[en] Pleural effusion is a frequent medical problem with a wide span of different causes. We wish to highlight the clinical management of the patient with pleural effusions but anatomic, physiologic and diagnostic management of the main pleural diseases will also be considered

[en] The urinary excretion database built up at Sellafield since the early 1950s was made available for analysis as part of a research programme into plutonium biochemistry. A set of cases was selected for which the data were adequate to support analysis based on a standard pharmacokinetics approach. Cases include exposures from both inhalation and wound deposition, and from plutonium nitrate, oxalate and metal. Data sets extended from 12 years post-exposure up to 25+ year post-exposure. The pharmacokinetics approach was found to be valuable, calling into question certain aspects of ICRP methodology and highlighting areas where further research is required. In particular, it suggested that the distribution equilibrium phase, reached within 3 to 4 years post-exposure, was followed by a terminal equilibrium phase with a half-life of some 12 years. This long-term half-life, which was much shorter than those in ICRP models, persisted for over 20 years in some cases. (author)

[en] Three cattle calves (Bos Taurus) and three buffalo calves (Bos bubalus) were weaned after receiving colostrum and reared by bottle-feeding of milk. During the first month the animal did not have access to solid food. Urinary purine derivative (PD), concentration, basal PD excretion and glomerular filtrate rate (GFR) were determined during fasting and feeding. After one month the animals were given access to solid feed (urea-treated rice straw 80% and molasses 20%) to stimulate rumen development. At three months of age, while the solid food was given, urinary PD, basal PD excretion and GFR were again determined. Urinary PD excretion both during fasting and milk feeding did not differ significantly between buffaloes to cattle during the period of milk feeding (P > 0.05), but there were highly significant differences between cattle and buffaloes after 3 months of age and two months of access to solid feed (P < 0.01). The GFR was lower in buffaloes than cattle on both milk fed and solid feed periods. It is suggested that the lower GFR found in buffaloes may be the reason for the differences as PD stay longer in the blood to give more time for recycling to the rumen when the rumen is developed and are then metabolized by bacteria. Whether permeability of PD from blood to rumen is an additional factor is not known. (author)

[en] At AWE plc, workers potentially exposed to long-lived alpha emitters, such as plutonium, provide urine samples on a routine basis. Each sample is collected during working hours over a number of days. The activity concentrations in the samples are determined by radiochemical analysis. The creatinine in the samples and the ICRP reference daily excretion rate (1700 mg and 1000 mg for men and women respectively) are used to normalise the activity to a nominal twenty-four hour excretion for dose assessment purposes. This study examines the average and daily variation of creatinine excretion in healthy male and female adults. The advantages of taking samples over an extended period are assessed. There is a large variation in creatinine excretion between individuals and significant deviation from the ICRP recommended values. (author)

[en] Epidermal growth factor (EGF) is a polypeptide hormone that stimulates growth of a variety of tissues. Although it was originally discovered in male mouse submaxillary glands, EGF has recently been isolated from human urine. A heterologous radioimmunoassay for human EGF (hEGF) has been developed, using purified hEGF as reference standard and radioiodinated tracer and antibodies raised against mouse EGF. Purified hEGF specifically displaced radioiodinated hEGF from the antibodies; no other human peptide hormone tested demonstrated any cross-reaction. Twenty-four hour urinary excretion of RIA-hEGF in normal adult males and females was 97.8 +- 10.7 and 72.0 +- 4.5 (mean +- SE) μg/total volume, or 51.7 +- 4.5 and 57.0 +- 4.9 μg/g of creatinine, respectively. Urinary excretion in normal children increased with age, from less than 40 μg/24 h at 4 years of age to adult levels at about the age of puberty. The concentration of RIA-hEGF in human saliva ranged from 5.6 to 16.8 ng/ml, was about 80 ng/ml in human milk and was undetectable in human amniotic fluid (<1.4 ng/ml). It was recently been suggested that human EGF is identical with human urogastrone. However, the tissue secreting this ''new'' human hormone and the role of hEGF in health and disease have yet to be determined

[en] The follow-up of a more than 25-year-old contamination case has been investigated since 1990 with improved accuracy for the measurement of the activity in the urine. Estimates of the body burden are based upon the late urinary excretion and the excretion factors given by Leggett. The case has also been proposed for the second European intercomparison organised by EURADOS. Most of the reported results are based upon the ICRP30/54 model but one laboratory gives an estimate of the body burden based upon the ICRP 66/67 biokinetic models. (author)

