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Spectral deconvolution and operational use of stripping ratios in airborne radiometrics.

Spectral deconvolution using stripping ratios for a set of pre-defined energy windows is the simplest means of reducing the most important part of gamma-ray spectral information. In this way, the effective interferences between the measured peaks are removed, leading, through a calibration, to clear estimates of radionuclide inventory. While laboratory measurements of stripping ratios are relatively easy to acquire, with detectors placed above small-scale calibration pads of known radionuclide concentrations, the extrapolation to measurements at altitudes where airborne survey detectors are used bring difficulties such as air-path attenuation and greater uncertainties in knowing ground level inventories. Stripping ratios are altitude dependent, and laboratory measurements using various absorbers to simulate the air-path have been used with some success. Full-scale measurements from an aircraft require a suitable location where radionuclide concentrations vary little over the field of view of the detector (which may be hundreds of metres). Monte Carlo simulations offer the potential of full-scale reproduction of gamma-ray transport and detection mechanisms. Investigations have been made to evaluate stripping ratios using experimental and Monte Carlo methods.

Air Pollution, Radioactive↗

The "stegosaurus" dressing: a simple and effective method of securing skin grafts in the burn patient.

Skin grafts are vulnerable to shear stress, infection, and hematoma formation during the postoperative period, all of which reduce graft survival. Various methods of dressing application and materials have been described in the literature to try and prevent graft loss. The authors report the use of the "stegosaurus dressing" (Eggcrate Pad) in 6 patients to secure skin grafts. Patients chosen were those who were either noncompliant or who sustained burns in unfavorable anatomic sites. All grafts demonstrated complete take without infection and hematoma formation. This foam dressing provides an even pressure to the recipient bed, absorbs drainage, and protects the graft from shearing. It also demonstrates the versatility to be used in difficult nonburn skin graft areas. The stegosaurus dressing is easy to apply, inexpensive, and provides a very secure dressing over the skin graft.

Burns↗

Fate of 7,12-dimethylbenz(a)anthracene absorbed from the rat intestine and transported in chylomicrons.

Chylomicrons obtained from the thoracic duct of rats fed [3H]7,12-dimethylbenz(a)anthracene (DMBA), a polycyclic aromatic hydrocarbon, were infused intravenously into rats with bile fistulas. Over 17 hr, 55.9 +/- 3.2% (mean +/- SEM) of the radioactivity was recovered in bile and 6.7 +/- 0.5% in urine. Minor amounts were deposited in liver, kidneys and epididymal fat pads. Injection of DMBA in ethanolic solution gave a similar pattern, while biliary DMBA metabolites resulted in higher recovery in urine and lower recovery in fat. In conclusion, the major part of chylomicron DMBA is rapidly excreted via the biliary route, while a fraction is probably retained in adipose tissue.

9,10-Dimethyl-1,2-benzanthracene↗

Breast cancer detection based on incremental biochemical and physiological properties of breast cancers: a six-year, two-site study.

RATIONALE AND OBJECTIVES: To demonstrate that near-infrared spectroscopy would achieve sufficient sensitivity and specificity in human breast cancer to reach ROC/AUC values in the 90s and yet to warn of the potential liabilities of introduction of a novel technology in this field. MATERIALS AND METHODS: 116 subjects from two nations (44 were cancer-verified by biopsy and histopathology) were reviewed. NIR spectroscopy of total hemoglobin and its relative oxygenation were monitored in breast cancers and compared to their contralateral breast in a 2D nomogram for diagnostic evaluation. A novel handheld NIR breast cancer detector pad with a 3-wavelength LED and 8 detectors with 4 cm separation between source and detectors was placed on the subject's breast. The method is convenient, rapid, and safe and has achieved high patient compliance with minimal patient apprehension of compression, confinement, or radioactivity. RESULTS: The absorbance increments of the cancerous region are referred to the mirror image location on the contralateral breast. The two metrics are increased hemoglobin concentration due to angiogenesis and decreased hemoglobin saturation due to hypermetabolism of the cancer. The 2D nomogram display of these two metrics shows Zone 1 contains verified cancers and Zone 2 contains noncancers. ROC evaluation of the nomogram gives 95% AUC for the two sites, Philadelphia and Leipzig. CONCLUSION: A simple, economical breast cancer detector has achieved high patient compliance and a high ROC/AUC score for a population which involved a range of tumors down to and including those of 0.8-1 cm in diameter.

Area Under Curve↗

Iron metabolism in genetically obese (ob/ob) mice.

