Evaluation of an in vivo prompt gamma neutron activation facility for body composition studies in critically ill intensive care patients: results on 41 normals.

A programme of metabolic and nutritional research is being undertaken in critically ill patients requiring intensive care. Central to this research is the measurement of the three nutritionally important compartments of body composition, protein, fat, and water by a combination of tritium dilution and prompt gamma in vivo neutron activation analysis (IVNAA). In this paper a calibration technique is presented that enables absolute estimates of total body nitrogen (TBN) to be made using prompt gamma IVNAA in critically ill patients with gross abnormalities in body composition, especially in their state of hydration. This technique, which is independent of skinfold anthropometry and does not make a priori assumptions about the ratios of major body compartments, has been applied to 41 normal volunteers and the derived values for nitrogen compared with values obtained by applying three currently used calibration methods to the same experimental data; the other methods are used at centers which also measure nitrogen by prompt gamma IVNAA. Close agreement is obtained between the four calibration methods, with correlation coefficients relative to the Auckland technique of 0.999, 0.998, and 0.994. In addition, the measured values of TBN are compared to values obtained for the same group of volunteers using sets of empirical equations from two centers, one of which uses prompt gamma IVNAA (Brookhaven National Laboratory, Long Island, USA) and the other delayed gamma IVNAA (Leeds, Britain). The empirical equations relate TBN in normal people to age, height, weight and sex. The mean ratios of experimental to predicted TBN (with SEMs) are 1.013 +/- 0.017 and 1.002 +/- 0.014, respectively. Mean values of the ratio of TBN to fat-free mass (0.0340 +/- 0.0004) and of total body water to fat-free mass (0.716 +/- 0.002) agree closely with values reported elsewhere for normals by a variety of techniques including chemical analysis. Finally, TBN results based on the four different calibration methods are presented for five surgical patients, demonstrating the importance of the calibration method on estimates of TBN in patients with abnormal body composition. It is concluded that this technique will provide accurate estimates of the total body content of protein, water, and fat in intensive care patients.

An iron metabolism study in humans by means of stable tracers.

An investigation of iron metabolism in a female patient volunteer by administration of stable iron isotopes as tracers was performed. The applied methodology had already been tested in rabbits in comparison with radioactive tracer technique. The subject under study was given 58Fe solution intravenously and about 45 min later 57Fe solution orally. Ten blood samples were drawn at different times within 522 min from injection. Single iron isotopes content in plasma samples was determined by proton nuclear activation. A Compton suppressor system was utilized to improve the detector limits. The characteristic parameters of iron plasma clearance and of iron intestinal absorption were determined.

Application of the library least-squares analysis to whole-body counter spectra derived from an array of detectors.

The library least-squares method was applied to the analysis of gamma-ray spectra obtained from an array of 54 NaI(T1) detectors in a whole-body counter. The analysis of spectra which were obtained over a period of 8 yr demonstrates the applicability of the method despite inherent variations encountered in large counting systems. The elements of interest analyzed were total-body K, Ca, Na, Cl, and P. Least-squares fits obtained with library standards derived from distributed sources were better than those obtained from library standards derived from localized sources.

A prompt gamma in vivo neutron activation analysis facility for measurement of total body nitrogen in the critically ill.

The quantitative assessment of the nutritionally-important components of body composition (protein, water and fat) provides a basic tool for research into the metabolic and nutritional problems of critically ill patients requiring intensive care. The construction and calibration of a facility that provides bilateral irradiation of patients with neutrons from two 281 GBq 238Pu-Be sources is described. Patients are scanned over a 36 min period, and composite prompt gamma-spectra are collected from two 5 in X 4 in NaI(Tl) detectors, placed on either side of the patient, using a conventional spectroscopy analysis system. A ratio of nitrogen to hydrogen counts corrected for body habitus and background is derived, from which protein can be estimated. This technique, combined with the measurement of water by tritium dilution, enables protein, water and fat to be estimated with precisions of 4.2%, 1.5% and 6.3% respectively, for a total dose equivalent (neutrons and tritium betas) of less than 0.5 mSv per examination.

Partial body calcium determination in bone by proton activation analysis.

