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Measuring single-kidney glomerular filtration rate on single-detector helical CT using a two-point Patlak plot technique in patients with increased interstitial space.

OBJECTIVE: We measured the single-kidney glomerular filtration rate (GFR) with a two-point Patlak plot technique based on multiphasic CT in patients with hydronephrosis or pyelonephritis or both. The question we sought to answer in our study was, Does increased interstitial space as measured with the Patlak plot technique cause overestimation of GFR? SUBJECTS AND METHODS: Twenty adult patients treated with percutaneous nephrostomy were studied. The CT protocol consisted of an unenhanced scan and three subsequent scans obtained 38, 71, and 102 sec after the initiation of the contrast medium injection. Plasma clearance of the contrast medium was determined and used as the reference. Additionally, single-kidney excretory clearance was determined by separate urine collections from the left and right kidneys. A three-compartment model calculation was made using all data available to estimate volume and transfer rate constant of the interstitial space. RESULTS: The GFR determined using plasma clearance correlated well with the GFR determined using excretory clearance, with a correlation coefficient of r = 0.94 and a regression line of y = -6 + 0.97 x x. GFR of both kidneys as measured using CT was overestimated according to the GFR determined using plasma clearance, with a correlation coefficient of r = 0.80, and a regression line of y = 35 + 0.79 x x. Single-kidney excretory clearance GFR was similarly overestimated using single-kidney CT GFR, with a correlation coefficient of r = 0.81 and a regression line of y = 20 + 0.84 x x. Single-kidney parenchymal volume was used as an indicator of interstitial space enlargement. The overestimation of excretory clearance GFR using CT correlated significantly with the parenchymal volume of the individual kidneys. A high correlation was also found between overestimation of total GFR determined with CT and interstitial space estimated using a three-compartment model calculation. Relative interstitial space was estimated to be 25% (range, 9-46%) of total kidney volume. CONCLUSION: Using the interstitial space as a third compartment may introduce an error into the measurement of GFR with the Patlak plot technique. We found that the CT protocol in our study resulted in considerable overestimation of GFR as determined with the Patlak plot in patients with increased interstitial space.

Contrast Media↗

An exploration of perception of body boundary, personal space, and body size in elderly persons.

A study of 108 elderly persons using the Body Distortion Questionnaire and the personal space simulation technique test did not support hypotheses that elderly persons with a large personal space will have a larger distortion of body boundary, a larger perception of large body size, a smaller perception of small body size, a larger distortion of body size, and a larger body distortion than elderly persons with a small personal space. The analyses with one-tail t tests showed elderly persons with a small personal space have a larger perception of large body size and a larger distortion of body size than elderly persons with a large personal space. When the extremes of personal space were used the results were the same. Males have a larger personal space and greater distortion of skin perceptions than females.

Aged↗

Extracerebral fluid collections in infancy: role of magnetic resonance imaging in differentiation between subdural effusion and subarachnoid space enlargement.

The pathological process of extracerebral fluid collections in infancy includes subdural effusion and enlargement of the subarachnoid spaces. Both conditions have traditionally been investigated as a single clinical entity, because of difficulty in differentiating between them. The prognosis of subdural effusion is not as benign as that of enlargement of subarachnoid spaces, requiring differential diagnosis between these disorders. The present study was conducted to elucidate whether this differentiation could be made on magnetic resonance (MR) images. The series consisted of 16 infants aged 10 months or younger, including eight with verified subdural effusion and eight in whom a diagnosis of enlargement of the subarachnoid spaces was achieved by neuroimaging studies other than MR imaging. In all eight patients with subdural effusion, the intensity of the fluid was greater than that of cerebrospinal fluid (CSF) in at least one of the sequences using T1-weighted, proton-density, and T2-weighted MR images. The flow-void sign, indicating vessels in the fluid spaces, was not seen in any of these eight patients. On the other hand, in all eight patients with enlargement of the subarachnoid spaces, the fluid was isointense in relation to CSF, and vascular flow-void areas were seen in at least one of the MR imaging sequences. Based on these observations, it is concluded that differentiation between subdural effusion and enlargement of the subarachnoid spaces can be established by focusing on two aspects of MR imaging findings: 1) the intensity of the fluid, which is either iso- or hyperintense relative to CSF, and 2) the presence or absence of vascular flow-void areas in the fluid spaces.

