radiotriolein revisited: astudy ofthe 1311..triolein...

In 1949 Stanley and Thannhauser introduced radioiodinated olive oil to study fat absorption (1).Subsequently, a number of reports supported theuse of the radioiodinated triolein (RITO) absorption test in the detection of fat malabsorption (2â€”9).However, these radioactivity results were not correlated with simultaneous chemical fat balance studies.When such correlations were carefully done, it became apparent that the â€˜311-trioleinabsorption testresults were often misleading (10â€”16) . Whole-bloodor plasma radioactivity levels within the normal rangehave been reported in from 42 to 71 % of subjectswith steatorrhea (10,1 1,16) . Fecal radioactivity cxcretion has in general correlated better with fat batance studies, but this correlation is especially poorin subjects with only moderate steatorrhea (15,17).

In 1960 Lakshminarayana showed that commercia! 1@I-triolein was quite impure, with 46â€”80% ofthe 13h1label on nontriglyceride fractions such asmonoglycerides, diglycerides, and monohydric alcoho! esters (18) . Subsequently, Tuna (19) and laterKennedy (20) demonstrated that only 30â€”60% ofthe label was on triglycerides.

Tuna, et at also made radiochemically purified 1311triolein and showed that four subjects with chemicalsteatorrhea but with normal blood radioactivity levelsusing commercial 1311-triolein had clearly abnormalblood radioactivity levels using purified radiotriolein(1 9) . These results suggested that the impuritiespresent in 1311-triolein might be responsible for theinaccuracy of this absorption test. To date, however,no further study of radiochemically pure 1311-trioleinin man has been reported.

The purpose of this study was to evaluate thetriolein absorption test with radiochemically purified131I-triolein (PRITO) simultaneously with chemicalfat balance studies in normal subjects and in patientswith steatorrhea.

METHODS

Commercial l:@IItriolein, 3_5 mCi/mi, was obtamed from Abbott Laboratories and was stored inredistilled hexane under nitrogen at 4Â°C. Aliquotswere spotted on thin-layered silicic acid plates* anddeveloped with 90/ 12/ 1 (vol/vol) hexane/diethylether/acetic acid. Lipid fractions were then identifiedby iodine vapor or H2SO.I charring and comparedwith neutral lipid standard mixturest. Autoradiographs were made by exposure of the plate to standard x-ray film. The distribution of radioactivity oneach chromatographic strip was quantitated bycounting the areas identified by the autoradiographin a sodium iodide scintillation crystal.

To obtain radiochemically pure radiotriolein(PRITO), aliquots of the hexane-'311-triolein solution containing approximately 400 mg trioleinand up to 1 mCi radioiodine were reduced undernitrogen to volumes of 3â€”5ml and applied to a50-gm silicic acids column. The triglyceride fraction was eluted with 5 % diethyl ether in redistilledhexane (21 ) with a flow rate of approximately 3mi/mm. Collection of appropriate radiolabeled fractions was monitored by a collimated detector at the

effluent end of the column. The collected fractionswere evaporated to dryness under nitrogen, dissolvedin 10 ml of redistilled hexane, and rechromatographed to check for radiochemical purity. Subsequently each flask was stored under nitrogen at 4Â°C,and radiochemical purity was determined weekly.

Received Aug. 11, 1971; original accepted Nov. 8, 1971.For reprints contact: Wil B. Neip, Div. of Nuclear Mcdi

cine, University of Washington School of Medicine, Seattle,Wash. 98105.

C Brinkmann precoated chromatoplates, Brinkmann In

struments Inc., Westbury, N.Y.t TLC Standard Mix 1, Hormel Institute, Austin, Minn.

@ 100-mesh, Mallinckrodt Chemical Works, St. Louis, Mo.

