Energy expenditure of deskwork when sitting, standing or alternating positions.

BACKGROUND: Recent guidelines recommend accruing 2-4h of standing or light activity during the working day. Use of sit-stand desks could achieve this goal, but whether standing can meaningfully increase energy expenditure (EE) is unclear. AIMS: To study EE, heart rate, feelings and productivity during deskwork while sitting, standing or alternating positions. METHODS: We measured EE by indirect calorimetry in working adults over three randomly ordered 60-min conditions while performing deskwork: continuous sitting (SIT), 30min of each standing and sitting (STAND-SIT) and continuous standing (STAND). We also assessed heart rate, productivity and self-reported energy, fatigue and pain. Linear mixed models compared minute-by-minute EE and heart rate across conditions. Non-parametric tests compared remaining outcomes across conditions. RESULTS: The study group comprised 18 working adults. Compared with SIT, STAND-SIT engendered an additional 5.5±12.4 kcal/h (7.8% increase) and STAND engendered an additional 8.2±15.9 kcal/h (11.5% increase) (both P < 0.001). Alternating positions to achieve the recommended 4h/day of standing could result in an additional 56.9 kcal/day for an 88.9kg man and 48.3 kcal/day for a 75.5kg woman. STAND-SIT and STAND also increased heart rate over SIT by 7.5±6.8 and 13.7±8.8 bpm, respectively (both P < 0.001). We observed no meaningful differences in feelings or productivity. CONCLUSIONS: Desk-based workers could increase EE without added discomfort by using a sit-stand desk. These findings inform future research on sit-stand desks as a part of workplace interventions to increase EE and potentially improve health.

In vitro-in vivo correlation of hepatobiliary drug clearance in humans.

The biliary clearance (Cl(biliary)) of three compounds was estimated using sandwich-cultured human hepatocytes (SCHH) and compared with Cl(biliary) values measured in vivo. Tc-99m sestamibi (MIBI) Cl(biliary) was determined in seven healthy volunteers using an oroenteric catheter to aspirate duodenal secretions, and gamma scintigraphy to determine gallbladder contraction; this technique was used previously to determine Tc-99m mebrofenin (MEB) and piperacillin (PIP) in vivo Cl(biliary). In vitro Cl(biliary) of MEB, MIBI, and PIP was quantified in SCHH as the ratio of mass excreted into bile canaliculi and area under the blood concentration-time curve (AUC) in medium. MIBI Cl(biliary) in vivo was 5.5+/-1.2 mL/min/kg (mean+/-SD). The rank order of Cl(biliary) predicted from SCHH corresponded well with the in vivo Cl(biliary) values in mL/min/kg for MEB (7.44 vs 16.1), MIBI (1.20 vs 5.51), and PIP (0.028 vs 0.032). In conclusion, the methods developed allowed for reproducible quantification of Cl(biliary) of drugs in healthy humans and prediction of Cl(biliary) from in vitro data.

In vivo and in vitro characteristics of double units of RBCs collected by apheresis with a single in-line WBC-reduction filter.

BACKGROUND: A novel apheresis procedure for a blood separator (MCS+, Haemonetics) enables the collection of 2 WBC-reduced RBC units in a single donation by using one disposable set with one in-line WBC-reduction filter (RC2H, Pall Corp.). The objective of this study was to evaluate the filtration performance in connection with different prefiltration RBC storage conditions and with the in vitro and in vivo storage quality of the filtered units. STUDY DESIGN AND METHODS: Sixty-six 2-unit RBC collection and gravity-filtration procedures were completed at three sites, resulting in 132 RBC units. Filtration of the double RBC units was performed at room temperature (RT) within 8 hours of collection (n = 36) and under refrigeration (1-6 degrees C) for up to 24 hours (n = 10) and 72 hours (n = 20) before filtration. RBC quality was compared to that of nonfiltered apheresis RBC units (n = 10). RESULTS: Median filtration time was 6.5 and 14 minutes for units stored at RT and under refrigeration, respectively. All 132 RBC units had residual WBC counts <0.4 x 10(6). The refrigerated units showed a greater mean log reduction in WBCs: 5.06 +/- 0.16 (24 hour) and 4.74 +/- 0.48 (72 hour), respectively, than did RT units: 4.47 +/- 0.28 (p<0.05). RBC loss was less than 12 percent in all cases (mean, 7.8 +/- 1.8%). Minimal differences in volume were observed between the paired RBC units. In vitro RBC storage characteristics of the filtered units were as expected and similar to those of the nonfiltered units. For RBC units held at RT (n = 24), the mean in vivo 24-hour recovery was 81.8 +/- 8.4 percent (double-label). CONCLUSION: Satisfactory filter performance in terms of WBC removal and RBC loss was observed with all 66 procedures, irrespective of storage conditions before filtration.