Contrast Media↗

[Growth of wheat from seed-to-seed in space flight].

In our earlier space experiment with super dwarf wheat we found the spikes developed in space to be barren. The cause of the full crop sterility was sensitivity of this wheat species to the ethylene concentration of 0.3-0.8 mg/m3 during the experiment. The follow-up ground experiments were made to identify species of dwarf wheat that could be raised in space greenhouse Svet and are distinguished by partial tolerance of their reproductive organs to elevated ethylene in air. The choice fell on the USU-Apogee cultivar specially developed for planting in growth chambers as an integral part of various bioregenerative life support systems, including the space ones. An experiment with wheat Apogee was performed in greenhouse Svet on board MIR. The period of the full crop vegetation cycle was not significantly altered under the spaceflight conditions. The experiment yielded 508 seeds from 12 plants, i.e. by 38% less than in laboratory experiments and by 69% more as compared with results of growing crops in ethylene-contaminated atmosphere (1 mg/m3). Mass of the space seeds was low if compared with the laboratory crops. This was the first time when the feasibility of gathering seeds from wheat that had passed the whole vegetation cycle in space flight was demonstrated. The experiment will give mightly impetus to the advancement of research on space biological LSS and gravitational biology.

Air Pollutants↗

Vertebrate development in the environment of space: models, mechanisms, and use of the medaka.

With the advent of space travel, it is of immediate interest and importance to study the effects of exposure to various aspects of the altered environment of space, including microgravity, on Earth-based life forms. Initial studies of space travel have focused primarily on the short-term effects of radiation and microgravity on adult organisms. However, with the potential for increased lengths of time in space, it is critical to now address the effects of space on all phases of an organism's life cycle, from embryogenesis to post-natal development to reproduction. It is already possible for certain species to undergo multiple generations within the confines of the Mir Space Station. The possibility now exists for scientists to consider the consequences of even potentially subtle defects in development through multiple phases of an organism's life cycle, or even through multiple generations. In this discussion, we highlight a few of the salient observations on the effects of the space environment on vertebrate development and reproductive function. We discuss some of the many unanswered questions, in particular, in the context of the choice of appropriate models in which to address these questions, as well as an assessment of the availability of hardware already existing or under development which would be useful in addressing these questions.

Animals↗

Microbial and fungal contamination contributes to physical stress in space flight: studies in the Euromir-95 mission.

Astronauts are subjected to flight-induced physical and psychic reactions which may be health threatening in the long term. Stress is a basic component of space missions, where astronauts are confined in a reduced volume, live in a hostile environment, have limited contact with the rest of the world and undergo a severe work load. Chronic stress in microgravity stimulates the HPA (hypothalamo-pituitary-adrenal) axis in astronauts with consequent hypercortisolim. Stress also stimulates the autonomic nervous system. Both increased cortisol and adrenergic stimulation suppress the immune function. For these reasons we developed experiments to contemporaneously measure the autonomic, HPA-axis and immune function in space missions. All measures are made with non-invasive methods. Autonomic adaptation is measured by spectral analysis of ECG derived interval, arterial pressure and respiration. HPA-axis function is assessed by measuring cortisol, F-Testosterone and DHEA in saliva. Immune function is monitored by measuring cytokine production and Th1/Th2 balance in saliva. Till now these experiments were performed on the ground. On 1998-99 space experiments will be performed and space technologies will be set up in collaboration with DMR company (Varese), to allow astronauts to measure stress factors directly in space. I.R.C.E.A. research, sponsored by the Italian Space Agency and selected by ESA and NASA, is focused on conditions which influence health in space flight: in particular, stress and microbial contamination. These two conditions are strictly correlated as infections causes stress and stress, by inhibiting the immune system, makes infection easier.

Adaptation, Physiological↗

[Growth and development of plants in a row of generations under the conditions of space flight (experiment Greenhouse-5)].

Results of the experiment aimed at harvesting a second space generation of wheat var. Apogee in Mir greenhouse Svet (experiment GREENHOUSE-5) are presented. In space flight, germination rate of space seeds from the first crop made up 89% against 100% of the ground seeds. The full biological ripeness was observed in 20 plants grown from the ground seeds and one plant grown from the space seeds following 80- to 90-d vegetation. The plant of the second space generation was morphologically different neither from the species in the first space crop nor from the ground controls. To study the biological characteristics of Apogee seeds gathered in the first and second crops in spaceflight experiment GREENHOUSE-5, the seeds were planted on their return to the laboratory. Morphometric analysis showed that they were essentially similar to the controls. Hence, the space experiments in Mir greenhouse Svet performed during 1998-1999 gave proof that plants cultivated in microgravity can pass the ontogenetic cycle more than once. However, initial results of the investigations into growth and development of plants through several generations are still in-sufficient to speak of possible delayed effects of the spaceflight factors (microgravity, multicomponent radiation, harmful trace contaminants etc.).

