Monitoring of ¹³7Cs fallout in Syrian environment.

This paper presents measurements of cesium 137 ((137)Cs) in the Syrian environment during the period between 2006 and 2010. More than 1,000 samples of soil, water, plants and aquatic life were collected from different locations. The measurements were realized using gamma spectroscopy, and the results showed that radioactivity concentrations were low overall. Concentrations ranged from below detection limits to several tens Bq kg(-1) (dry matter) or 9.8 mBq L(-1) (water), which were well below maximum allowable levels in food or drinking water as established according to Syrian national standards or the WHO/FAO Codex guidelines. However, high (137)Cs activity levels were observed in soil samples collected at a high elevation (Kadmous highs), where a mean concentration of 1,900 Bq kg(-1) was obtained.

Effect of curvature on C-F bonding in fluorinated carbons: from fullerene and derivatives to graphite.

The effect of the curvature of the carbon lattice is discussed taking into account NMR data on various fluorinated carbons including C(60) fullerenes, single, double and multiwall carbon nanotubes. Graphite fluorides and highly fluorinated fullerenes are used as limit model compounds for planar and spherical geometries, respectively. The curvature results in a weakening of the C-F bonding covalence. First of all, various highly fluorinated fullerenes with increasing F/C molar ratio were prepared by treatment with pure gaseous fluorine. A preliminary study using XRD, EPR and IR spectroscopy confirms that the highest fluorination level can be reached either at 133 or at 300 degrees C. In order to extract the correlation between fluorine and carbon atoms and the C-F bond length, specific sequences such as solid echo, two-dimensional (19)F -->(13)C cross polarization wide-line separation and inverse (19)F -->(13)C cross polarization were also used for fluorinated C(60).

Oxygen consumption and pumping rates in the hard clam Mercenaria mercenaria: a direct method.

Respiratory and pumping rates in the hard clam Mercenaria mercenaria were measured directly in running seawater; the quiatntity of oxygen used was calculated from the difference in concentrations in incurrent and excurrent water. A linear relationship between pumping and respiratory rates suggests regulation of water transport by, oxygen requirement rather than by feeding.

Transfer factors of 137Cs and 90Sr from soil to trees in arid regions.

Transfer factors of (137)Cs and (90)Sr from contaminated soil (Aridisol) to olive, apricot trees and grape vines were determined under irrigated field conditions for four successive years. The transfer factors (calculated as Bqkg(-1) dry plant material per Bqkg(-1) dry soil) of both radionuclides varied among tree parts and were highest in olive and apricot fruits. However, the values for (90)Sr were much higher than those for (137)Cs in all plant parts. The geometric mean of the transfer factors in olives, apricots and grapes were 0.007, 0.095 and 0.0023 for (137)Cs and 0.093, 0.13 and 0.08 for (90)Sr, respectively, and were negligible in olive oil for both radionuclides. The transfer factors of both radionuclides were similar to, or in the lower limits of, those obtained in other areas of the world. This could be attributed to differences in soil characteristics: higher pH, lower organic matter, high clay content, and higher exchangeable potassium and calcium.

Quantitative measurement of HbA1c by an immunoturbidimetric assay compared to a standard HPLC method.

Determination of hemoglobin A1c (HbA1c) is one of the most important monitoring procedures for long-term control of diabetes mellitus. Several analytical methods have been developed for the measurement of glycohemoglobin (GHb). Those most frequently used are ion-exchange chromatography for HbA1c and affinity chromatography for total GHb. In this study, a new turbidimetric immunoassay for HbA1c (Boehringer Mannheim, Germany) was evaluated that was performed on a Hitachi 911 clinical chemistry analyzer (Boehringer Mannheim). Good linearity in the range of 5% to 15% HbA1c, within-run and between-run coefficients of variation ranging from 2.4% to 5.9% were obtained. Results of 179 diabetic and nondiabetic patients showed good correlation to those of a routine HPLC method (r = 0.96). In addition, HbA2, HbS, and HbF in samples from nondiabetic patients were not detected by the immunoturbimetric assay and the "labile" HbA1c fraction (Schiff base) did not interfere with the new test.

Evaluation of four automated methods for determination of whole blood cyclosporine concentrations.