Several reports in the clinical literature suggest that obese children may be at risk for developing iron deficiency. Here the absorption, retention, tissue distribution and tissue levels of iron were compared in lean (+/?) and obese (ob/ob) C57BL/6J mice to examine the impact of obesity on the iron status of this animal model. Obese mice absorbed and retained approximately twice as much 59Fe as lean mice after receiving a solution containing 1 mumol iron per os. This difference was independent of age, severity of obesity and mass of the gastrointestinal tract. Obese mice fed ad libitum had higher levels of 59Fe in blood and fat pads, but lower amounts of 59Fe in the skeletal-muscular system, than lean mice 6 d after subcutaneous injection of 1 mumol of the metal. At least 30% of carcass 59Fe was present in the liver of obese and lean mice 6 d after injection. Despite significantly lower concentrations of iron in liver and bone, blood hemoglobin and hematocrit were significantly higher in obese mice fed ad libitum than in lean mice at 10 wk of age. Plasma iron and transferrin were not affected by chronic obesity. Although several characteristics of iron metabolism differed in obese and lean mice, the results indicate that ob/ob mice were not iron deficient when fed a diet containing an adequate level of this micronutrient. The increased absorption of iron by obese mice probably represents an adaptive response that is required to supply additional micronutrient for the expanded blood volume in these animals.

Absorption↗

Prevalence of urinary incontinence among Spanish older people living at home.

OBJECTIVE: To estimate the prevalence and characteristics of urinary incontinence (UI) in the noninstitutionalized elderly population of Madrid, Spain. METHODS: We carried out a cross-sectional study in a representative sample of all community-dwelling people aged 65 or over. Subjects were interviewed in their homes. The question: Do you currently experience any difficulty in controlling your urine? . In other words, does your urine escape involuntarily? was used to identify UI. Type of UI, use of absorbents and specific drugs were also assessed, as well as consultation behavior. RESULTS: 589 persons were interviewed (response rate: 71.2%). The prevalence of UI was 15.5%. No significant difference was observed between men and women. Urge UI was the main type for men and mixed UI for women. Use of pads was referred by 20.2%. A total of 34.3% of subjects never went to the doctor for their problem (25.2% of men and 39.4% of women). CONCLUSION: Compared to other populations the overall prevalence of UI in Spanish elders living at home is relatively high. A very small difference by gender was found, although a lower response rate in women could in part explain this unexpected finding.

Activities of Daily Living↗

Skin care in the frail, elderly, dependent, incontinent patient.

Despite a plethora of recommendations, protocols and dictums in the nursing literature, no research studies have defined the basic elements of preventive skin care for incontinent patients, and the prevalence of skin problems associated with incontinence is unknown. Yet the importance of skin care for incontinent elderly or immobilized patients has long been acknowledged. This literature review sought to determine current practices and principles for skin care of frail, elderly, dependent, incontinent patients. Protocols vary widely. And although there is mounting evidence that incontinence, particularly fecal incontinence, is a primary risk factor for pressure ulcer development, most preventive efforts focus on pressure relief, repositioning, and nutrition, rather than incontinence care. More clinical trials are needed in this area. The design and analysis of these trials should take into account the frequency and manner in which skin is cleansed, products used for skin care, risks and benefits of absorbent products and devices, the presence of infection, and patients' concomitant medical conditions and degree of immobility.

Activities of Daily Living↗

Comparison of bone-anchored male sling and collagen implant for the treatment of male incontinence.

AIM: To compare the effectiveness of transurethral collagen injection and perineal bone-anchored male sling for the treatment of male stress urinary incontinence (SUI). METHODS: Seventy-one men with SUI underwent either transurethral collagen injections (n = 34) or perineal bone-anchored male sling (n = 37) between June 1999 and October 2003. Most of the patients in each group had radical retropubic prostatectomy and/or external beam radiation therapy (EBRT) in relation to the cause of incontinence. There was one patient in both groups who only had EBRT for the cause. The mean duration of incontinence were 4.2 and 4.4 years, respectively. Collagen injections were carried out transurethrally either under regional or general anesthesia until co-aptation of mucosa was observed. The male sling was placed under spinal anesthesia with a bone drill using either absorbable or synthetic materials. Retrospectively, all patients were assessed for continence status and procedure-related morbidity, if present. The outcome of both procedures was also compared with the degree of incontinence. RESULTS: Ten (30%) patients in the collagen group showed either significant improvement or were cured following injections. Preoperatively, the mean pad use in collagen group was 4.5 (SD 2.8) per day, whereas it was 2.2 (SD 1.1) after the injection(s). Collagen injection failed in 24 (70%) of the patients. Patients who received the male sling had a mean preoperative pad use of 3.7 (SD 1.5) and postoperatively, the number decreased to 1.6 (SD 1.2). Most of the patients in this group were either totally dry or significantly improved (n: 28, 76%). There was a statistically significant difference between two groups in respect to success rate (P < 0.05). Analysis of treatment outcome with the degree of incontinence revealed that the male sling is most effective in patients with minimal-to-moderate incontinence. CONCLUSIONS: Our results suggest that the male sling, a minimally invasive procedure, is more effective than collagen implant in the treatment of mild-to-moderate SUI in men.

