Test Bank for Nuclear Medicine and PET CT 8th Edition by Waterstram Rich

Test Bank for Nuclear Medicine and

PET CT 8th Edition by Waterstram Rich
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 6. A source of 131
IÍ t 1 = 8.05 d ˙ is delivered to the nuclear medicine department calibrated for 100 mCi at 8:00 AM on Monday. If this
ÎÍ 2 ˚˙
radioactivity is injected into a patient at noon on Tuesday, what radioactivity will the patient receive?
a. 80 mCi
b. 85 mCi
c. 90 mCi
d. 95 mCi
ANS: C
Solving the differential equation yields the radioactive decay law: A = A 0e–λt where A = activity at time t, A0 = activity at starting
time, λ = decay constant, t = time since starting time. The decay constant λ is the fraction of atoms that decay per (small) time
interval, and has units of 1 over time (e.g., 1/hr) or inverse time (hr–1). The typical radioactive decay calculation required in nuclear
medicine specifies three of the four variables (A, A0, λ, t) in the decay equation, requiring that the fourth unknown variable be
solved for.

REF: p. 10

7. A patient was injected with 131I on Monday at 10:00 AM. On Tuesday at 10:00 AM, the thyroid probe was placed over the thyroid
and produced 100,000 counts. On Thursday at 10:00 AM, the probe showed 25,000 counts. What is the effective half-life in this
patient’s thyroid?
a. 12 hours
b. 24 hours
c. 48 hours
d. 72 hours
ANS: B
Typically the patient’s organ excretes the radiopharmaceutical with some biologic half-life t B while the radioactivity also decays
physically with a physical half-life that is denoted as tP. The counts observed by the gamma camera follow an exponential decay
1 = 1 1 or, in a format that is much easier for calculation purposes,
law based on the effective half-life tE, where: tp + t
tE B

t p × tB
tE = Ê . The effective half-life is always less than or equal to the smaller of t P or tB.
Á t p + t B ˆ˜
Ë ¯

REF: p. 15

8. A 99Mo-99mTc generator is eluted Monday at 7:00 AM, producing 1.8 Ci of 99mTc

in the eluate vial, in 20 ml saline. What volume of
eluate should be withdrawn from the eluate vial into a syringe in order to inject a patient with 20 mCi of 99mTc at 3:00 PM? (Given
the half-life of 99mTc is 6.02 hours.)
a. 0.56 ml
b. 0.66 ml
c. 0.76 ml
d. 0.86 ml
ANS: A
The radioactive decay law can be algebraically rearranged (dividing both sides of the decay equation by A 0) as:
ÈÍÍ ˘˙˙
-0.639 Í t t 1 ˙˙
ÍÍÎ 2 ˚˙
A A0 = e . After solving for the half-life, the concentration (radioactivity per volume) in the eluate vial is then

determined and the volume needed to be withdrawn into the syringe can be calculated from the equation activity = concentration ×
volume: A = C × V.

REF: p. 10

9. If the HVL for some radionuclide in lead is 0.30 mm, what thickness of lead shielding is necessary to reduce the radiation exposure
from 8 mR/hr to 1 mR/hr?
a. 0.30 mm
b. 0.45 mm
c. 0.60 mm
d. 0.90 mm
ANS: D
It is common to follow the method used in radioactive decay and define a half-value layer (HVL) as that thickness of material that
absorbs 50% of the photons. The HVL is the analog of t/2in radioactive decay. One HVL transmits 50% of the photons. The
equation of photon attenuation then can be expressed as: I = I0e–μx = I0e–0.693 × (x/HVL) and a relationship exists between μ and HVL,
given by μ = 0.693/HVL. Remember the units of x and HVL must be the same, and remember that this equation calculates the
transmitted intensity.

REF: p. 16

Copyright © 2017, Elsevier Inc. All Rights Reserved. 2

 10. The linear attenuation coefficient in lead for gamma rays (140 keV) is 23 cm–1. What percentage of these gamma rays will be
99mTc

absorbed by a lead apron that contains 0.60 mm of lead?

a. 75%
b. 50%
c. 25%
d. 12.5%
ANS: A
The intensity of the transmitted radiation is given by:
I = I0e–μx
where μ is the linear attenuation coefficient, or the fraction of the beam absorbed in some (very small) thickness x. The linear
attenuation coefficient μ is the analog of the decay constant λ in radioactive decay. The linear attenuation coefficient μ depends on
the type of absorbing material and the energy of the photons.

REF: p. 15

11. A new gamma camera/computer system that uses a new method of calculating cardiac ejection fraction (EF) is installed in a nuclear
medicine department. The department decides to calculate EF for the next 25 patients on both the old gamma camera and the new
gamma camera before discontinuing the use of the old camera. In the future, if it is desirable to convert the new EF value to that
which would have been obtained on the old gamma camera (e.g., to assess if the patient’s EF had changed), the mathematical
analysis to be used is called a(n)
a. independent t-test.
b. linear regression.
c. standard error.
d. chi-square.
ANS: B
The least squares method, or linear regression, calculates the best-fit values for y-intercept (a) and slope (b) in the best-fit straight
line: y = a + bx. The line of identity is often drawn on regression graphs when the same parameter, here the ejection fraction, is
being plotted on both the x and y axes. The line of identity facilitates an evaluation of whether the two methods (the x and y axes)
are predicting the same result for ejection fraction. If the two methods produce the same value for ejection fraction, then the
regression line should be the same as the line of identity.