Cyclosporine is a widely used and potent immunosuppressant drug with a narrow therapeutic index. Therefore, cyclosporine concentrations should be monitored closely. Various automated immunologic methods for cyclosporine whole blood determinations are available. Two new methods, fluorescence polarization immunoassay (FPIA) for the AxSYM by Abbott Laboratories, Chicago, IL, and the cloned enzyme donor immunoassay (CEDIA) by Boehringer Mannheim, Mannheim, Germany, have been introduced. In addition, Dade Behring improved its enzyme multiplied immunoassay (EMIT) assay. The present study evaluated all 3 new methods in comparison with high-performance liquid chromatography (HPLC) and the FPIA for the TDx analyzer. We measured whole blood cyclosporine concentrations of 179 samples obtained from 127 patients after kidney, bone marrow, heart-lung, and liver transplantation. All 4 automated immunologic methods can be used for routine measurement of cyclosporine whole blood concentrations. Disadvantages, such as higher cross-reactivity (Abbott TDx, CEDIA) or a limited linearity range (EMIT), are accompanied by advantages, such as a high precision (Abbott TDx) or an easy sample handling procedure (CEDIA). Information presented in this article should help to find the most adequate cyclosporine method for each medical laboratory.

Cyclosporine metabolism in patients after kidney, bone marrow, heart-lung, and liver transplantation in the early and late posttransplant periods.

Cyclosporine is used in the prevention of allograft rejection. Owing to its narrow therapeutic index, regular monitoring of the whole blood levels of cyclosporine is required. We observed that immunoassays measured significantly higher cyclosporine levels than did high-performance liquid chromatography (HPLC) over time after transplantation. As cyclosporine metabolites cross-react even with immunoassays, this observation might be due to alterations of the cyclosporine metabolism. We analyzed cyclosporine metabolite concentrations in the early and in the late posttransplantation periods in 127 patients after kidney, bone marrow, heart-lung, and liver transplantation by HPLC and determined whole blood levels of cyclosporine by 4 immunoassays (enzyme-multiplied immunoassay [EMIT], cloned enzyme donor immunoassay [CEDIA], AxSYM [Abbott Laboratories, Chicago, IL], and TDx [Abbott Laboratories]). Despite reduced dose, we found significantly higher cyclosporine concentrations measured by the EMIT, AxSYM, and TDx assays in various patient groups. These results are due to the increased metabolite/cyclosporine ratio in the late posttransplantation period. In particular, the metabolites AM1 and AM19 increased significantly over time in bone marrow transplant recipients. Therefore, cyclosporine levels measured by immunoassays should be interpreted with caution.

Comparison of four rapid D-Dimer tests for diagnosis of pulmonary embolism.

Aim of this study was to evaluate rapid D-Dimer tests for their utility in diagnosis of acute pulmonary embolism (PE). Tests were performed in 183 consecutive pats referred for lung scanning because of clinically suspected PE. According to lung scans and the clinical course of disease 19 pats were classified to have PE with high probability and 164 with low probability. An ELISA (Agen) was used as the D-Dimer reference, and results compared with those of a turbidimetric (Behring), an immunofiltration (Nycomed), latex plasma and whole blood agglutination test (both Agen). There was a poor correlation between the turbidimetric test and either the ELISA (R = 0.38) and immunofiltration test (R = 0.49). The correlation between the ELISA and immunofiltration test was better (R = 0.73). The qualitative latex and whole blood agglutination tests were better fitted to ELISA since positive and negative samples were overlapped only in their 1st and 9th percentiles of ELISA values. The whole blood agglutination test was positive at lower ELISA values than the latex test. The highest sensitivity test for PE was the immunofiltration test (95%) (500ng/mL cut-off), followed by the turbidimetric method (89%) (66ng/mL), the ELISA (89%) (300ng/mL), the whole blood test (88%) and the latex test (68%). Specificity was lowest for the immunofiltration test (33%), intermediate (57-65%) for the turbidimetric and whole blood agglutination tests, and highest for the ELISA and the most insensitive latex test (76/77%). The whole blood assay was found to be the fastest and most suitable for bed site testing but weak positives were difficult to read. The immunofiltration test required plasma preparation but allowed objective semiquantitation of results. The less rapid turbidimetric assay was fully quantitative and objective.

The effect of calisthenic home exercises on postmenopausal fractures--a long-term observational study.

OBJECTIVES: To evaluate the long-term effects of calisthenic home exercises on the incidence of fractures in postmenopausal women. DESIGN: Controlled long-term observational study. METHODS: Postmenopausal women between 45 and 75 years of age who had been randomly assigned to an exercise or control group in the course of a previous study conducted 5-10 years ago, were invited for follow-up. The number of fractures before and during the observation time were recorded by means of a questionnaire. Vertebral deformities due to fractures were diagnosed by X-rays at entry and at follow-up. Walking speed, muscle strength, static posturography, and maximum oxygen uptake were measured in addition. RESULTS: After an average follow-up time of 7.6+/-1.1 years, 73 women of the exercise group and 64 subjects of the control group were investigated. Thirty-three per cent (n=24) of the exercise group reported to have exercised continuously at least three times a week for 20 min. No intergroup differences between the compliant and non-compliant exercisers and the control group were seen in the number of fractures. However, the incidence of fracture was lowest in women with a baseline bone mass less than one standard deviation (SD) below the mean for young adults (high BMC) and highest in those with more than 2.5 SD below the mean for young adults (low BMC) (P<0.001, odds ratio 2.9 [95% CI, 1.59-5.39]). CONCLUSION: This long-term follow-up did not produce any evidence that prescription of a calisthenic home exercise program may prevent fractures in postmenopausal women aged between 61+/-6.4 and 68+/-6.5 years.