The feasibility of a new method for in vivo regional bone calcium measurement has been studied in phantoms using the 160 MeV Harvard cyclotron, Advantages include the capability of measuring bone calcium directly directly in a well defined anatomical region (such as one or several vertebrae) and restriction of the dose to the immediate region of interest. Proton activation of 40Ca (97% natural abundance) produces radionuclide 38K. Its 2-17 MeV gamma ray (T 1/2 = 7-71 min) is detected by a NaI counter. Separation of this activity from room background and interfering nuclides, 14O and 34Clm, proceeds by decay curve analysis. Phantom studies showed the dependence of 38K activity to be highly linear with calcium content (r= 0-998). Non-linearities with dose did not appear below the 20 rad level. The precision of measurements on a phantom with two calf vertebrae exposed to 2-4 rad was 3% and was mostly limited by counting statistics. System reproducibility on phantoms given a high dose proved better than 0-5%.

Calibration of a prompt neutron activation analysis facility for the measurement of total body protein.

Prompt neutron activation analysis with 252Cf has been used to measure total body protein. Since simultaneous irradiation and detection generated a high count rate at the detectors the nucleonic system was optimised to reduce distortions in the gamma ray energy spectrum. Tissue-equivalent phantoms were used to calibrate the apparatus. A total of 53 studies was performed on 39 normal subjects. Ratios of total body protein to fat-free mass agreed well with those from other centres and with cadaver studies. Duplicate measurements of 14 subjects gave a coefficient of variation of +/- 2.9% for a measurement of total body protein, which is close to that calculated from the known errors of the technique of +/- 2.7%. The whole body dose equivalent was 0.17 mSv.

Radiation does from medical in-vivo prompt gamma-ray activation using a mobile nuclear reactor.

A method of medical diagnosis of toxic elements, using a neutron beam from a mobile nuclear reactor to perform partial-body in-vivo prompt gamma-ray activation technique, has been developed. Both neutron and gamma-ray dose equivalents in an irradiated phantom and around medical researchers were measured and evaluated. Neutron flux at various kinetic energies was measured using an activation foil technique, and the neutron dose equivalents at tissues of risk inside the irradiated phantom were calculated by neutron transport code. Gamma-ray dose equivalents inside the irradiated phantom and around the nuclear reactor were measured by thermoluminescent dosimeters. The risk associated with the neutron and gamma radiation dose equivalents received by both the irradiated phantom and medical researchers were evaluated in detail. The radiation safety of the in-vivo medical diagnosis using the mobile nuclear reactor, under the context of radiation protection guidelines, is discussed.

Apparatus for the measurement of total body nitrogen using prompt neutron activation analysis with californium-252.

Details of clinical apparatus designed for the measurement of total body nitrogen (as an indicator of body protein), suitable for the critically ill, intensive-care patient are presented. Californium-252 radio-isotopic neutron sources are used, enabling a nitrogen measurement by prompt neutron activation analysis to be made in 40 min with a precision of +/- 3.2% for a whole body dose equivalent of 0.145 mSv. The advantages of Californium-252 over alternative neutron sources are discussed. A comparison between two irradiation/detection geometries is made, leading to an explanation of the geometry adopted for the apparatus. The choice of construction and shielding materials to reduce the count rate at the detectors and consequently to reduce the pile-up contribution to the nitrogen background is discussed. Salient features of the gamma ray spectroscopy system to reduce spectral distortion from pulse pile-up are presented.

A compact neutron beam generator system designed for prompt gamma nuclear activation analysis.

In this work a compact system was designed for bulk sample analysis using the technique of PGNAA. The system consists of (252)Cf fission neutron source, a moderator/reflector/filter assembly, and a suitable enclosure to delimit the resulting neutron beam. The moderator/reflector/filter arrangement has been optimised to maximise the thermal neutron component useful for samples analysis with a suitably low level of beam contamination. The neutron beam delivered by this compact system is used to irradiate the sample and the prompt gamma rays produced by neutron reactions within the sample elements are detected by appropriate gamma rays detector. Neutron and gamma rays transport calculations have been performed using the Monte Carlo N-Particle transport code (MCNP5).