252 JOURNAL OF NUCLEAR MEDICINE

RADIOTRIOLEIN REVISITED: A STUDY OF THE

1311..TRIOLEIN ABSORPTION TEST USING

RADIOCHEMICALLY PURE TRIOLEIN IN MAN

Gary E. Leinbach, David R. Saunders, and WiI B. NeIp

University of Washington School of Medicine, Seattle, Washington

by on January 11, 2020. For personal use only. jnm.snmjournals.org Downloaded from

http://jnm.snmjournals.org/

patient to insure 72-hr collections. If the first stoolon the morning of the test occurred after ingestion ofthe isotope, this stool was collected separately,checked for radioactivity, and the 72-hr collectionwas then begun. In several cases, bowel evacuationwas not possible at the termination of the 72-hrperiod, and diet and stool collections were continuedfor another day.

The stool cans were weighed; ethanol and waterwere added to a total dilution of 2,000 or 3,000 cc

(26) , homogenized on a paint can shaker, andcounted and compared to 131! standards dilutedwith water to similar geometry. Fecal radioactivitywas expressed as the percent administered dose per72-hr stool. After counting, chemical fat determinations were performed on weighed aliquots of thesesame 72-hr collections by the Jover and Gordonmodification (26) of the method of van de Kamer(27) . All determinations were done in duplicate bythe same two research technicians. More than 92%of measured amounts of triglyceride (Mazola oil)added to several control 3-day fecal collections wererecovered by this method. Stool fat was expressedas grams fat â€œexcretedâ€•per day and as the coefficientof fat absorption:

Coefficient of fat absorption ( %)

â€” gm fat ingestedâ€” gm fat â€œexcretedâ€•

â€” gm fat ingested X -

RESULTS

Purified 1311-triolein. Staining of the developed

chromato-plates containing the commercial 1311_triolein compared to a standard lipid mixtureshowed that the principal lipid present in the Abbottpreparation was triglyceride (Fig. 1) with a faintspot of free fatty acid and several unknown spotscloser to the origin. Autoradiography disclosed thepresence of numerous radiochemical impurities.The principal radioactive spot coincided with thetail of the chemical triglyceride and was shownto be a triglyceride by elution from a silicic acidchromato-plate and determination of the fattyacid/glycerol molar ratio after alkaline hydrolysis.Two radioactive spots were always seen immediatelyafter this principal radioactive triglyceride spot andwere thought to be the result of different degrees ofiodination of the double bonds present in the oleicacid side chains (20) . Of all the batches of cornmercial RITO, from 50 to 82% of the total radioactivity applied to the chromato-plate was found inthis principal radioactive spot, from 18 to 39 % inthe two immediately following spots, and from 7 to27 % in the several spots closer to the origin (Fig. 1).No significant radioactivity remained at the origin.

Forty-four subjects were studied, 42 while on an80-gm fat diet for 5 days, and two while on an100-gm fat diet. Three to five drops of Lugol'ssolution were administered daily. On the morningof the third day, following an overnight fast, eachsubject ingested the purified 1311-triolein in a liquidtest meal (22â€”24). To make this meal, 70 gm ofskimmed milk powder, 39 gm of dextrose, 1 gm ofvanilla, and 2 10 cc of water were initially blendedin a Waring blender. An aliquot of hexane containing15â€”25@@Ciof PRITO was evaporatedunder nitrogenin a flask, and 30 gm of fresh corn oil (Mazola) wereadded to this flask. After mixing, this radioactivelipid-oil mixture was added to the blender, and thecontents were blended at low speed for 1 mm. Thetest meal thus contained 75 gm of carbohydrate, 25gm of protein, 30 gm of fat, and 15â€”25 @CiPRITOin a total volume of 325 cc. Meal radioactivity wascounted in a plastic container and then ingested bythe patient over a 5â€”10-mm period. Immediatelyafterwards, the residue was washed from the sidesof the cup with 60 cc of water and was also drunkby the patient. Following completion of ingestion,325 cc of water were added to the plastic cup andthe radioactivity present was compared with theinitial count. In all cases more than 98% of theinitial radioactivity in the cup was ingested by thepatient.