Inflammatory response and myocardial injury following coronary artery bypass grafting with or without cardiopulmonary bypass.

OBJECTIVE: In coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) the inflammatory response is suggested to be minimized. Coronary anastomoses are performed during temporary coronary occlusion. Inflammatory response and myocardial ischaemia need to be studied in a randomized study comparing CABG in multivessel disease with versus without CPB. METHODS: Following randomization 30 consecutive patients received CABG either with (n=16) or without CPB (n=14). Primary study endpoints were parameters of the inflammatory response (interleukin (IL)-6, interleukin-10, ICAM-1, P-selectin) and of myocardial injury (myoglobin, creatine kinase-MB (CK-MB), troponin I) (intraoperatively, 4, 8, 16, 24 and 48 h after surgery). The secondary endpoint was clinical outcome. RESULTS: The incidence of major (death: CABG with CPB n=1, not significant (n.s.)) and minor adverse events (wound infection: with CPB n=2, without CPB n=1, n.s. ; atrial fibrillation: with CPB n=3, without CPB n=2, n.s.) was comparable between both groups. The release of IL-6 was comparable during 8 h of observation (n.s.). Immediately postoperatively IL-10 levels were higher in the operated group with CPB (211.7+/-181.9 ng/ml) than in operated patients without CPB (104.6+/-40.3 ng/ml, P=0.0017). Thereafter no differences were found between both groups. A similar pattern of release was observed in serial measures of ICAM-1 and P-selectin, with no difference between both study groups (n.s.). Eight hours postoperatively the cumulative release of myoglobin was lower in operated patients without CPB (1829.7+/-1374. 5 microg/l) than in operated patients with CPB (4469.8+/-4525.7 microg/l, P=0.0152). Troponin I release was 300.7+/-470.5 microg/l (48 h postoperatively) in patients without CPB and 552.9+/-527.8 microg/l (P=0.0213). CK-MB mass release was 323.5+/-221.2 microg/l (24 h postoperatively) in operated patients without CPB and 1030. 4+/-1410.3 microg/l in operated patients with CPB (P=0.0003). CONCLUSIONS: This prospective randomized study suggests that in low-risk patients the impact of surgical access on inflammatory response may mimic the influence of long cross-clamp and perfusion times on inflammatory response. Our findings indicate that multiregional warm ischaemia, caused by snaring of the diseased coronary artery, causes considerably less myocardial injury than global cold ischaemia induced by cardioplegic cardiac arrest.

Pharmacokinetics of teicoplanin during continuous hemofiltration with a new and a 24-h used highly permeable membrane: rationale for therapeutic drug monitoring-guided dosage.

OBJECTIVE: Continuous venovenous hemofiltration (CVVH) is widely used in the management of critically ill patients, but only few administration guidelines for antimicrobial drugs are available. It is unclear whether the use of a filter for more than 24 hours might lead to less efficient extraction. This study describes the pharmacokinetics of teicoplanin during CVVH using a highly permeable membrane. METHODS: Pharmacokinetics of teicoplanin during continuous hemofiltration with a new (group 1) and a 24-h used (group 2), highly permeable polyamide membrane were assessed in 3 patients. RESULTS: The teicoplanin serum concentrations (44.0 +/- 18.5 mg/l vs 109.5 +/- 34.5 mg/l) and half-life of teicoplanin (4.6 +/- 1.1 h vs 5.2 +/- 0.7 h) differed significantly between the 2 groups indicating a smaller elimination of the drug on the second day. Substantial binding of teicoplanin to filter membranes could explain this observation. CONCLUSION: The results suggest that daily adjustment of the dosage is necessary to achieve sufficient teicoplanin concentrations and a fixed dosage recommendation is not suitable for this drug.

Pancreatic elastase 1 in stool: variations within one stool passage and individual changes from day to day.

