Ear-lobe anthropometric signs do not relate to longevity. Ear length relates to age.

Dear Editor, During the last 30 years we are collecting various photographs which showed the face of persons who died at various ages during their lifetime. We so collected more than 235 photographs. After strict selection of these photographs, so that we could see well the ear and the ear-lobe we chose 57 of them and studied the following parameters: the vertical length of the ear till the lobe, the vertical length of the earlobe, the total ear length, the width of the ear-lobe and the area of the lobe, in order to relate them to longevity. All persons were Caucasians from western countries. No persons from Mediterranean countries were included. The above persons were separated into 2 Groups: Group A, 25 persons who lived 38-70 years, and Group B, 32 persons who lived 89-106 years. In both Groups it was more than obvious after calculating the Mean and the Standard Deviation (M±SD) that no relation existed between all above factos and longevity in both groups. In order to confirm the above result we separated both Groups into Subgroups. Subgroup A1 included 9 cases who lived 38-59 years and Subgroup A2 included 16 cases who lived 60-70 years. Subgroup B1 included 25 cases who died at 89-99 years of age and Subgroup B2 included 7 cases who lived 99-106 years. All above parameters were still unrelated to longevity. We noticed that the length of the total ear although unrelated to longevity was related to age till the age of 99 years. In Subgroups A1 and A2 the M±SD was 1.20±0.41cm and 1.48±0.42cm, respectively and in Subgroups B1 and B2 the M±SD of the total ear length was 2.28±0.47cm and 2.32±0.54cm, respectively (Table). The small number of persons studied was a handicap. There seemed to be a relation between total ear length and age till 99 years (Figure). It is known that the ear like all other parts of our body enlarges up to the end of our maturity and later by age. This finding in the present paper covers a wider range of ages as compared to other related papers, i.e. covers the ages of 38-106 years and so seems to be as for this point prototype. Another paper studied ear length up to the age of 41 years.

Circulatory system and neurosciences. Some perspectives in diagnosis and treatment.

This paper aims to describe how radial artery obstruction can support blood circulation in an ischemic area. A dramatic case is described. Furthermore aims to describe that fatigue, atherosclerosis and toxic substances like in alcoholism may reduce blood flow and energy supply in the cortex and other brain areas and thus unconsciously modify our usual civilized behavior. Intense mental and physical fatigue was described as: "vital exhaustion".

Changes in esophageal mucosal morphology and in growth of breast feeding rats fed with milk of low or high temperature.

Dear Editor, This rather original investigation was performed some time ago but is still unpublished. Its aim was to estimate the effect of low or high temperature cow's milk given to breast feeding rats in order to study possible influence of this diet to rats, to their physical growth and also esophageal mucosal pathology. Ten white female Wistar rats, 20 days of age were separated from their mothers and divided in 2 groups of 5 members each. Five of them were fed with milk kept at 42oC by using a special warming device. The other 5 animals were fed with cold milk kept at 4oC during feeding. The duration of feeding was 34 days. Animals were finally sacrificed with a lethal dose of ether. The two groups were examined and compared. The group of rats fed by the warm milk was better grown as indicated by gaining more body weight, being more active and drinking more milk. Specimens were taken from the middle esophagus and after specific treatment were examined under the electronic microscope. We found: In both groups the most impressive finding in esophageal mucosa was an edematous intercellular space in all epithelial layers with many microorganisms in these layers. Acantholysis was often identified while in other areas a keratin transformation was noticed even in the basic layers, while basic membrane was absent. Epithelial cells showed edematous mitochondria and formation of myelin bodies. Degenerative changes and interstitial edema were noticed in the chorio. The above findings suggest that hot milk but not cold milk improves the growth of the rats studied. Cold and also hot milk had a damaging effect on the rats' esophageal mucosa. It is obvious that many options for further research arise related to the range of temperature of food intake that will not cause damage to gastric epithelium.

About an energy functioning by fusion, independently.

An innovative biological energy has been observed related to the eye sight and fusing with another energy over tap water through a small metallic chain. The fused energy has been repeatedly described under standard conditions and it is characteristics vary according to the condition of the eye sight and the water content. This energy may be called: "EFI" (energy functioning, by fusion, independently).