Adult↗

Dermal absorption and urinary elimination of N-methyl-2-pyrrolidone.

OBJECTIVES: The dermal absorption of the solvent N-methyl-2-pyrrolidone (NMP) and its elimination in urine was investigated in an experimental study. METHODS: Seven volunteers were exposed to 1045 mg of liquid NMP under occlusive conditions for 2 h. Urine was collected before, during and up to 72 h after the exposure and analysed for NMP by GC/MS after liquid-liquid extraction. Additionally, the remaining NMP in the pads was determined to estimate the total dermal uptake. RESULTS: The concentration of NMP in urine increased rapidly after beginning of the exposure up to 1 h after the exposure was completed. A peak concentration of 1,836+/-863 microg/l was observed, the half-life in urine was 3.2 h. About 0.5% of the absorbed dose was excreted metabolically unchanged. An average dermal absorption of 5.5 mg cm(-2) h(-1) was calculated. CONCLUSIONS: The results of this study show that the percutaneous absorption of NMP may contribute significantly to the overall uptake of the solvent, e.g. in the workplace. Therefore, a biological monitoring of NMP exposed workers is essential for occupational-medical surveillance.

Administration, Topical↗

Preclinical studies of [(99m)Tc]DTPA-mannosyl-dextran .

We report the preclinical testing of a synthetic receptor-binding macromolecule, [(99m)Tc]DTPA-mannosyl-dextran (36 kDa, 8 DTPA and 55 mannosyl units per dextran, K(D) = 0.12 nM), for sentinel node detection. Nonclinical safety studies included cardiac pharmacology safety studies, acute toxicology and pathology studies at 50 and 500 times the scaled human dose in both rats and rabbits after foot pad administration, and perivascular irritation studies in rabbits following intra-muscular administration at 100 and 1000 times the scaled human dose. Biodistribution studies in rabbits at 15 m, 1 h, and 3 h indicated that [(99m)Tc]DTPA-mannosyl-dextran cleared the hind foot pad with a biological half-life of 2.21 +/- 0.27 h. Other than mild hepatocyte hypertrophy in rabbits, no abnormalities in toxicology or pathology were found. Intravenous administration had no effect on survival, any clinical observations, electrocardiograms, or blood pressures. Intramuscular injection had no effect on survival, clinical observations, injection site observations, or injection site histopathology. The estimated absorbed radiation dose to the affected breast was 0.15 mGy/MBq and the effective dose was 1.06 x 10(-2) mSv/MBq. This preclinical study demonstrates that [(99m)Tc]DTPA-mannosyl-dextran has no toxicities and has an acceptable biodistribution and radiation dose.

Animals↗

Safety and efficacy of midface-lifts with an absorbable soft tissue suspension device.

OBJECTIVE: To evaluate the safety and efficacy of midface-lifting using an absorbable suspension device (Endotine ST). DESIGN: Prospective cohort of 10 consecutive adult female patients seen in a private practice who underwent isolated midface-lift without accompanying eyelid surgery or volume augmentation procedures in the setting of an accredited ambulatory surgical center. All patients underwent endoscopic-assisted midface-lifts with general anesthesia or intravenous sedation. Subperiosteal dissections of the midface were performed with fixation of the Endotine ST device to temporalis fascia. Objective and subjective criteria were recorded and photodocumented during the postoperative period at 1 week and 1, 3, and 6 months. Patient characteristics of erythema, tenderness, and pain were recorded with a visual analog scale. The patients and surgeon rated changes from the baseline condition and overall satisfaction with the procedure at 1, 3, and 6 months. RESULTS: All 10 patients completed the 6-month postoperative follow-up. Nine of the 10 patients had significant improvements in their aesthetic outcome. The most common objective symptom of malar sensitivity diminished significantly between the 1- and 3-month visits. One patient experienced a temporary paresis of the zygomaticofacial nerve that resolved at 3 months. There were no major complications of infection, extrusion, skin irregularities, or device removals. CONCLUSIONS: Midface-lifting with the Endotine ST device provided significant elevation of the malar fat pad with improvement in facial contour. Safety of this surgical technique was comparable to that of midface-lifts in other published studies. Patient acceptance of the midface-lift using the Endotine ST device was favorable. Temporary tenderness over the malar area can be expected during the early postoperative period.