Aerospace Medicine↗

Space for missing maxillary lateral incisors--orthodontic perceptions.

Historically there has been a long-standing debate regarding the orthodontic management of dentitions with missing maxillary lateral incisors. Whether to provide space for prosthetic replacements or to close space utilizing the canines as substitute lateral incisors are the options of treatment planning for an individual. This presentation is directed at the orthodontic management of those patients who were orthodontically treated in the past by providing space for replacement lateral incisors and now at dental maturity or even later, seek a prosthetic replacement in the form of an osseointegrated fixture. In many instances there will be inadequate interradicular bone space and yet at the time of debanding adequate space often was present and now some years hence the patient is faced with orthodontic re-treatment to provide that space again. Whilst that is a challenge in itself, there is a further apparent problem to be met for those younger patients requiring space opening mechanics in deciding upon and implementing at the debanding phase, the form of retention that will hold the teeth and the roots firmly in position until the time is right for an osseointegrated fixture to be placed and treatment finalized.

Adolescent↗

Renal control of interstitial space compliance: a physiological mechanism which may play a part in the etiology of hypertension.

"Overloading" with salt and water, i.e., increasing extracellular fluid, can, if maintained for a period, lead to hypertension in which the main hemodynamic abnormality is increased peripheral resistance. There is evidence that salt and water overload is the chief factor in the hypertension of the majority of patients suffering from chronic renal failure. "Overloading" occurs not only when the contents of a container are increased, but also when the capacity of a container is decreased. Reduction of the compliance of the interstitial space would reduce its capacity to hold fluid without increase in pressure. Evidence is presented that the presence of the kidney affects interstitial space compliance; bilateral nephrectomy decreases interstitial space compliance four fold. Hypertension induced by renal artery partial constriction and removal of the other kidney is also associated with reduction of interstitial space compliance; a sudden rise in interstitial space compliance may be the primary factor in the course of events that leads to the rapid fall in blood pressure which occurs when the constriction is removed from the renal artery. It is suggested that the kidney secretes a hormone which increases interstitial space compliance and that this represents a physiological mechanism which enables animals to store water in the interstitial space without undue rise in interstitial tissue pressure. The role of this mechanism in hypertension and in chronic renal failure is discussed.

Animals↗

Digital radiography in space.

With the permanent habitation of the International Space Station, the planning of longer duration exploration missions, and the possibility of space tourism, it is likely that digital radiography will be needed in the future to support medical care in space. Ultrasound is currently the medical imaging modality of choice for spaceflight. Digital radiography in space is limited because of prohibitive launch costs (in the region of $20,000/kg) that severely restrict the volume, weight, and power requirements of medical care hardware. Technological increases in radiography, a predicted ten-fold decrease in future launch costs, and an increasing clinical need for definitive medical care in space will drive efforts to expand the ability to provide medical care in space including diagnostic imaging. Normal physiological responses to microgravity, in conjunction with the high-risk environment of spaceflight, increase the risk of injury and could imply an extended recovery period for common injuries. The advantages of gravity on Earth, such as the stabilization of patients undergoing radiography and the drainage of fluids, which provide radiographic contrast, are unavailable in space. This creates significant difficulties in patient immobilization and radiographic positioning. Gravity-dependent radiological signs, such as lipohemarthrosis in knee and shoulder trauma, air or fluid levels in pneumoperitoneum, pleural effusion, or bowel obstruction, and the apical pleural edge in pneumothorax become unavailable. Impaired healing processes such as delayed callus formation following fracture will have implications on imaging, and recovery time lines are unknown. The confined nature of spacecraft and the economic impossibility of launching lead-based personal protective equipment present significant challenges to crew radiation safety. A modified, free-floating radiographic C-arm device equipped with a digital detector and utilizing teleradiology support is proposed as a theoretical solution to help overcome many of these difficulties.

Humans↗

Biological effects of space radiation.