Endless research II. The genomic era. Neohippocratic Medicine.

The great progress of genetics research, during 2015-2017, will certainly influence all medical specialties including nuclear medicine. In nuclear medicine there are still problems to solve as to differentiate between infection, inflammation and cancer etc. Furthermore, in dosimetry and radiation protection there are worldwide problems. It has been reported that 64 Cu-cetuximab immune-PET represented EGFR expression levels in ESCC tumors and that 177 Lu-cetuximab radioimmunotherapy effectively inhibited the tumor growth. Recent important research findings and few related suggestions for further research are mentioned related to Gastroenterology, Neohippocratic Medicine, the Respiratory System, Neurology and the Hayflick phenomenon. Perhaps we now live in the genetics transformation era, the Genomie's Era.

An endless research for 2016.

In a moment of reflection of the past year of 2015, as to what we have achieved in medical research and what we need to do in the future we realize that although we have performed an enormous progress in medical research in the past we still have to do much more. In nuclear medicine there are many problems to solve like, how can we differentiate between infection, inflammation and cancer or between lymphomas and adenocarcinomas. In bone scans we need to differentiate traumatic lesions acute or chronic and lesions from another origin. Dosimetry and radiation burden is another problem. In HJNM we have previously published related papers. Not to mention radiation sickness due to modern atomic or hydrogen bombs. Labeling antibodies and genetic material is another issue. Additionally, in general medical knowledge is still unable to solve many unknown, difficult or tragic problems of our lives, like cancer, some viral infections, research in immunology, collagen diseases, genetics, radiation treatment, psychological disorders, anesthetics, the Hayflick phenomenon, hypertension, asthma, the function of the gastrointestinal tract, infectious diseases, physical exercise, all of which are briefly mentioned. We hope that even under the present financial problems and considering that almost 90% of medical truth is still unknown, our research in 2016 will be very important. In this paper we also discuss means for a more genuine and effective research.

Morning and night gastric emptying half-time differed more than 220% in two young healthy adults.

OBJECTIVE: It is important to know normal GEHT of a specific meal taken at specific hours and at specific physical and biological conditions in order to better evaluate abnormal GEHT. It seems that it is more specific to study as we have done in the present paper GEHT in the same individual of a certain meal administered at two different hours, i.e. in the morning and at night. Thus, we avoided many errors and issues. SUBJECTS AND METHODS: We studied 2 healthy individuals, one male 26 years old and one female, 19 years old, who received the same French toast meal at 08.00 and 23.00. RESULTS: The GEHT for the morning and the night test for the male individual (P.F.) were 55min and 125min, respectively. For the female individual (K. F.) the GEHT were ∼70min and ∼120min, respectively. For both individuals GEHT differed more than 220% between the morning and night tests. CONCLUSION: We noticed a more than 220% delay of the GEHT in a normal young man and a normal young woman when they received a French toast meal at 23.00h as compared to the same meal at 08.00h. The female had 58% more delayed in GEHT at night as compared to the GEHT of the male individual.

Medical deontology, meetings, journals, candidacy for higher posts and how to better enjoy life.

Unfortunately, today few physicians care about medical deontology and medical ethics, that is how to behave and respect others when exercising our medical profession. Some of us may not show the care and kindness we should show towards our students or the due respect to our senior colleagues. Occasionally, when examining our patients we may not pay the proper attention to their problems, being tired from work overload. Another issue of deontology is medical meetings. Do they offer us enough knowledge or mainly pleasure? Is our curriculum vitae comprised by useful to society and to medicine original or confirmatory research work? Few examples to illustrate what the situation is at present are included in this paper. Our financial success in practice should not compete with the "old" Hippocratic oath and ideals. The pursuit of happiness in our life is not achieved through untruthfulness, dishonesty or only high financial status. "The Lancet"mentioned long ago (1969; September 27; 681-4) a phrase by John Keats: "Truth is beauty‥this only exists on Earth and this is what we need to know".