REF: p. 20

12. What is the standard deviation of 40,000 counts?

a. 4000 counts
b. 2000 counts
c. 400 counts
d. 200 counts
ANS: D
Counting statistics, meaning the number of counts expected from a sample, follow the Poisson distribution. In the Poisson
distribution, the standard deviation (σC) for any number of counts (C) is fixed at the square root of C:
σc = C
This fixed definition of standard deviation does not exist in Gaussian distributions; essentially only counting statistics are Poisson.

REF: p. 24

13. What is the coefficient of variation of 40,000 counts?

a. 2%
b. 1%
c. 0.5%
d. 0.25%
ANS: C
The standard deviation can be expressed as a percentage of the mean value, which is frequently called the percent standard
deviation, or coefficient of variation (CV):
ÊÁ σ ˆ˜
Á ˜
CV = × 100
Á ˜

Ëx ¯
In this problem, the counts would be substituted for the mean in the equation.

REF: p. 25

Copyright © 2017, Elsevier Inc. All Rights Reserved. 3

 14. How many counts should be acquired into each pixel of a nuclear medicine flood image if it is desired to be 95% confident that the
true count in each pixel is within 1% of the measured counts in each pixel?
a. 100,000 counts
b. 40,000 counts
c. 10,000 counts
d. 4000 counts
ANS: B
Counting statistics, besides being Poisson, are also described by a Gaussian distribution as long as the number of counts is greater
than about 30. Hence, given some number of counts C, the standard deviation is automatically known. It is also known that 68% of
repeat measures of the sample fall within C ± C and 95% of repeat measures of the sample fall within C ± 2 C and so on (95%
confidence = C ± 2σc = C ± 2 C ).
Sometimes this type of problem is expressed by saying that a certain number of counts are needed to be 95% confident that the true
count is within 2% of the measured value. The presence of two different percentage values can seem confusing. The 95%
confidence interval on 10,000 counts is ±200 counts, and this figure of 200 counts represents 2% of 10,000 counts. The general
formula expressing the number of counts needed to be “nσ” sure that the true answer is within some percent (p) of the measured
counts is given by:
ÈÍ ˘˙ 2
Í ˙˙
Í
Í ˙

n ˙˙
C = ÍÍ Ê
ÍÍ ÁÁ P ˆ˜˜ ˙˙
ÍÎ ËÁ 100% ˜¯ ˙˙˙˚

In this formula, n is replaced with a 1 for 68% confidence, a 2 for 95% confidence, and a 3 for 99% confidence.

REF: p. 25

15. A patient’s thyroid is counted with the thyroid probe and produces 8000 counts. Then the patient is removed and background is
found to be 2000 counts. The (net counts) ± (standard deviation in the net counts) in this patient is
a. 10,000 ± 100 counts.
b. 10,000 ± 77 counts.
c. 6000 ± 77 counts.
d. 6000 ± 100 counts.
ANS: D
Background counts are a problem in most measurements of counts from a radioactive sample. Background arises from natural
terrestrial and cosmic sources of radioactivity or from other nearby sources of radioactive material. The sample is usually counted
in the presence of some background radiation, yielding a gross count for sample plus background, denoted by the letter C. The
sample is then removed from the counter, and the background B is counted. The net, or true counts, which represents the sample
only, is denoted by N and given by:
N=C–B
The standard deviation of the net counts is given by:
σ N = (C+B)

This is an example of the rules for combinations of errors, which states that for addition or subtraction, errors add in quadrature
within the square root:
σN = σ c +σ
2 2
B

Additionally, since
σC = C and σ B = B
we obtain

σN = (C+B)

REF: p. 26

16. The gamma camera seems to be producing erratic results. A 57Co flood source is counted 10 times, producing the following count
values: 1000, 975, 1032, 1096, 982, 997, 1012, 1090, 994, 977. What is the chi-square value for these counts?
a. 19.3
b. 18.3
c. 17.3
d. 16.3
ANS: C
Too little or too much variation in repeat measurements indicates equipment may not be functioning properly. The chi-square test
is used to determine an acceptable range of variability in the repeat measurements. The mean C of the 10 measurements is
determined (C = ΣC/n), and chi-square is calculated as:
ÈÍ
Í ÊÍ 2
˙˙
ÍÍÎ Ë C-C ˜ ˙˙˚
x2 = .
C

REF: p. 26

Copyright © 2017, Elsevier Inc. All Rights Reserved. 4

 17. Which expression describes the operation of the gamma camera in question 16?
a. Operating properly
b. Showing too much variation
c. Showing too little variation
d. Not enough information to answer the question
ANS: B
The definition of acceptable chi-square is given by looking up the probability (P) of this chi-square value for the n repeated
measures in a table. Too little variation is shown by a chi-square smaller than the P = 0.9 value; an amount of variation exactly as
expected from the statistical nature of the decay process would yield P = 0.50; and an unacceptably large chi-square would yield a
P value greater than 0.10. So, P = 0.90–0.10 range is acceptable.