Beginning 2 hr after ingestion, whole-blood sampies were obtained hourly. Aliquots of these sampleswere counted immediately after each venepuncture,and blood collection was continued until the increasing blood radioactivity concentration leveled off oractually felt on two successive hourly determinations.Blood was thus collected for at least 6 hr in all subjects and in some for 7 hr. From each sample, 2 mlof whole blood and plasma were removed andcounted in a sodium iodide well counter and cornpared to a 1311standard. In addition, lipids wereextracted from 2-ml plasma (25) , redissolved inhexane, and counted similarly. Results were cxpressed as the percent administered dose per literwhole blood or plasma and as the percent administered dose which was lipid soluble per liter of plasma.The maximal (peak) concentration of radioactivityobtained was then used for correlation with chemical fecal fat results.

Urine was collected for the first 24 hr after isotopeingestion and compared to an @Istandard. Resuits were expressed as the percent of the administered dose excreted per 24-hr urine.

Following completion of the blood sampling, thepatient resumed his 80-gm fat diet, and 72-hr stoolswere carefully collected free of urine in weighedgallon paint cans. A stool diary was kept on each

Volume 13, Number 4 253



LEINBACH, SAUNDERS, AND NELP

groups on the basis of their chemical fat balancestudies (Table 1). Group I included 15 normalvolunteers (12 males, three females, ages 22â€”35)with no history of intestinal disease and normalchemical fat absorption. Group II included ten subjects with previously documented gastrointestinaldisease but who had normal chemical fat absorptionwhen we studied them. Group III consisted of 19patients with chemical fat malabsorption ( I 3 males,six females) of various etiologies (Table 1).

The carbohydrate-rich test meal was well tolerated by the majority of the subjects studied. Onepatient with a vagotomy and pyloroplasty had symptoms of dumping. A patient with cirrhosis, who had

been slightly nauseated prior to the study, vomited1 hr after ingestion of the test meal, but the radioactive emesis was counted and the study was cornpleted. Two other subjects (one from Group I andone from Group II) complained of transient postprandial epigastric discomfort.

The individual results of this study are given inTable 1. The coefficient of fat absorption in theGroup I subjects ranged from 94.2 to 98.7% witha mean of 97.6% . Peak whole-blood radioactivitylevels in this normal group are shown in Fig. 2. Meanpeak whole-blood radioactivity was 2.8% of theadministered dose per liter whole blood, and the2-standard deviation lower limit was 1.9 % dose!liter. Three-day fecal radioactivity measurements inthis group ranged from 5.1 to 0.4% of the administered dose (Fig. 3) , indicating an absorption of from94.9 to 99.6% of the radioactive label. Since fecalradioactivity levels were not normally distributed*,calculation of the standard deviations were of novalue, and the â€œlowerlimit of normalâ€• absorptionof radioactive label was 94.9 % of the administereddose.

The coefficient of fat absorption in the 19 abnorma! subjects (Group III) ranged from 27 to 90%(Table 1) . Peak whole-blood radioactivity levels oftwo subjects ( 11% ) in this group fell within normallimits (Fig. 2). One (4% ) of these abnormal subjects absorbed 98.9 % of the radioacitve label, butall others absorbed less than 93 % (Fig. 3).

The coefficient of fat absorption in the ten subjects in Group II ranged from 93.5 to 97.3%(Table 1) . The peak whole-blood level in one (10%)of these ten subjects was clearly below the normalrange (Fig. 2), but his absorption of radioactivelabel by fecal determination was normal. Three(30% ) of the ten had excessive fecal radioactivity,absorbing less than 92% of the radioactive label

* Rankit Test. Bliss CI: Statistics in Bio!ogy. vol I, New

York, McGraw-Hill, 1967

. 18-39

.I

7-27

Charred Auto.. SChromatogram radi 0 9 ra ph Rod ioocti v ity

F1G. 1. Comparisonof charredchromatogramwithautoradiograph of commercial triolein. Developed chromato-plate drawn onleft shows spots of triglyceride, fatty acid, and several unidentifiedspots closer to origin. Numerous radiochemical impurities may beseen on autoradiograph on right with principal radioactive spotcoinciding with tail of chemical triglyceride spot. Percentages listedat far right represent ranges of percentages of total radioactivityapplied to plates which were found in three areas indicated. Onlymaterial from principal radioactive spot (shown chemically to bea triglyceride) was used in study.

