[Exposure of personnel in interventional radiology]. / Exposition des Personals bei interventioneller Radiologie.

The surface dose at five typical positions around the patient couch was measured during transjugular intrahepatic porto-systemic stent shunt (TIPSS) interventions for retrospective calculation of staff dose. Additionally, the surface dose was measured on three members of staff (two radiologists and one technician) by placing thermoluminescence (TL) dosimeters directly on the eyebrows, thyroid, sternum, gonads, hands, knees, and feet. The measured surface dose values and the TL dosimeter measurements are used for estimation of effective dose per examination received by personnel. The effective dose for the radiologists is calculated to 25-35 microSv. The maximum number of examinations allowed per year is calculated on the basis of a given yearly dose limit, by looking at organ dose and effective body dose.

Protein requirements in maintenance hemodialysis.

Protein requirements in maintenance hemodialysis patients are still unclear. Based on nitrogen balance studies and different analyses of protein and amino acid metabolism, the recommendations until recently were 1 g/kg of body weight, primarily of high biological value protein. According to the results of controlled long-term studies the 1 g recommendation now seems too low. The paper reports on the results of a controlled study undertaken to define protein requirements. The effect of supplementation with a special protein mixture is studied on the basis of 1 g of protein per kilogram of body weight intake and about 20 hr standard dialysis per week. The results suggest that 1.2 g of protein per kilogram of body weight primarily of high biological value protein and 35 kcal/kg of body weight should be prescribed for dialysis patients. In case of complications (bleeding, infection, and other stress situations) additional supplements are necessary.

Amino acid and protein intake in RDT patients. A nutritional and biochemical analysis.

In 40 unselected RDT patients (20 center and 20 home dialysis patients) the intake of nutrients was measured using the precise weighing method of Wirths [1969]. The protein intake was found to be 0.97 plus or minus 0.19 g/kg predialysis body weight, the calorie intake 32.3 plus or minus 6.4 cal/kg. Two thirds (0.65 plus or minus 0.15 g/kg) of the protein consisted of high biological value protein. Despite the fact that according to current recommendations the protein intake should have been adequate, signs of protein malnutrition were found. The mean serum concentrations of total protein, transferrin and valine and the ratio of essential amino acids to nonessential amino acids (EAA/NEAA) were significantly lower than in normal subjects and the glycine level was elevated. Histidine levels were normal indicating that the histidine intake measured at 1.75 plus or minus 0.47 g/day appeared adequate under these conditions. Phenylalanine levels were elevated indicating a blocking of 4-hydroxylase leading to low tyrosine levels. A possible reason for these findings may be that the protein requirements of the RDT patient over a long period of time are higher than those found experimentally in short term studies. An inadequate calorie intake could not be excluded. Additionally a dialysis dependent pathologic variation of the daily intake of nutrients may be responsible for the disturbed nutritional status. In connection with this, three distinct types of intake variation can be described: A stable type in which the variation in the daily protein and calorie intake does not differ by more than 20% from a daily mean value, an unstable type I with significantly lower intake on the day of dialysis and an unstable type II with a significantly higher intake on the day of dialysis. Signs of protein malnutrition occurred significantly more frequently in the unstable groups.