Dose calibrator assay of iodine-123 and indium-111 with a copper filter.

OBJECTIVE: The accurate measurement of radionuclides in a dose calibrator can be affected by container geometry especially for low-energy photons. This study investigated the effectiveness of using copper filtration for selective absorption of low-energy x-rays during the measurement of 123I and 111In to minimize variations in measurement as a function of geometry. METHODS: Copper absorbers of varying thickness were used to define the absorption profile of low-energy x-rays in the 20- to 50-keV energy window with 125I and a gamma scintillation spectrometer. Iodine-123 and 111In standards were assayed in a dose calibrator, with and without a copper filter positioned in the ion chamber well, to determine new isotope calibration settings for these nuclides with the copper filter. Samples of 123I and 111In, of constant activity but various volumes, were assayed in 1-ml, 3-ml and 10-ml plastic syringes and a 10-ml glass vial with and without copper filtration to assess the influence of geometry on the accuracy of measurement. RESULTS: A copper thickness of 0.6 mm removed 99.5% of 125I photons in the 20- to 50-keV window and significantly reduced the low-energy component of 123I and 111In. Activity measurements of 123I and 111In in the dose calibrator varied with container type and volume without copper filtration but were essentially unchanged when a copper filter was used. CONCLUSION: A copper filter > or = 0.6 mm thick eliminates the need for geometry correction factors for measuring 123I and 111In with the dose calibrator.

Ozone exposure increases respiratory epithelial permeability in humans.

Ozone is a respiratory irritant that has been shown to cause an increase in the permeability of the respiratory epithelium in animals. We used inhaled aerosolized 99mTc-labeled diethylene triamine pentacetic acid (99mTc-DTPA) to investigate whether human respiratory epithelial permeability is similarly affected by exposure to ozone. In a randomized, crossover double-blinded study, 8 healthy, nonsmoking young men were exposed for 2 h to purified air and 0.4 ppm ozone while performing intermittent high intensity treadmill exercise (minute ventilation = 66.8 L/min). SRaw and FVC were measured before and at the end of exposures. Seventy-five minutes after the exposures, the pulmonary clearance of 99mTc-DTPA was measured by sequential posterior lung imaging with a computer-assisted gamma camera. Ozone exposure caused respiratory symptoms in all 8 subjects and was associated with a 14 +/- 2.8% (mean +/- SEM) decrement in FVC (p less than 0.001) and a 71 +/- 22% increase in SRaw (p = 0.04). Compared with the air exposure day, 7 of the 8 subjects showed increased 99mTc-DTPA clearance after the ozone exposure, with the mean value increasing from 0.59 +/- 0.08 to 1.75 +/- 0.43%/min (p = 0.03). These data show that ozone exposure sufficient to produce decrements in the pulmonary function of human subjects also causes an increase in 99mTc-DTPA clearance.

CSF rhinorrhea: detection and localization using overpressure cisternography with Tc-99m-DTPA.