Absorbable Implants↗

Research in biomechanics of occupant protection.

This paper discusses the biomechanical bases for occupant protection against frontal and side impact. Newton's Laws of Motion are used to illustrate the effect of a crash on restrained and unrestrained occupants, and the concept of ride down is discussed. Occupant protection through the use of energy absorbing materials is described, and the mechanism of injury of some of the more common injuries is explained. The role of the three-point belt and the airbag in frontal protection is discussed along with the potential injuries that can result from the use of these restraint systems. Side impact protection is more difficult to attain but some protection can be derived from the use of padding or a side impact airbag. It is concluded that the front seat occupants are adequately protected against frontal impact if belts are worn in an airbag equipped vehicle. Side impact protection may not be uniform in all vehicles.

Accidents, Traffic↗

Low frequency changes in skin surface potentials by skin compression: experimental results and theories.

Human living skin generates an increase in the skin potential when compressed. This was measured on eight subjects with a matrix of nine Ag/AgCl electrodes. The potential increased with the pressure until it reached a maximum. When the pressure was increased stepwise, the response showed an overshoot at each step. Human cadaver skin did not show these potential increments. Neither did pads of collagen, paper tissue soaked in a KCl solution, nor layers of cultured keratinocytes. Three theories are described that may explain the origin of the measured skin potentials. The first is based on the piezoelectric characteristics of proteins in the skin. The second theory assumes that the skin is a charged membrane which generates a streaming potential when deformed. A third theory is proposed in which deformation of absorbed charged protein layers on structures in the skin change the alignment of Donnan potentials in the surrounding tissue.

Collagen↗

Multicentre, randomised controlled trial of four-layer bandaging versus short-stretch bandaging in the treatment of venous leg ulcers.

BACKGROUND: Aim of the study was to compare the healing rates of venous ulcers obtained with four-layer bandages (4LB) versus short stretch bandages (SSB). DESIGN: Multicentre, randomised controlled trial performed in 5 centres of the Netherlands and in 2 centres in Austria ("PADS-study" = Profore Austrian Dutch Study). PATIENTS AND METHODS: 112 patients (53 treated with 4LB and 59 treated with SSB) completed at least one post-treatment follow-up, 90 completed the study. Bandaging and ulcer assessment was performed at weekly intervals. Randomisation was carried out for each centre and was stratified according to the size (more or less than 10 cm2) of the ulcerated area. Local therapy consisted of plain absorbing, non-adherent dressings. Time to complete healing was recorded up to a maximum of 16 weeks. The two treatment-groups were comparable regarding their baseline-characteristics. RESULTS: In total 33/53 (62%) of ulcer-patients were healed in the 4LB group, compared with 43/59 (73%) in the SSB group (difference 11%, 95% CI -28% to 7%). 77% of the ulcers with an initial area less than 5 cm2 healed as compared with 33% of the larger ulcers. The different healing rates in the centres could be explained by the different sizes of the treated ulcers. Based on Kaplan-Meier estimates the median healing time was 57 days for the 4LB (95% CI 47-85 days) and 63 days for the SSB (95% CI 43-70 days). CONCLUSION: The ulcer healing rate and the median healing time did not differ among the two types of bandages. The main discriminant criterion for healing was the initial ulcer size. In centres who are experienced users of short-stretch bandages, no statistically significant different healing rates of venous ulcers could be found after 4LB or SSB.

Adult↗

Absorbent products for containing urinary and/or fecal incontinence in adults.