Diagnosing atherosclerosis makes Nuclear Medicine a tissue imaging modality.

Atherosclerosis can be identified by fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and is associated with cardiovascular events and all-cause mortality. Inflammation and classification appear jointly in the formation of atherogenesis. Arterial calcification has been also determined by CT, by (18)F-FDG PET and also in the last few years by (18)F-sodium fluoride (NaF) PET. Beheshti et al, have introduced a new concept for the detection of early molecular and cellular calcification in the atherosclerotic plaques of the heart and aorta, based upon the concept of global disease burden, which had been employed earlier using (18)F-FDG PET. Fluorine-18-NaF uptake in the heart and aorta increased significantly with advancing age. In a screening study involving 1,825 individuals, CT coronary artery calcification (CAC) was found to be common in healthy middle-aged individuals with a low Heart Score and, on the contrary, high-risk subjects very frequently did not have CAC. It is obvious that atherosclerosis appears early in life and also that the actual limits of atherosclerosis related to serious cardiovascular events should be determined by more research, since atherosclerosis is not the only cause of these episodes. It is possible that (18)F-NaF PET/CT may provide information about ongoing active molecular calcification in the plaque before calcification as a cause of cardiovascular episodes is detectable. Global molecular cardiovascular calcification, before becomes macroscopically visible, before it can be identified by CT, may be assessed by nuclear medicine procedures. (18)-NaF PET/CT is the first non-invasive imaging method to identify and localize high risk coronary plaque, a new frontier in nuclear cardiology. The above nuclear medicine diagnostic technique is a major and historical new application, for the diagnosis and the study of cardiovascular diseases, by which a certain tissue per se can be identified.

Medical Deontology towards medical students, our colleagues and our patients. About meetings, medical journals, candidacy for higher posts and the "silent" society.

Unfortunately, today very few care about medical deontology-ethics that is about how to behave and respect others when we exercise our medical duties. Perhaps we do not show our real care and kind leadership to our students. We do not very much respect our medical colleagues. We are often tired to spend much time examining patients. We attend medical meetings for pleasure or because our expenses are covered by pharmaceutical firms. We write unimportant papers in order to have a rich curriculum. We consider the Impact Factor of a journal as awarded only to underline the importance of a letter to the Editor we publish in a prestigious journal. We refrain from useful research. We are not always truthful in publishing the results of our research. Many such examples are included in this paper. Overall, we go for a financial success disregarding the "old" Hippocratic ideas and oath. We are supposed to seak for life-happiness. Instead, we feel guilty, inconvenient as to our social behaviour and unhappy. "The Lancet" mentioned long ago (1969) a phrase by John Keats: "Truth is beauty...this only exists on Earth and this is what we need to know".

Errors inducing radiation overdoses.

There is no doubt that equipments exposing radiation and used for therapeutic purposes should be often checked for possibly administering radiation overdoses to the patients. Technologists, radiation safety officers, radiologists, medical physicists, healthcare providers and administration should take proper care on this issue. "We must be beneficial and not harmful to the patients", according to the Hippocratic doctrine. Cases of radiation overdose are often reported. A series of cases of radiation overdoses have recently been reported. Doctors who were responsible, received heavy punishments. It is much better to prevent than to treat an error or a disease. A Personal Smart Card or Score Card has been suggested for every patient undergoing therapeutic and/or diagnostic procedures by the use of radiation. Taxonomy may also help.

[Medical behavior (deontology) towards our students, our colleagues, our patients and the society].

In this paper we try to describe the importance of a dignified behavior of the physician to his students, colleagues, patients and the society. We come to the conclusion that even if the other party is not showing the best of behavior, the physician has not only the responsibility and the duty but it is very much for his own interest to show a dignified and useful behavior to others. This is the main route for having a good reputation which will help him better exercise his medical duties and offer him personal happiness. Jeremy Bentham, an English judge and philosopher formed the Greek word deontology to mean correct behavior stating that this behavior is morally useful and a source of pleasure. The codes of Hammurabi, of the Indian Ayr Veda, of the Egyptians, the teaching of Aristotle, Hippocrates and others also describe medical deontology.