To determine the effects of space radiation on human health for long-term stays in space, we performed 21 space experiments on radiation biology. Two main characteristics of space are microgravity and space radiation that consists of low dose, chronic exposure at low dose-rates, and heavy particles. Through space experiments, we demonstrated the formation of DNA strand breaks, induced mutations, abnormal cell differentiation and the inducible gene expression of a tumor suppressor gene product, p53, in various kinds of organisms. In addition, we investigated the influence of microgravity on radiation-induced biological effects in in vitro biochemical reaction systems and in vivo cell culture systems of bacteria and lower eukaryotes. We review here the importance of radiation biology studies on space radiation from the viewpoints of human health and biological evolution, from the beginning of life until today, in the context of environmental genotoxic radiation.

Aerospace Medicine↗

Effects of space flight on endocrine system function in experimental animals.

The effects exposing rats to space flights of various lengths in a series of COSMOS satellites are reported based on an evaluation of plasma hormone levels and several enzyme activities in the tissues. The results after space flights are compared with those obtained from rats exposed to acute or repeated stress. Space flight induced selective morphological responses in the corticotrophs and gonadotrophs of the pituitary. Plasma levels of ACTH did not change, but plasma growth hormone and TSH levels decreased after longer space flights (>14 days), while prolactin in the plasma increased after short flights (5-7 days). Plasma corticosterone was higher after all flights. Catecholamine levels in plasma increased only after long space flights. These changes in plasma hormone levels affected the activities of enzymes involved in the amino acid metabolism of the liver and lipolysis in the adipose tissues. Norepinephrine level and catecholamine synthesizing enzyme activity in the hypothalamus did not change in flight rats. The norepinephrine content, however, decreased in several nuclei selected from the hypothalamus of flight rats. Increases in plasma insulin and glucose were noted in rats after space flight. Glucagone values in plasma remained unchanged. Comparing these results from flight rats against rats exposed to acute or repeated stress indicate that long stays in microgravity do not represent intensive stressogenic stimulus of the adrenocortical and sympathetic adrenomedullar systems, and hormone alterations observed after space flight may be due primarily to acute stressor activity resulting from a return to Earth's gravity (gravitational stress).

Adaptation, Physiological↗

[Development of medical monitoring and support in the practice of manned space flight].

The astronaut medical monitoring and support is an important part of space operational medicine. With the rapid development of the cause of China's manned space flight, the astronaut medical monitoring and support work has also made considerable progress since 1990s. Space operational medicine is responsible for the medical monitoring and support during astronaut selection and training as well as during the space flight. It's a severe challenge for mid-long term space flight to assure astronauts in sound body and mind and have good working capability. On the basis of the medical monitoring and support in short-term space flight, we should carry out the research of space operational medicine.

Aerospace Medicine↗

Crewmember communication in space: a survey of astronauts and cosmonauts.

A total of 54 astronauts and cosmonauts returned questionnaires which addressed various aspects of crewmember communication in space. All respondents believed that crewmembers should be fluent in one shared common language, but American and Soviet space travelers were less tolerant of dialect differences than their international counterparts. Sensory activities (Watching and Listening) were rated as significantly increasing in space, whereas more complex communicative activities (Reading, Gesturing, and Writing) were judged to significantly decrease. Cosmonauts scored higher than astronauts in all verbal and nonverbal activities, possibly reflecting more responsiveness to the space environment. Several factors were rated as significantly helping intracrew communication: Shared Experience, Excitement of Space Flight, Close Quarters, and Isolation from Earth. Other factors were judged to significantly hinder communication: Facial Swelling, Spacecraft Ambient Noise, and Space Sickness. These findings have important operational and scientific implications involving future manned space missions.

Communication↗

Clinical evaluation of simple fixed space maintainers bonded with flow composite resin.

The aim of this study was to evaluate the clinical performance of simple fixed space maintainers bonded by using a flow composite resin (Tetric Flow) to prevent space resulting from early extracted primary teeth. For that reason, 64 fixed space maintainers (34 in the lower jaw and 30 in the upper jaw) were applied to 45 patients. The patients followed up for 12 to 18 months. Survival rate, prevention ability of that space, and whether damage to the abutment teeth occurred were evaluated. Five percent of space maintainers were determined to be unsuccessful at the end of the control period. During this period, loss of space among the abutment teeth was found to be statistically insignificant (P > .05). Finally, it was observed that the use of simple fixed space maintainers was successful due to operator experience and the choosing of favorable patient groups.

