsorptionsspektralphotometrische Eisenbestimmung in Vollblut zur Messung des Hb-Gehalts beschrieben. Ihre Anwendung wird für die Hb-Bestimmung von faulen Blutproben empfohlen, da hier die photometrische Cyan-Met-Hb-Methode nicht immer zuverlässig ist. Für den Probenansatz werden zu 5 ml 0,5%iger wäßriger Triton-X-100-Lösung 0,1ml Blut pipettiert; nach erfolgter Hämolyse kann die Probe vermessen werden. Die Eichung des Atomabsorptionsspektralphotometers erfolgt mit einem Standard von 10g Fe/ml H₂O. Proben mit einem Fe-Gehalt von 1g bis 20g/ml H₂O (1,6g–32g Hb/100ml) liegen im linearen Meßbereich des Gerätes. Die atomabsorptionsspektralphotometrische Methode wird mit der photometrischen Messung verglichen; zwischen den Meßergebnissen besteht ein linearer Zusammenhang.