Highlights and prizes of an international meeting.

A short description selected from the presentations which had been awarded prizes in the 4th International Meeting of Nuclear Medicine, of the Hellenic Society of Nuclear Medicine, in Thessaloniki, Greece, is as follows: Professor L.G. Strauss from Heidelberg received the first prize for his original paper under the title: "Modulation of FDG kinetics in tumors by gene expression". He studied 25 patients with colorectal tumors with dynamic PET-FDG within 2 days prior to surgery and he finally came to the conclusion that angiogenesis has a significant impact primarily on the kinetic data (k1, k3), but also on the global FDG uptake. A detailed analysis of the FDG kinetics can help to classify the grade of angiogenesis in primary colorectal tumors. The cell cycle associated genes have a comparable impact on the FDG kinetics as compared to the angiogenesis related genes. Furthermore, hypoxia was associated with the FDG parameters. Enhanced expression of HIF-1a was primarily associated with an enhanced influx of FDG. The results demonstrated the impact of dedicated groups of genes on the FDG kinetics. Furthermore, if the FDG kinetics are quantitatively analyzed, the expression of certain genes may be predicted from these data. Dr. P. Bouziotis et al. received the second prize for their original paper under the title: "Labeling of bevacizumab, an anti-VEGF monoclonal antibody, with technetium-99m and rhenium-188". The authors were from Athens and Oxford and studied the reduction of the endogenous disulphide bonds of bevacizumab by treatment with 2-mercaptoethanol and TCEP-HCl. The number of generated-SH groups was estimated before each labelling experiment. The results of the present study show that VEGF expression in tumors can be detected and visualized specifically with the anti-VEGF monoclonal antibody bevacizumab, labelled with gamma-emitting radioisotopes. The third prize went to Dr C. H. Tsopelas et al. from Adelaide who presented an original paper under the title: "Evaluation of visceral sensitivity after transient inflammation-An experimental model". Their aim was to characterise the inflammatory response to the transient chemically-induced colitis after instillation of trinitrobenzenesulfonic acid. Inflammation was tested by (99m)Tc-Sn-colloid-leucocytes. They concluded that the Group of Lewis rats compared to Fisher rats, developed a prolonged visceral hyperalgesia and more severe inflammation following colorectal instillation of TNBS/ethanol doses, possibly involving the systemic immune response. The Lewis rat species appears to be a good model of transient colitis, because of its heightened sensitivity to the chemical stimulus, and due to detectable visceral changes long after administration of the above stimulus. Professor A.M. Peters from England, received the fourth prize with his original paper: "New quantitative techniques for investigating and predicting lymphoedema resulting from breast cancer treatment". In lymphoedema from breast cancer treatment he investigated local uptake via putative peripheral lympho-venous communications (LVCs), using intradermally injected labelled red cells. He concluded that his results suggest that protective mechanisms could include i) interstitial proteolysis, ii) increased peripheral trans-endothelial protein transport or iii) development of peripheral LVCs. Other prizes were awarded to: Professor G.P. Bandopadhyaya et al. from New-Delhi for their original paper: "Molecular targetting of infective bacterial maltose binding protein for infection imaging using Tc-99m hydroxypropyl cyclodextrin in patients with knee joint replacement and other prostheses", to Dr P.J. Marsouvanidis et al. from Demokritos Athens and Patras for their original paper: "Synthesis, radiochemistry and preclinical comparison of [(111)In-DOTA(0)]SS-14 and [(111)In-DOTA(0),(D)Trp(8)]SS-14 in AR4-2J cells and Swiss albino mice", to Professor B. Singh et al. from Chandigarh and New Delhi for their original paper: "Efficacy of indigenously developed single vial kit preparation of (99m)Tc-ciprofloxacin in the detection of bacterial infection-An Indian experience" and to Dr. A. Bantis et al. from Alexandroupolis for their original paper: "The prognostic value of serum chromogranin A in patients with advanced prostate cancer".

Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus.