Bisphenol A-Glycidyl Methacrylate↗

Ten years after medaka fish mated and laid eggs in space and further preparation for the life-cycle experiment on ISS.

In the second International Microgravity Laboratory (IML-2/STS-65) mission in 1994, medaka fish (Oryzias latipes) performed their successful mating behavior in space for the first time among vertebrate animals. The eggs the fish laid in space developed normally, and hatched as fry (baby fish) in space. Those fry born in space had the same number of germ cells as the ground control fish, and these germ cells later developed to produce the offspring on the ground. Fry hatched in space did not exhibit any looping behavior regardless of their strain, visual acuity, etc. For fish, one of the most exciting experiments to be done abroad the International Space Station (ISS) is a realization of fish life cycles in microgravity. At present, fish are the most likely candidates to be the first vertebrate to live their life cycle in space. Research done in our laboratory for realizing the life-cycle experiment of medaka fish are also introduced.

Animals↗

Stretched and upside-down maps of auditory space in the optic tectum of blind-reared owls; acoustic basis and behavioral correlates.

Vision during early life plays an important role in calibrating sound localization behavior. This study investigates the effects of visual deprivation on sound localization and on the neural representation of auditory space. Nine barn owls were raised with eyelids sutured closed; one owl was congenitally anophthalmic. Data from these birds were compared with data from owls raised with normal visual experience. Sound localization behavior was significantly less precise in blind-reared owls than in normal owls. The scatter of localization errors was particularly large in elevation, though it was abnormally large in both dimensions. However, there was no systematic bias to the localization errors measured over a range of source locations. This indicates that the representation of auditory space is degraded in some way for blind-reared owls, but on average is properly calibrated. The spatial tuning of auditory neurons in the optic tectum was studied in seven of the blind-reared owls to assess the effects of early visual deprivation on the neural representation of auditory space. In normal owls, units in the optic tectum are sharply tuned for sound source location and are organized systematically according to the locations of their receptive fields to form a map of auditory space. In blind-reared owls, the following auditory properties were abnormal: (1) auditory tuning for source elevation was abnormally broad, (2) the progression of the azimuths and elevations of auditory receptive fields across the tectum was erratic, and (3) in five of the seven owls, the auditory representation of elevation was systematically stretched, and in the two others large portions of the representation of elevation were flipped upside down. The following unit properties were apparently unaffected by blind rearing: (1) the sharpness of tuning for sound source azimuth, (2) the orientation of the auditory representation of azimuth, and (3) the mutual alignment of the auditory and visual receptive fields in the region of the tectum representing the area of space directly in front of the animal. The data demonstrate that the brain is capable of generating an auditory map of space without vision, but that the normal precision and topography of the map depend on visual experience. The space map results from the tuning of tectal units for interaural intensity differences (IIDs) and interaural time differences (ITDs; Olsen et al., 1989).(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗

Large Virchow-Robin spaces: MR-clinical correlation.

High-field MR scans frequently show Virchow-Robin spaces, which conform to the path of the penetrating arteries as they enter either the basal ganglia or the cortical gray matter over the high convexities. A retrospective review of 816 MR scans was undertaken to determine the clinical significance and associations (if any) of this finding. The Virchow-Robin spaces were graded, as were the nonspecific white-matter lesions. The presence of atrophy, infarction, hydrocephalus, and miscellaneous disease was noted. Large Virchow-Robin spaces were identified in 314 cases. A study sample was created consisting of a positive group containing all the larger grade 2 and 3 Virchow-Robin spaces (67 patients) and a negative or control group of 109 randomly selected patients from the original 502 who did not have large Virchow-Robin spaces. The charts of this study sample were reviewed and the following patient variables were noted: age, gender, incidental white-matter lesions, infarction, dementia, hypertension, and atrophy. For each variable, the proportion of patients who were positive for that variable was calculated for each of the two groups and compared across groups by using a Fisher exact test. Multiple logistic regression analysis was used to determine whether any of these variables were jointly associated with being "positive" or "negative" for large Virchow-Robin spaces. Some variables were strongly associated with being positive for large Virchow-Robin spaces: age, hypertension, dementia, and incidental white-matter lesions. Logistic regression analysis revealed that when all of these variables are considered jointly, only age remains significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