OBJECTIVES: The objectives of this study were to assess the effectiveness and cost-effectiveness of different types of absorbent product for people with incontinence. DESIGN: A systematic review of randomized and quasi-randomized controlled trials was performed to compare different types of absorbent products for the containment of urinary and/or fecal incontinence in adults. SETTING AND METHODS: Randomized and quasi-randomized trials available by March 2000 were used. Trials were identified through searches of major bibliographic and research databases. Investigators in the field were also contacted to locate studies. SUBJECTS: The trials reviewed comprised a total of 345 participants. RESULTS: Five trials were identified. The following comparisons were considered: disposable versus nondisposable pad-and-pant systems or all-in-one diapers (bodyworns), disposable versus nondisposable underpads, bodyworns versus underpads, and superabsorbent versus fluff-pulp products. Outcomes and type of intervention were heterogeneous among trials. Combining data from more than one trial proved to be impracticable. In a single trial, fewer people who used disposable products complained of skin problems compared with those who used nondisposable products (odds ratio, 0.08; 95% confidence interval 0.03 to 0.20). Similarly, people who used superabsorbent products experienced less severe skin problems than those who used fluff pulp products (P <.03). CONCLUSIONS: The data were too few and of insufficient quality to provide a firm basis for practice. However, the data suggest that disposable products are more costly but more effective than nondisposable products in decreasing the incidence of skin problems and that superabsorbent products perform better than fluff pulp products.

Absorption↗

Effects of vitamin E-enriched egg yolk on lipid peroxidation, hemolysis and serum lipid concentration in young and old rats.

Effects of a diet containing different amount of vitamin E-enriched egg yolk powder on lipid peroxidation, hemolysis, and serum lipid concentration were examined in young and old rats. Young and old rats were fed experimental diets containing 5.6% or 22.5% of normal egg yolk powder, and 5.6% or 22.5% of vitamin E-enriched egg yolk powder. When young rats were fed these diets, their tocopherol concentrations in testes, heart, kidneys, and retroperitoneum fat pads increased according to the diet tocopherol contents. Lipid peroxide levels in these tissues were inversely proportional to the tocopherol concentrations. The liver and serum, however, did not show the above relationship. In the rats fed vitamin E-enriched egg yolk diets hemolysis did not increase, in contrast to those fed normal egg yolk diets. The rats fed a 5.6% vitamin E-enriched egg yolk diet had a lower serum cholesterol level than those fed a normal egg yolk diet. In old rats, one control group was used to determine initial tocopherol concentration and two other groups were fed 5.6% normal and vitamin E-enriched egg yolk diets. The vitamin E-enriched egg yolk rats showed lower weights of the body, liver, and retroperitoneum fat pads at the end of the experiment. The normal egg yolk group had atrophied testes. The tissue and serum tocopherol concentrations were increased in the vitamin E-enriched egg yolk group, whereas they were decreased in the normal egg yolk group. In the vitamin E-enriched egg yolk group, lipid peroxide, hemolysis and serum cholesterol, especially HDL-cholesterol, did not increase. These results indicate that egg yolk tocopherol was absorbed and prevented lipid peroxidation and hemolysis in young and old rats, and testes atrophy in old rats.

Age Factors↗

Evidence of self-inhibition by filamentous fungi accounts for unidirectional hyphal growth in colonies.

Hyphal growth in filamentous fungi proceeds in an unidirectional radial pattern from a point inoculation. An inhibitor produced, secreted, and absorbed by the advancing hyphae has been speculated to account for directional growth. Working with Mucor and Aspergillus, laboratory evidence is provided for the production of an inhibitory by the advancing hyphae of these filmentous fungi that precludes back growth. Strains of Mucor and Aspergillus inoculated in agar on a 0.45-mm membrane filter placed on agar surfaces grow radially beyond the filter perimeter and onto the agar surface. Removal of the filter pad does not result in hyphal extension back into the clear zone underlying the membrane filter. Inoculation of the clear zone with a fresh Mucor or Aspergillus spore suspension does not result in hyphal growth. Instead, germinating spores show aberrant and aborted hyphae. The fungal inhibitor shows cross-reactivity between Mucor and Aspergillus, is resistant to pronase (10 mg/mL) but not chloroform inactivation, and passes through dialysis tubing with a molecular weight cutoff of 3500.

Agar↗

Crushed cartilage in nasal reconstruction.

Experience when using crushed cartilage for restoration of the dorsal nasal contour is presented. The septal cartilage is used as fresh autogenous grafts and as preserved septal cartilage. Implantation of autogenous grafts is preferable. Bank cartilage, however, has the advantage of being easily available and of causing very little reaction in the host organism. Normally, it is absorbed very slowly and replaced by connective tissue, which retains most of the bulk and shape of the implant. The crushed material is pushed in over the undermined nasal dorsum by means of a syringe connected to a plastic tube. When the piston of the loaded syringe is depressed, the cartilage is injected and the crushed cartilage can be moulded under the skin and the shape maintained by a tight dressing. The cartilage serves as a padding, which covers bony defects, smooths out the irregularities of the bone and avoids the open roof syndrome as well as retracted scar formation between skin and bone.

Absorption↗