We performed 32 overpressure radionuclide cisternography (ORNC) studies to examine 26 patients who were clinically suspected of having cerebrospinal fluid (CSF) fistula with rhinorrhea. Fifteen (47%) of these cisternography studies were positive, and the site of the leak was identified. No leak could be demonstrated in the other 17. Of 23 examinations performed in patients who had clinically documented CSF rhinorrhea, 15 (65%) were scintigraphically positive. The rapid cephalad transit of the radionuclide bolus allowed completion of the study within 30 to 45 minutes. Seven examinations were also performed with overpressure metrizamide CT cisternography (OMCTC), and five demonstrated concordant results with the radionuclide study. Patient discomfort and side effects were minimal. We conclude that radionuclide infusion cisternography is a safe, rapid, and accurate method of investigating a suspected or proven CSF rhinorrhea and that it is complementary to metrizamide cisternography.

Radioiodinated bleomycin: stoichiometry of iodination and structural characterization by 1H-nuclear magnetic resonance.

Bleomycin was iodinated by reaction with iodine monochloride (ICl). A direct relationship was found to exist between the average number of iodine atoms bound per molecule of bleomycin and the ICl: bleomycin molar ratio. Characterization by 1H-NMR analysis denoted that mono, di-, tri- and tetraiodobleomycin are formed when the reacting molar ratios, respectively, are 2:1, 4:1, 6.8:1 and 8.5:1 or greater. The sites of iodination of the bleomycin molecule have been identified to be the imidazole ring which iodinates first, followed by the bithiazole ring system which iodinates last.

Technical problems associated with the production of technetium Tc 99m tin(II) pyrophosphate kits.

The amount of tin(II) required for adequate reduction, complexation, and stability of technetium Tc 99m pertechnetate in radiopharmaceutical kits, and methods of preventing the loss of tin(II) during formulation of these lyophilized kits are investigated. Tin(II) loss from stannous chloride solutions was studied under several conditions, including room air versus nitrogen atmospheres, during vial filling in a laminar-flow hood with samples frozen on dry ice versus samples at room temperature, during lyophilization, and during storage under refrigerated, ambient, and elevated temperatures. Various amounts of stannous chloride, ranging from 5 to 1000 microgram/ml, were used in formulating sodium pertechnetate Tc 99m kits containing 100 mCi technetium Tc 99m and 0.4 microgram total technetium. Samples were removed at various times; hydrolyzed technetium, pertechnetate, and technetium Tc 99m pyrophosphate were isolated on instant thin-layer chromatography-silica gel and quantified with a scintillation counter. The time necessary to deoxygenate distilled water by nitrogen purging was measured. Several sources of stannous chloride were assayed for tin(II) content. Tin(II) loss occurs rapidly in solution (15% in one hour) unless continuously protected with nitrogen, and during vial filling in a laminar-flow hood unless frozen with dry ice. No substantial loss of tin(II) was detected during lyophilization or during storage of lyophilized product at any of the three temperatures. A minimum of 400 microgram tin(II) was required to provide 90% technetium Tc 99m pyrophosphate at six hours after preparation. Adequate deoxygenation of small quantities (450 ml) of water was accomplished in less than one hour. Some stannous chloride salts were highly oxidized in the dry state, and only high-purity elemental tin wire gave acceptable yields of tin(II).

A simple device for efficient transfer and unit dose packaging of Xe-127: concise communication.

An inexpensive system has been devised for the efficient transfer of Xe-127 gas from the manufacturer's ampule into individual dose vials for patient use. By displacing the gas with an aqueous solution, the initial transfer is made from an ampule of known activity into an evacuated serum vial of predetermined volume with transfer efficiency greater than 99%. A similar principle is used to transfer Xe-127 from the stock serum vial into individual dose vials, with total xenon recovery exceeding 98%. Ability to deliver the desired activity to each vial is within 90-110% of that predicted by calculation. Reproducibility in delivering a given activity was excellent, with all vials falling between 95 and 105% of the mean activity. Stability studies showed that 94% of the Xe-127 activity can be removed from the vials with only 6% absorbed in the rubber stopper after 5 wk of storage. The device costs less than $25.00 and can be constructed easily from common laboratory materials.