After column purification only fractions with morethan 98 % of their radioactivity in this principalradioactive spot were used subsequently for patientstudies because of the lack of absolute certainty ofthe nature of the other labeled spots.

Storage of the purified radiotriolein for up to 4weeks showed no significant radiochemical change.

Absorption of purified 1511-triolein. The 44 subjects studied were separated into three different


50-82



RadioactivityPeakPeak24-hrPeak

WBfplasmalipidurinePatient%label(% dose/(% dose/(% dose/(%dose/No.

DiagnosisCFA' absorbedliter)liter)liter)liter)

131I-T1u0LEIN ABSORPTION TEST

(Fig. 3 and Table 1) . In each of these three cases,however, whole-blood radioactivity levels were withinthe normal range.

Results obtained using the combination of peakwhole-blood and total fecal radioactivity are givenin Fig. 4. When both blood and fecal radioactivitylevels were normal, steatorrhea was never seen. Whenboth of these parameters were abnormal, steatorrhea

was always present. When one or the other of theseparameters were abnormal, the patient either hadsteatorrhea or a gastrointestinal disease in remissionat the time of this study.

To determine whether the number of blood specimens taken could be reduced, whole-blood radioactivity concentrations at the fifth and at the sixthhours were evaluated separately. Using the 6-hr

TABLE1. SUMMARYOF CHEMICALAND RADIOACTIVERESULTSOF 44 SUBJECTSSTUDIEDWITH PURIFIEDRADIOTRIOLEIN

Group I: Normal Volunteers

23456789

101112131415

Group II: Disease in Remission16 Pancreatitis17 Celiac sprue18 Celiac sprue19 Celiac sprue20 Celiac sprue21 Celiac sprue22 â€¢Celiac sprue23 Celiac sprue24 Celiac sprue25 Short bowel

Group Ill: Steatorrhea26 Pancreatic insufficiency27 Collagenous sprue28 Cirrhosis29 Pancreatic insufficiency30 Celiac sprue31 Short bowel32 Celiac sprue33 Blindloop34 Non tropical sprue35 Celiac sprue36 Pancreatic insufficiency37 Giardiasis & hypogamma

globulinemia38 Pancreaticinsufficiency39 Dermatitis herpetiformis40 lleo-colonic shunt41 Pancreatic insufficiency42 Non tropical sprue43 Pancreatic insufficiency44 Pancreatic insufficiency

t Wholeblood.

97.998595.697.894.298.497.898.097.197.998.297.998.698397.6

97.395.096.696.396393.596395.395.494.7

2739859080425781905686

8882734054896748

97.399.194.998.599.698.498.699.498.899.598.998.999.697.997.0

97397.198.296.198.679.996.991.396.1913

620

247691.8115253337692.7

85.598.989.214.358.280.48547

3j 5j 3.4 â€”

2.9 4.1 1.5 â€”2.9 4.2 2.2 â€”3.3 5.4 2.9 â€”2.4 3.4 1.1 â€”2.4 3.2 1.0 â€”2.3 3.0 0.7 552.6 5.5 1.4 553.6 4.7 1.4 612.7 3.5 1.1 â€”3.2 4.0 0.9 592.1 2.7 0.5 682.6 3.6 1.1 632.7 3.8 1.6 6623 3.0 1.2 44

4.1 7.42.1 2.93.1 4.32.8 3.81.0 1.22.9 3.62.8 3.82.1 3.22.3 2.82.2 2.9

0.5 0.60.1 0.10.6 0.81.6 2.40.5 030.2 0.20.2 0.22.1 3.20.5 0.70.9 1.01.6 2.4

1.5 1.71.1 1.61.3 1.50.1 0.21.4 1.92.2 2.91.4 1.81.4 1.9

330.82.01.4

1.51.82.01.11.3

0.30.10.31.10.20.20.11.60.50.61.0

0.6 560.6 240.4 48â€” 2

0.9 331.0 530.6 341.1 23

71

5548622843

26

163554

* Coefficient of fat absorption % of daily fat intake absorbed.