Concentration of fecal pancreatic elastase 1 has been claimed to be a highly sensitive and specific noninvasive test for exocrine pancreatic function. The aim of our study was to investigate variations in elastase concentration within one stool passage and from day to day. For the analysis of the variation of fecal elastase within one stool passage, we utilized 3 different samples collected from 8 patients. Further, we assessed the individual day to day variation of fecal elastase using stools collected on 3 consecutive days from 40 patients. For the determination of pancreatic elastase 1 in stool we used an ELISA kit. We found a relatively considerable variation of fecal elastase concentration within one stool passage (n = 8, mean CV = 22%, range 4.6-83.1%) and from day to day (n = 40; mean CV = 26%, range 2.4-61.1%). Therefore, we recommend routine analysis of more than 1 stool sample collected on different days for fecal elastase and to use a borderline area of +/- 25% of the recommended cut off of 200 micrograms/g stool for the diagnosis of pancreatic insufficiency.

Serum calcium in thyroid disease.

Thyroid hormones are believed to influence calcium metabolism. In the present prospective study we investigated the influence of various thryroid diseases on serum calcium levels. In addition to screening for thyroid diseases we measured serum calcium concentrations (S-Ca) in individuals who came to our outpatient service for thyroid diseases from 1992 to 1998. 13,387 persons, among them 9017 patients with thyroid diseases and 4370 persons without thyroid dysfunction, were studied. S-Ca was found to be higher in patients with hyperthyroidism (2.36 +/- 0.11 mmol/L n = 1201, p < 0.05) than in those with subclinical hyperthyroidism (2.33 +/- 0.11 mmol/L, n = 494), with euthyroid goiter (2.32 +/- 0.10 mmol/l, n = 5599), with hypothyroidism (2.31 +/- 0.11 mmol/L, 344), with subclinical hypothyroidism (2.32 +/- 0.10 mmol/L, n = 1290) and in healthy persons (2.31 +/- 0.11 mmol/L, n = 4370). 173/13,387 persons had serum calcium levels < 2.1 mmol/L, among them 31 patients with hypoparathyroidism after strumectomy (31/592) and 2 patients with primary hypoparathyroidism. 106/13,387 persons showed a S-Ca of > 2.6 mmol/L, which in 30 cases was due to primary hyperparathyroidism. Of 55 persons with S-Ca of > 2.6 mmol/L and without any other reason for hypercalcaemia, 31 were found to be in a hyperthyroid state. In conclusion, a clinically not relevant influence on S-Ca was demonstrated in patients with hyperthyroidism as compared with other thyroid diseases and individuals with no thyroid diseases. Measurement of S-Ca in every patient being referred to a thyroid outpatient department is recommended because of the frequent occurrence of postoperative hypoparathyroidism and primary hyperparathyroidism in this setting.

Preparation of in-house reference soil sample containing high levels of naturally occurring radioactive materials from the oil industry.

An in-house reference soil sample containing high levels of naturally occurring radioactive materials collected from contaminated areas in the Syrian oilfields has been prepared as a part of the quality assurance program in AECS. Homogeneity of the sample has been examined using three methods, viz. particle size distribution of the sample matrix, total alpha/beta counting and gamma spectrometry. In conjunction with Dixon and Grubb tests as statistical tools, ten random samples from the original sample were used for this investigation. Reference values for the three radium isotopes (224Ra, 226Ra, 228Ra) were determined using gamma spectrometry equipped with HPGe detectors having high relative efficiencies of 80%, while the reference value of 210Pb in the sample was determined using radiochemical separation and counting of its daughter 210Po by alpha spectrometry. ANOVA analysis was used to estimate the uncertainties due to measurement and inhomogeneity of the sample; uncertainty due to inhomogeneity was found to be around 2.6 times the measurement uncertainty.

[Pseudo-coronary form of hemorrhagic rupture in pheochromocytoma. Apropos of a case]. / Forme pseudo-coronarienne de rupture hémorragique d'un phéochromocytome. A propos d'une observation.

The authors report a case of non-malignant pheochromocytoma which presented by its hemorrhagic rupture in two stages and with a clinical picture of threatened myocardial infarction. The progressive nature of these events enabled full laboratory, angiographic, computed tomography and nuclear magnetic resonance investigation and, as a result, planned surgery with hemodynamic monitoring and postoperative intensive care crowned by success with a follow-up period now exceeding a year.

[Should Doppler echography in the diagnosis of the extra-cardiac sites of atherosclerosis be routine in patients with coronary disease? Apropos of 248 cases]. / La recherche, par échographie-doppler, des localisations extra-cardiaques de l'athérosclérose chez le coronarien doit-elle être systématique? A propos de 248 observations.