Hippocrates is considered to be the father of modern medicine because in his books, which are more than 70. He described in a scientific manner, many diseases and their treatment after detailed observation. He lived about 2400 years ago. He was born in the island of Kos and died at the outskirts of Larissa at the age of 104. Hippocrates taught and wrote under the shade of a big plane tree, its descendant now is believed to be 500 years old, the oldest tree in Europe--platanus orientalis Hippocraticus--with a diameter of 15 meters. Hippocrates saved Athens from a plague epidemic and for that was highly honored by the Athenians. He considered Democritus--the father of the atomic theory--to be his teacher and after visiting him as a physician to look after his health, he accepted no money for this visit. Some of his important aphorisms were: "As to diseases, make a habit of two things -to help or at least to do no harm". Also: "Those by nature over weight, die earlier than the slim.", also, "In the wounds there are miasmata causing disease if entered the body". He used as a pain relief, the abstract from a tree containing what he called "salycasia", like aspirin. He described for the first time epilepsy not as a sacred disease, as was considered at those times, but as a hereditary disease of the brain and added: "Do not cut the temporal place, because spasms shall occur on the opposite area". According to Hippocrates, people on those times had either one or two meals (lunch and dinner). He also suggested: "...little exercise...and walk...do not eat to saturation". Also he declared: "Physician must convert or insert wisdom to medicine and medicine to wisdom". If all scientists followed this aphorism we would have more happiness on earth.

Editor and authors' psychology and the chance of teaching.

It is the duty of the editor to communicate with the authors who submit their scientific work for publication. The question arises as to the best way to perform this communication. The goal is to publish papers that would make their authors proud and the readers of the journal, satisfied. This goal is expressed with honesty, kindness, politeness, diplomacy and when the editor communicated with authors from other Countries, the advice of a person familiar with the traditions of these Countries may be welcome. The unpleasant editor's duty to inform the authors of their paper being rejected, can be expressed either by writing a brief straight forward letter or by giving a more detailed answer or finally, by explaining to the authors their errors in a detailed manner, in other words, by giving them advice and consultation. In his reply to the authors whose paper has been rejected, the editor may touch a sensitive part of their behavior. Authors may consider their paper as "their intellectual child". Some times authors make unacceptable mistakes that may or may not be revealed by the reviewers. Explaining in detail errors and thus counseling the authors, is hard work for the editor but not always appreciated by the authors. The value of counseling and teaching has been emphasized even by ancient philosophers but nowadays enthusiasm in learning is sometimes lacking. Is there a solution to the above? Perhaps if "the instructions to authors" of a journal specified clearly the "submission terms" for accepting a paper for publication, then the authors could be self-evaluated and perhaps all parties concerned would be happier.

Nucleology, nuclear medicine, molecular nuclear medicine and subspecialties.

Henry N. Wagner Jr started the presentation of the highlights of the 39th Annual Meeting of the Society of Nuclear Medicine by quoting: "The economist JM Keynes said: "the difficult lies not in new ideas but in escaping from the old ones". Many changes have taken place in the actual term describing our specialty during the last 15 years. Cardiologists have adopted an important chapter of nuclear medicine and to describe that they use the term of "nuclear cardiology". Radiologists have proposed the term "radionuclide radiology". "Nuclear endocrinology", "nuclear oncology", "nuclear nephrology" may be considered as terms describing chapters of nuclear medicine related to other specialties. Will that indicate that our specialty will be divided into smaller chapters and be offered to colleagues working in other specialties leaving to us the role of the supervisor or perhaps the radioprotection officer for in vivo studies? Of course this role is now being exercised by our colleagues in medical physics. It is suggested to use the word " nucleology", instead of "nuclear medicine" where "nuclear" is used as an adjective. Thus, we will avoid being part of another specialty and cardiologists would use the term cardiac nucleology where "cardiac" is the adjective. The proposed term "nucleology" as compared to the existing term "nuclear medicine" has the advantage of being simpler, correct from the grammar point of view and not related to combined terms that may seem to offer part of our specialty to other specialties. At present our specialty faces many problems. The term "nucleology" supports our specialty from the point of view of terminology. During the 3rd International Meeting of Nuclear Medicine of N. Greece which was held in Thessaloniki, Macedonia, Greece on 4-6 November 2005, a discussion arose among participants as to whether the name of "nucleology" could replace the existing name of "nuclear medicine". Finally, a vote (between "yes" and "no") for the new proposed term showed that the "yes" votes were 72 and the "no" votes were 49.