255Volume 13, Number 4




radioactivity values alone gave essentially the sameresults as with the overall peak values, except thatone (7 % ) of the 15 normal subjects in Group Iwould have fallen below the normal range. Usingthe single 5-hr radioactivity values alone, considerable overlap was seen between these three groups.

Results obtained using peak plasma radioactivitylevels were similar to those using peak whole-bloodradioactivity levels. Plasma always contained thehighest concentration of radioactivity. The percentof total plasma activity which was lipid soluble wasextremely variable, ranging from 8 to 100% (mean40% ) . There were no significant differences in thepercent of plasma activity which was lipid boundbetween these three groups.

Peak lipid radioactivity levels and 24-hr urinaryradioactivity determinations were of no value inseparating Groups I and III because of the markedoverlap between these two groups (Table 1).

DISCUSSION

There are at least three major problems inherentin the radioiodinated triolein absorption test. First,variable gastric emptying may result in equally vanable blood radioactivity levels (2).

Second, the process of iodinization of triolein mayproduce an abnormal fat molecule, the extent ofthe abnormality depending on how many of the threedouble bonds are labeled. Such a chemically abnorma! triglyceride might behave abnormally during anyor all of the phases of the digestive process. lodinated2-mono-o!eate or oleic acid might be less solublein the micellar phase than the ordinary â€œparentâ€•compounds. Further, iodinated fatty acids and mono

5

I

q)

.

.

.

.

...

S

0â€¢

20

40

60

80

100@Group I

Normals

Groupfl Group]fl

Remission Steatorrhea

FIG. 3. Percentof total1:311labelabsorbedas determinedby72-hr fecal radioactivity measurements after ingestion of radiochemically purified radiotriolein. Shaded area indicates normalrange for fecal radioactivity as determined in our 15 normal volunteers.

glycerides might cross the intestinal mucous membrane less well. Three of our ten subjects with intestinal disease (Group II) but with normal chemicalfat absorption on an 80-gm fat diet absorbed lessradioactive label than normal. Perhaps any abnormalbehavior of iodinated tniolein might be magnified inthe setting of minor abnormalities of the !uminaland/or mucosal phases of fat absorption.

Third, it has been clearly shown that unpurifiedRITO (1,28â€”30) is de-iodinated following oral ingestion. In our own study the mean maximum 1311lipid radioactivity averaged 40% of the total 1311plasma activity. Just where this de-iodinization occurs is less clear but possibly within the wall of thesmall intestine (31).

Despite the fact that radioiodinated tniolein haschemical differences from natural fat, no attempts

.. have been made to study the purified material in aclinical setting.

The radioactivity results in these 44 subjects correlate with chemical fat balance determinations betten than do radioactivity results previously reportedwith unpurified triolein. Using peak blood radioactivity levels alone, falsely normal results were seenin 11% of the patients with steatorrhea. Using fecalradioactivity levels alone, only 4 % of patients withsteatorrhea had a falsely normal result. On the otherhand, 30% of the ten subjects with gastrointestinaldisease in remission without steatorrhea had exces

$$

1%

.

.$

4.

:â€¢4.

Steatorrheo0

Normal Diseaseremission

FIG. 2. Peakwhole-bloodradioactivitylevelsin 44 sublectsstudied. Mean peak whole-blood radioactivity in 15 normal subjectswas 28% dose/liter whole blood, and 2-standard deviation lowerlimit 1.9 dose/liter.




â€œâ€”@15@â€”00015613010012@4

@16@?irA1921251644

131I..TMOLEIN ABSORPTION TEST

sive fecal radioactivity. When peak whole-blood radioactivity levels were used together with fecal

radioactivity determinations of label absorption, amore clear-cut separation of subjects with and without steatorrhea was possible. When both. blood andfecal radioactivity levels were normal, steatorrheawas never present. When both these parameters were

abnormal, steatorrhea was always present. Threesubjects ( 16 % ) with steatorrhea had only one orthe other parameter abnormal, however, and suchfindings would therefore necessitate a chemical fatbalance. Since 40% of the ten Group II subjects alsohad one or the other of these two parameters abnormal, such findings in the absence of steatorrhea onan 80-gm fat diet may warrant either (A) repeatchemical fat balance with an intake of 100â€”120 gmfat per day, or (B) a search for intestinal disease inremission. This is especially true if it is the fecalradioactivity parameter which is abnormal.