Análise comparativa da reatividade anti-LID-1, NDO-LID, NDO-HSA e PGL-1 em hanseníase / Comparative analysis of the reactivity anti-LID-1, NDO-LID, NDO-HSA and PGL-1 in leprosy

A infecção subclínica pode ser avaliada por meio de teste sorológico, que determina imunoglobulinas circulantes. O objetivo do presente estudo foi analisar a reatividade de diferentes antígenos em casos novos de hanseníase, contatos domiciliares de casos e em população de área endêmica, com o intuito de identificar o melhor antígeno para o diagnóstico sorológico da hanseníase e detecção de indivíduos infectados pelo Mycobacterium leprae.Trata-se de um estudo transversal de natureza exploratória e analítica. A reatividade anti-LID-1, NDO-LID, NDO-HSA e PGL-1 foi avaliada por meio do enzyme-linked immunosorbentassay. Foram analisadas amostras de sangue total em papel de filtro Whatman de 2494indivíduos da população de sete municípios da microrregião de Almenara e de soro de 94casos novos de hanseníase e 104 contatos domiciliares de casos residentes no município de Uberlândia. O Banco de Dados foi criado no Software Epi Info versão 3.5.1 e análise realizada no software Statistical Package for the Social Sciences for Windows 18 e no GraphPad Prism versão 5. Para análise estatística foram utilizados os seguintes testes: Kolmogorov-Smirnov, Kruskal-Wallis one-way (H), Mann-Whitney (U) com correção de Bonferroni, kappa, Spearman (rho), teste Qui-quadrado de Pearson e regressão logística binária. Foi observado maior soropositividade no grupo de casos multibacilares (MB), em contatos domiciliares de casos MB e nos indivíduos residentes nos municípios de Almenara e Jequitinhonha. Obteve-se correlação positiva entre a sorologia e o índice baciloscópico,concordância substancial e significativa no grupo de casos novos de hanseníase e correlação positiva para todos os antígenos testados. Os testes anti-LID-1 e anti-NDO-LID apresentaram melhor performance para identificar os contatos domiciliares e ou indivíduos da população...

The subclinical infection can be evaluated by serologic test which determine circulating immunoglobulins. The aim of this study was to analyze the reactivity of different antigens inleprosy cases, household contacts of index cases and the population of the endemic area toidentify the best antigen for the diagnosis of leprosy and detection of individuals infected with Mycobacterium leprae. It is a cross-sectional study of exploratory and analytical nature. There activity anti-LID-1, NDO-LID, NDO-HAS e PGL-1 were evaluated using the enzyme linke dimmunosorbent assay. The whole blood in What man filter paper of 2494 individuals from the general population of seven municipalities in the micro-Almenara and serum of 94 patients with leprosy and 104 household contacts of patients residing in Uberlândia were analyzed. The database was created in Epi Info software version 3.5.1 and analysis in the software Statistical Package for Social Sciences for Windows 18 and GraphPad Prism version5. For statistical analysis the following tests were used: Kolmogorov-Smirnov, Kruskal Wallisone-way (H), Mann-Whitney (U) with Bonferroni correction, kappa, Spearman (rho), chisquaretest of Pearson and binary logistic regression. Identied higher seropositivity in the group of MB patients, household contacts of MB patients and in individuals living in the municipalities of Almenara and Jequitinhonha. Observed positive correlation between serology test and bacterial index, substantial agreement and significant in patients positive and positive correlation for all antigens. The LID-1 and NDO-LID antigens showed greater ability to identify household contacts or the general population infected with M. leprae, but the performance of the NDO-LID was better. The native PGL-1 had higher seropositivity than the NDO-HSA for all clinical forms of leprosy and household contacts. The seropositivity prevalence in the general population was higher than the detection rate of leprosy...

Gamma-ray spectrometry data collection and reduction by simple computing systems.

The review summarizes the present state of the involvement of relatively small computing devices in the collection and processing of gamma-ray spectrum data. An economic and utilitarian point of view has been chosen with regard to data collection in order to arrive at practically valuable conclusions in terms of feasibility of possible configurations with respect to their eventual application. A unified point of view has been adopted with regard to data processing by developing an information theoretical approach on a more or less intuitive level in an attempt to remove the largest part of the virtual disparity between the several processing methods described in the literature. A synoptical introduction to the most important mathematical methods has been incorporated, together with a detailed theoretical description of the concept gamma-ray spectrum. In accordance with modern requirements, the discussions are mainly oriented towards high-resolution semiconductor detector-type spectra. The critical evaluation of the processing methods reviewed is done with respect to a set of predefined criteria. Smoothing, peak detection, peak intensity determination, overlapping peak resolving and detection and upper limits are discussed in great detail. A preferred spectrum analysis method combining powerful data reduction properties with extreme simplicity and speed of operation is suggested. The general discussion is heavily oriented towards activation analysis application, but other disciplines making use of gamma-ray spectrometry will find the material presented equally useful. Final conclusions are given pointing to future developments and shifting their centre of gravity towards improving the quality of the measurements rather than expanding the use of tedious and sophisticated mathematical techniques requiring the limits of available computational power.