Doppler ultrasound investigation of cervical and aorto-iliac arteries, performed in 248 patients investigated by coronary angiography (including 80% with coronary heart disease: 23% single-vessel, 23% two-vessel and 34% three-vessel disease) confirmed the frequency of dissemination of the atheromatous process (in the cervical vessels: non-stenotic atheroma: 45%, significant single- or multi-vessel stenoses: 16%, in the aorto-iliac vessels: non-stenotic atheroma: 32.8%, significant stenoses: 17.2%), which has been known for a long time. The unreliability of clinical examination, the reliability, safety and low cost of ultrasound, the discovery of a considerable number of critical, potentially dangerous arterial lesions, some of which may require a surgical procedure or angioplasty (3.4%), the value of assessing, either before coronary angiography or before cardiac surgery, certain specific arterial territories such as the aortic bifurcation and subclavian vessels, justify systematic use of this examination in coronary patients, particularly before coronary angiography and always before coronary surgery.

Radionuclide transfer from feed to camel milk.

The transfer of (137)Cs, (85)Sr, (131)I, (210)Po, (210)Pb and (238)U from feed to camel's milk was investigated in a pilot experiment with three lactating camels. For a period of 60 days, the animals were fed on spiked feed containing the studied radionuclides. They were subsequently returned to a contamination-free diet and monitored for another 90 days. The activity concentrations of (137)Cs, (85)Sr and (131)I in milk decreased with time and reached background levels after 20 days. Equilibrium transfer coefficients and biological half-lives were estimated and transfer coefficients were calculated as (8.1 ± 3.6) × 10(-4), (4.4 ± 1.6) × 10(-2), (7.8 ± 3.9) × 10(-4), (2.7 ± 3.5) × 10(-4), (1.8 ± 1.5) × 10(-4) and (7.0 ± 3.6) × 10(-3) d L(-1) for (85)Sr, (131)I, (137)Cs, (210)Po, (210)Pb and (238)U, respectively. The biological half-lives were estimated to be 6.4, 4.2, 8.9, and 53.3 days for (85)Sr, (131)I, (137)Cs, and (238)U, respectively. Estimates of the half-lives were based on a one component model: it was found that the half-life values measured for artificial radionuclides were slightly shorter than those for natural radionuclides. The data obtained in the study are the first published experimental data on radionuclide transfer to camel milk.

Mass attenuation coefficients of soil and sediment samples using gamma energies from 46.5 to 1332 keV.

Mass attenuation coefficients of various soil and sediment samples (density range between 1.0 and 1.7 g cm(-3)) collected from 60 sites distributed in Syrian land have been determined for gamma lines of 46.5, 59.5, 88, 122, 165, 392, 661, 1173, and 1332 keV using gamma spectrometry and simulation software program X-com. The average mass attenuation coefficients for the studied samples were found to be 0.513, 0.316, 0.195, 0.155, 0.134, 0.096, 0.077, 0.058, and 0.055 cm(2) g(-1) at previous energies, respectively. The results have shown that Ca and Fe contents of the samples have strong effect on the mass attenuation coefficient at lower energies. In addition, self-attenuation correction factors determined using mass attenuation coefficient was in good agreement with addition spiked reference material method provided that the sample thickness is 2.7 cm. However, mass attenuation coefficients determined in this study can be used for determination of gamma emitters at energy ranges from 46.5 to 1332 keV in any soil and sediment samples having density of 1.0-1.7 g cm(-3).

Transfer factors of polonium from soil to parsley and mint.

Transfer factors of (210)Po from soil to parsley and mint have been determined. Artificial polonium isotope ((208)Po) was used as a tracer to determine transfer factor of Po from soil to plant in pot experiments. Two plant growing systems were used for this study namely, an outdoor system and a sheltered system by a polyethylene tent. (208)Po and (210)Po were determined in soil and different parts of the studied plants (stem and leaf), using alpha spectroscopy. The results have shown that there was a clear uptake of (208)Po by roots to leaves and stems of both plants. Higher values of transfer factors using the (210)Po activity concentrations than the (208)Po activity concentration were observed. Transfer factors of (210)Po from soil to parsley varied between 20 × 10⁻² and 50 × 10⁻² and 22 × 10⁻³ and 67 × 10⁻³ in mint, while (208)Po transfer factors varied between 4 × 10⁻² and 12 × 10⁻² for parsley and 10 × 10⁻² and 22 × 10⁻² in mint. Transfer factors of Po were higher in those plants grown in the sheltered system than in the open system; about 75% of Po was transferred from atmosphere to parsley parts using the two systems. Ratios of transferred Po from soil to mint stem and leaf in the sheltered system were higher by 2 times from those in the open system.