It would appear then that radiochemical purification of 131I-triolein definitely improves the accuracyof this test of fat absorption. Optimally for the routine hospital isotope laboratory, this radiochemicalpurification should be carried out by the commercialmanufacturer. Given the availability of purified radioiodinated tniolein, however, there are still significant objections to the use of this material as a screenlug test for steatorrhea:

1. The amount of radioactive label absorbed didnot correlate well with chemical fat absorptionin the 19 subjects with steatorrhea (correlationcoefficient = 0.54, Fig. 5 ) . Wide fluctuationsin short-term chemical fat balance results maybe seen where the coefficient of fat absorptionis low ( < 80% ) (32), but in the present study

NBÂ° ABC NB ABNFb NF AFd AF Total

FECAL FAT AND FECAL RADIOACTIVITY

0@

b 20qs

i@ .@ 40

.@

.@ .

@6O .

.@

.@ .

@80 .cI:@

@ [email protected]@J,.J I I I I I

100 80 60 40 20 0

Coefficient of fat absorption

FIG. 5. Correlationof chemicalfat absorptionandabsorptionof purified radiolabel in 19 subjects with steatorrhea.

the correlation was poor even at coefficientsof absorption between 80â€”90%. Thus fecalradioactivity determinations cannot be usedto quantitatively assess fat malabsorption.

2. One should use both blood and fecal radioactivity determinations for optimal use ofPRITO as a test for steatorrhea. Even thoughblood collection can be simplified by drawinga single 6-hr specimen, the unpleasant 3-daycollection of feces cannot be obviated sinceuse of blood specimens alone did not providesuitable accuracy.

SUMMARY

Results of the 131I-tnioleinabsorption test correlatepoorly with chemical fecal fat balances. It has beenshown that numerous radiochemical impurities arepresent in radioiodinated tniolein. To test the hypothesis that these impurities are responsible forthis poor correlation, commercial radioiodinatedtriolein was purified to greater than 98 % radiochemical purity and fed to 44 subjects during 3-day chem

ical fat-balance studies. These subjects included 15normal volunteers (Group I) , ten subjects with intestinal disease but without chemical fat malabsorption (Group II) , and 19 subjects with steatorrheaof various etiologies (Group III) . Whole-blood,plasma, plasma lipid, urine, and fecal radioactivitieswere measured after ingestion of the labeled testmeal. Results obtained with radiochemically purified131I-tniolein (PRITO) were better than previouslyreported results using unpurified radioiodinated

Groupl

Normals

GroupflRemission

GroupIllSteatorrhea

Total

FIG. 4. Useof combinationof wholebloodandfecalradioactivity levels in diagnosis of steatorrhea. a normal peak bloodradioactivity levels; b normal total fecal radioactivity (i.e., absorption of label); c abnormal peak blood radioactivity (belownormal range); and d abnormal total fecal radioactivity.

257Volume 13, Number 4




tniolein (RITO) . Blood radioactivity levels withinthe normal range were seen in 11% of patients withsteatorrhea, but normal fecal radioactivity levelswere found in only 4% of this same group. The 15normal volunteers had both normal peak levels ofwhole blood radioactivity and normal fecal radioactivity. Sixteen of the 19 subjects with malabsorption had both excessive fecal radioactivity and lowlevels of whole blood radioactivity. Thus when bothparameters were normal, chemical fat absorptionwas normal; when both parameters were abnormal,steatorrhea was present. The remaining three subjects in Group III and four subjects in Group II hadone or the other of these two parameters abnormal.Whole-blood and plasma radioactivity determinations gave identical results; plasma lipid and urinaryradioactivity levels were of no value because of thewide overlap between groups. There was no correlation between the amount of 131J and the amountof chemical fat excreted in the stool. It is concludedthat the radiochemical purification of radioiodinatedtriolein improves the accuracy of this absorption testof fat malabsorption. However, the inability to quantitate fat malabsorption and the need for a 3-daycollection of stool limit the usefulness of this absorption test in screening patients for suspected steatorrhea.