[en] Full text: Introduction: The calculation of the urinary excretory index of patients has been an integral part of the diuresis renography done with Tc-99m DTPA (Pentetate) at Tygerberg Hospital. The value of twenty percent was accepted as normal. Since most renograms are now done with Tc-99m MAG3, normal values of urinary excretion of Tc-99m MAG3 should be available, but nothing was found in the literature. Objectives: 1. To determine whether renography reports can be used to predict normal values of MAG3 excretion in urine during diuresis renography 2. To investigate if there is a relationship between the age of the patient and the urinary excretory index 3. To compare excretory index in patients who had both DTPA and MAG3 studies. Methods: Renography reports and excretion values of diuresis renograms performed during a 15-month period were retrospectively reviewed. According to renogram reports, the patients were classified as normal or abnormal. Where possible, plasma creatinine values were obtained for patients In the normal group. MAG3 excretion values were studied in relation to age, creatinine values and DTPA excretion in those patients who had studies with both agents. Average values and ranges were compared for MAG3 excretion of the normal and abnormal groups. Statistical methods included linear regression and student's t test. Results: One hundred patients data were reviewed; age range 3 to 90 years. The MAG3 normal group included 36 patients. Plasma creatinine values were obtained for 14 patients. There was no correlation between MAG3 excretion and age (r=0.1). Average MAG3 excretion for cases reported as normal was 62.6 + 19.6% and for abnormal studies 51.0 + 21.6%. As plasma creatinine increased, MAG3 excretion decreased (correlation coefficient 0.77). Six patients had studies with both DTPA and MAG3. In this limited group, the correlation coefficient between DTPA excretion and MAG3 excretion was 0.67. Conclusion: This retrospective study demonstrates that grouping patients by renogram reports cannot be used to ascertain normality or abnormality of MAG3 excretion values. The percentage excretion of MAG3 is not age related. No conclusion can be drawn from the DTPA-MAG3 comparison due to the small number of patients. A prospective study with a gold standard, possibly creatinine values, should lead to better differentiation between normal and abnormal excretion. (author)

[en] The published data on the biokinetics of actinide distribution and retention in humans and animals have been reviewed. It is concluded that in humans there are strong indications that urinary and faecal excretion of plutonium is greater in females than males. Animal data indicate that this may also be true for americium, neptunium and uranium. (author)

[en] The determination of radionuclides in human excreta is one method for monitoring the internal exposure of workers handling radioactive material. For the purposes of calculating the internal dose from such exposures one has to consider the natural background caused by the ubiquitous but area-dependent exposure to natural radionuclides. This is especially true of monitoring of the exposure to long-lived natural radionuclides of the ²³⁸U and ²³²Th series. To get a first impression of the natural background of some of these radionuclides the amount of various natural radionuclides present in faeces and urine of non-exposed persons from Berlin were measured. In the faecal samples, each collected over a period of 24 h, the following levels were found: uranium ranged from 0.4 to 2.2 μg.d^-1, mean 1.4 μg.d^-1, ²²⁶Ra from 38 to 121 mBq.d^-1, mean 65 mBq.d^-1, ²¹⁰Pb from 52 to 185 mBq.d^-1, mean 111 mBq.d^-1, ²³²Th from 1.6 to 12 mBq.d^-1, mean 5.4 mBq.d^-1, ²³⁰Th from 1.7 to 16 mBq.d^-1, mean 9.8 mBq.d^-1, and ²²⁸Th ranged from 11 to 39 mBq.d^-1, mean 23 mBq.d^-1. Ten 24 h urine samples were analysed to determine ²¹⁰Pb and ²¹⁰Po. Only one value for ²¹⁰Pb and six for ²¹⁰Po were above the detection limit of 6 mBq.1^-1 and 2 mBq.1^-1, respectively. The highest value for ²¹⁰Po was at 10 mBq.d^-1. (author)

[en] Purpose: Renal excretion of orally or rectally applied Gastrografin is reported to be a reliable indicator of a perforation or a post-operative anastomotic dehiscence of the GI-tract. The study was conducted to determine whether increased attenuation of the urine measured by CT after oral or rectal application of Gastrografin can give reliable evidence of any leakage from the gastrointestinal tract. Materials and Methods: Urine samples of 33 patients, who underwent a Gastrografin-enhanced fluoroscopic examination of the esophagus or the GI-tract for different clinical reasons, were examined by CT. The samples had been taken immediately before and 60 to 90 minutes after application of 100 ml Gastrografin. The results were compared with those of 5 healthy volunteers, who took urine samples before, 30, 60, 90, and 120 minutes after drinking 100 ml of Gastrografin. Results: Maximal attenuation of the volunteers' urine samples was achieved 60 to 90 minutes after Gastrografin application with a mean of 50 Hounsfield units (HU), SD=17 HU. The urine of three patients with radiologically proven fistula or dehiscence of a GI-tract anastomosis had no relevant increase in attenuation. Three other cases without any clinical or radiological evidence of an anastomotic leak had a substantial increase in the attenuation of the urine probes (87, 110, and 290 HU, respectively). Conclusion: The CT-measured urine samples as evidence of renal excretion of orally or rectally applied Gastrografin are not reliable for the detection of leaks from the GI-tract. (orig.)