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A new method for the rapid measurement of body composition in critically ill surgical patients.

A rapid, non-invasive method for the measurement of absolute amounts of fat, protein, minerals and water in the body has been developed which is applicable to very ill patients. The patient is weighed and skinfold thickness is measured with calipers. The body contents of potassium, nitrogen, sodium, chlorine, calcium and phosphorus are measured in a whole-body radiation counter after irradiation with fast neutrons. From these values absolute amounts of body fat, protein, minerals and water are calculated. The procedure, which takes about 40 min, is carried out with the patient lying supine on a couch. The errors in the absolute measurement of the components expressed as percentages of body weight are: for fat, 4.5 per cent; for protein, 1.6 per cent; for minerals, 0.8 per cent; and for water, 4.9 per cent. The radiation dose is equivalent to that of a chest radiograph (50 mrem). We have used this technique (a) to determine the tissue composition of the weight lost in 16 patients after excision of the rectum; (b) to establish that the weight gained by 16 patients receiving intravenous nutrition was mainly water; and (c) to show that in 10 patients who received a simple solution of amino acids for 2 weeks after rectal excision body protein was preserved as efficiently as in 10 similar patients who received a full course of intravenous nutrition. This is the first time body weights of living persons have been broken down into terms of fat, protein, minerals and water, and the method should help to solve a number of metabolic and nutritional problems in clinical surgery.

Adipose Tissue

[Studies of 57-co-bleomycin in patients with carcinoma colli uteri (author's transl)].

The kinetics of 57Co-Bleomycin was studied in twelve patients with histologically proven carcinoma colli uteri and in ten patients with benign gynaecological conditions. Measurements were carried out on the whole body, on parts of the body and on urine and blood using a whole body counter. Excretion of the tumour-seeking radio-pharmaceutical is predominantly through the kidneys and can be described by a double compartment model. After 48 hours, 2-4% of the applied activity is still present in the body. Radiation exposure to the body, the kidneys and bladder was calculated from the measurements and MIRD tables as 0.02 rad/mci (total body), 0.4 rad/mCi (kidneys) and 0.2 rad/mCi (bladder). In view of the rapid elimination of 57Co-Bleomycin, these figures are lower than data data quoted in the literature. There was no evidence of significantly higher uptake of 57Co-Bleomycin in the carcinomatous epithelium of the collum uteri compared with benign diseases, using the total body counter in the scan node. As possible explanations for this, the authors suggest inadequate geometric resolution of the system and a low tumour/non-tumour distribution ratio.

Bleomycin

Distribution of 14C-lindane in Japanese quail using autoradiography of whole body sections.

Information on the distribution of lindane in Japanese quails was obtained by autoradiography of whole body sections. The most part of lindane was found in fatty tissues of the animals and the distribution in the other parts of the organism was equal. A single dose of 14C-lindane is found in the organism of Japanese quails mainly in the gastro-intestinal tract and is excreted within 72 hours after the application.

Animals

Calibration and evaluation of a system of total body in vivo activation analysis using 14 MeV neutrons.

A system has been established for determining the total body contents of calcium, phosphorus, sodium, chlorine and nitrogen by neutron activation analysis using sealed-tube neutron generators and a shadow-shield whole-body counter. The system was calibrated using three anthropomorphic phantoms of different sizes, filled with various mixtures of the activatable elements in amounts similar to those in man. The reproducibility determined from replicate measurements, was on average +/- 2.9% (SD). The average uncertainty in absolute measurements was estimated to be +/- 4.2% (68% confidence interval).

Activation Analysis

67Ga-citrate scanning in gastrointestinal malignancies.

The value of 67 Ga-citrate scanning in cases of gastrointestinal malignancies is discussed. Seven cases are presented, including lymphomas of the stomach, small bowel, and rectum, and adenocarcinomas of the stomach and colon. In a review of the literature, there is general pessimism regarding the use of 67Ga scans in GI malignancies. Based on previous reports and our own experience, specific clinical situations are cited in which the scan is of considerable value for diagnosis and followup of GI malignancy.

Adenocarcinoma

Total body potassium in cor pulmonale.

Total body potassium was measured in 12 patients with cor pulmonale, by determination of potassium-40, a naturally occurring radioisotope. In all subjects the observed value of total body potassium showed no significant depletion when compared with that predicted from height and age. All previous studies in similar groups of patients have been confined to the estimation of exchangeable potassium by the technique of isotope dilution. Results using the latter technique have shown gross potassium depletion. It is suggested that the apparent disparity between total body potassium and exchangeable potassium could be explained by the requirement for a longer equilibration period when using isotope dilution techniques in patients who are in chronic hypoxaemic state.

Aged

Inorganic iron absorption in subjects with iron deficiency anemia, achylia gastrica and alcoholic cirhosis using a whole-body counter.

A precise although technically complicated method is described for the estimation of iron absorption. A steel chamber is used to measure the total radioactivity of the patients. A dose of 59Fe is administered orally and the retention of radioactivity is measured on the 14th day, this amount being equivalent to the amount absorbed. In our male group, the mean absorption of inorganic iron was 22.5 +/- 8%, and in females it was 43.3 +/- 11%. In 10 patients with iron deficiency anemia, the mean was 92.2 +/- 6% , in 10 with gastric achylia it was 4.6 +/- 4%, and in 12 chronic alcoholics a value of 13.9 +/- 7% was found.

Absorption