ACKNOWLEDGMENTS

This investigation was supported by a grant from AbbottLaboratories, North Chicago, Ill. 0. E. Leinbach was supported by Gastroenterology Training Grant ST1 A, 5099and Research Training Unit Grant AM 1000 from theNational Institutes of Health, United States Public HealthService. D. R. Saunders is the recipient of a ResearchCareer Development Award (5 K04 AM3S 150-04).

A portion of this work was conducted in the Clinical Research Center at the University of Washington, which issupported by National Institutes of Health Grant FR-37 andin the Clinical Research Center of the Harborview MedicalCenter, which is supported by a grant (RR-l33) from theGeneral Clinical Research Centers Program of the Divisionof Research Resources, National Institutes of Health.

Mrs. Linda Danielson and Miss Robin Baxter providedtechnical assistance.

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â€˜31IT@JOLEINABSORPTION TEST

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28. BERES P, WENGER J, KIRSNER JB: The use of 19@triolein in the study of absorptive disorders in man. Gastroentero/ogy32: 1â€”16,1957

29. TURNER DA: The absorption, transport and deposition of fat. Amer J Dig Dis NS3 : 594â€”642,1958

30. BEaxowrrz D, SKLAROFF D, WoLDow A, et al:Blood absorptive patterns of isotopically labeled fat andfatty acid. Ann mt Med 50: 247â€”256,1959

31. SIE HO, VALKEMA Al, LOOMEIJER FJ: Re-evaluationof radio-iodinated triolein as a test fat in fat absorptionstudies. I Lab C/in Med 70: 121â€”128,1967

32. WEIJERS HA, DRION EF, VAN DE KAMER JH : Analysis and interpretation of the fat-absorption coefficient. ActaPaediat49:615â€”625,1960

July 11â€”14,1972 Sheraton-Boston Hotel Boston, Massachusetts

Clinical DiagnosisClinical InvestigationRadiation Biology

RadiopharmaceuticalsRadioisotope TherapyNuclear Instrumentation

1. Purpose of the study2. Methods used3. Resultswith pertinentsupportingdata4. Conclusions.

Send the official abstract form and the five copies to:

DEADLINE: May 19,1972

C. DouglasMaynard,MD.Chairman, Scientific Program CommitteeDepartment of RadiologyThe Bowman Gray School of MedicineWinston-Salem, North Carolina 27103

Volume 13, Number 4 259

THE SOCIETY OF NUCLEAR MEDICINE

19th ANNUAL MEETING

ANNOUNCEMENTAND CALL FOR WORKSIN PROGRESS

ABSTRACTS FOR SCIENTIFIC PROGRAM

The ScientificProgramCommitteewelcomesthe submissionof abstractsof original contributionsin nuclear medicine from members and nonmembers of the Society of Nuclear Medicine. Papers will be con

sidered on the following subjects:

Basic Science Aspects of Nuclear Medicine

Papers will be selected for brief presentation at Works in Progress Sessions. All Works in Progressabstracts must be postmarked no later than May 19, 1972.

GUIDELINESFOR SUBMITTINGABSTRACTS:Absfracts must be submitted in the following format to receive consideration. Abstracts are to be typed

on the official abstract form which can be obtained from the Society of Nuclear Medicine, 211 East 43rdStreet, New York, New York, 10017. An original and five (5) copies must be submitted.

Each abstract must contain the name(s) of the author(s), the institution(s), and the mailing address ofthe author presenting the paper. Underline the name of the author who will present the paper. Two gummedlabels with the addressof the presentingauthor mustbe included.

Each abstract must contain the following information in this order:



1972;13:252-259.J Nucl Med. Gary E. Leinbach, David R. Saunders and Wil B. Nelp Radiochemically Pure Triolein in Man

I-Triolein Absorption Test Using131Radiotriolein Revisited: A Study of the

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radiotriolein revisited: astudy ofthe 1311..triolein...

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