Pioneers of nuclear medicine, Madame Curie.

Among those who have made important discoveries in the field of radioactivity and thus helped in the development of nuclear medicine as an identical entity are: Heinrich Hertz who in 1886 demonstrated the existence of radiowaves. In 1895 Wilhelm Röntgen discovered the X-rays. In 1896 H. Becquerel described the phenomenon of radioactivity. He showed that a radioactive uranium salt was emitting radioactivity which passing through a metal foil darkened a photographic plate. An analogous experiment performed by S.Thomson in London was announced to the president of the Royal Society of London before the time H.Becquerel announced his discovery but Thomson never claimed priority for his discovery. Muarie Sklodowska Curie (1867-1934) was undoubtedly the most important person to attribute to the discovery of radioactivity. In 1898 she discovered radium as a natural radioactive element. This is how she describes the hard time she had, working with her husband Pierre Curie (1859-1906) for the discovery of radium and polonium: "During the first year we did not go to the theater or to a concert or visited friends. I miss my relatives, my father and my daughter that I see every morning and only for a little while. But I do not complain...". In presenting her discovery of radium, Madame Curie said: " ...in the hands of a criminal, radium is very dangerous. So we must often ask ourselves: will humanity earn or lose from this discovery? I, myself belong to those who believe the former...". The notebooks that Madame Curie had when she was working with radium and other radioactive elements like polonium, thorium and uranium are now kept in Paris. They are contaminated with radioactive materials having very long half-lives and for this reason anyone who wishes to have access to these notes should sign that he takes full responsibility. There are some more interesting points in Madame Curie's life which may not be widely known like: Although her full name is Maria Sklodowska-Curie, she is not known neither by that full name nor as Maria Sklodowska but as Marie Curie. Madame Curie was the second of five children. At the age of 24 she went to Sorbonne-Paris after being invited by her sister Bronja to study for about 2-3 years; instead she stayed in Paris for her whole life. Her doctorate was on the subject: "Research on radioactive substances" which she completed in six years under the supervision of H. Becquerel. Pierre Curie was Director of the Physics Laboratory of the Ecole Municipale of Physics and Industrial Chemistry when he married M. Curie in 1895. Pierre Curie left his other research projects and worked full time with his wife. In this laboratory M. Curie and her husband Pierre discovered radium and polonium. In 1901 Pierre Curie induced a radiation burn on his forearm by applying on his skin radiferous barium chloride for 10 hours. During World War I, M.Curie organized for the Red Cross a fleet of radiological ambulances each with X-ray apparates which were called "Little Curies". The X-ray tubes of these apparates were unshielded and so M.Curie was exposed to high doses of radiation. Once an ambulance fell into a ditch and M.Curie who was inside the ambulance was badly bruised and stayed at home for 3 days. M. Curie with her daughters, Irene and Eve, was invited and visited America in 1921. She led a successful campaign to collect radium for her experiments. Before leaving America, President Harding donated through her to the Radium Institute of Paris 1 g of radium for research purposes. At that time the process to obtain 0.5 g of pure radium bromide required 1 ton of ore and 5 tons of chemicals. No measures of radiation protection were taken back then. In 1929 Madame Curie visited the United States for a second time. She met with President Hoover and with the help of the Polish women's association in America collected funds for another gram of radium. Madame Curie died of leukemia on July 4, 1934. Sixty years after her death her remnants were laid to rest under the dome of the Pantheon. Thus she became the first woman under her own merit, to rest in the Pantheon. In 1934 at the Institute of Radiology in Paris, Frederique Joliot and Irene Curie-Joliot discovered artificial radiation. They studied alpha particles and beta;-radiation.