REF: p. 26

18. One group of 20 patients is given a drug that is thought to have an effect on kidney function, and another group of 20 patients is
given a placebo (i.e., sugar pill, which is known not to have an effect on kidney function). The nuclear medicine gamma camera is
used to calculate the glomerular filtration rate (GFR) in these two groups of patients. What would be the proper statistical test to
use to test the hypothesis that no difference in GFR exists between these two groups of patients?
a. Chi-square test
b. Paired t-test
c. Independent t-test
d. Linear regression analysis
ANS: C
The t-test is used to test for differences between mean values. The two forms of the t-test are for independent samples and paired
samples. For independent t-tests, two independent groups of data are used. The two groups are completely independent. No
relationship or correlation exists between the two groups, typically because the groups represent different patients. Th e two groups
have mean and standard deviations denoted by x1 , SD1, x 2 , and SD2.
t = Á x 1 − x2 ˜ /
Ë ¯
ÏÔ Ê ˆ ÔÔ̧ 1 2
Ô 1 1 1 1
Ô
Ô Í ÊÁ n 1-1 ˆ˜ × SD 2 + ÊÁ n 2-1 × SD ˙ × Á n × n
˜Ô

Ô Ë Á ˜Ô
Í ˙˙˚
Ô ÍÎ Ë ¯ ¯ 2
Ë 1 2
¯Ô
Ì ˝
Ô n 1 + n 2 -2 Ô
Ô Ô
ÔÓ Ô˛

REF: p. 28

19. A nuclear medicine test produces a positive test result in only 80 of the 100 patients known to be ill. Similarly, the test produces a
negative test result in only 190 of the 200 patients known to be not ill. Which is correct?
a. Sensitivity = 80%, specificity = 95%, accuracy = 90%, prevalence = 33%
b. Sensitivity = 90%, specificity = 95%, accuracy = 90%, prevalence = 33%
c. Sensitivity = 90%, specificity = 80%, accuracy = 90%, prevalence = 33%
d. Sensitivity = 90%, specificity = 80%, accuracy = 70%, prevalence = 33%
ANS: A
The sensitivity, or true positive fraction (TPF), is the percentage or fraction of ill patients who have a positive test:
TP
Sensitivity = TPF =
(TP + FN)
The specificity, or true negative fraction (TNF), is the percentage or fraction of well patients who have a negative test:
ÊÁ TN ˆ˜
Sensitivity = TNF = ÁÁ ˜˜
Ë (TN + FP) ¯

The prevalence is the fraction or percentage of ill persons in the study population:
(TP + FN)
Prevalence = TPF =
(TP + FN+ TN + FP)

REF: p. 31

20. One radiologist is known to be a lax reader compared with another radiologist who is known to be a strict reader. In comparing
these radiologists, how would one expect their sensitivity and specificity to compare?
a. The lax reader would have lower sensitivity and higher specificity.
b. The lax reader would have higher sensitivity and lower specificity.
c. The readers would be expected to have the same sensitivity and specificity.
d. Not enough information is given to answer the question.
ANS: B
The sensitivity, or true positive fraction (TPF), is the percentage or fraction of ill patients who have a positive test:
TP
Sensitivity = TPF =
(TP + FN)
The specificity, or true negative fraction (TNF), is the percentage or fraction of well patients who have a negative test:
ÊÁ TN ˆ˜
Sensitivity = TNF = ÁÁ ˜˜
Ë (TN + FP) ¯

For an example, data that show a sensitivity of 78%, less than the specificity of 95%, mean that this test does a better job at
correctly diagnosing well people than it does at correctly diagnosing ill people. High sensitivity = correctly finding i ll people; high
specificity = correctly finding well people.

REF: p. 31
Copyright © 2017, Elsevier Inc. All Rights Reserved. 5
Another random document with
no related content on Scribd:
 Rakastuneet menivät sivuhuoneeseen, saadakseen olla kahden
kesken. Katri tuli puhumaan kihlauksesta ja häävalmistuksista. Minä
sanoin, että se oli liian varhaista, ja käskin hänen mennä suohon.
Hän ei kuitenkaan mennyt pitemmälle kuin keittiöön.

Mutta nyt alkoi seinän takaa kuulua naurua ja tukahtunutta

läiskinää. Raotin hiljaa ovea ja huomasin, että nuoret olivat ottaneet
itselleen vapauksia, jotka kuuluivat rakkauden myöhempään
kehityskauteen. Yllätin heidät äkkiä, otin ankaran muodon ja sanoin:

"Vai niin, te varastatte täällä suudelmia etukäteen!"

Rakastuneet karahtivat tulipunaisiksi ja katselivat hämillään toinen

lattiaan, toinen kattoon. Mutta minä jatkoin:

"Minä olin tuntenut nykyisen vaimoni viisi vuotta, eikä päähänikään

pälkähtänyt suudella häntä ennen kuin olimme julkikihloissa."

"Sinä hävytön valehtelija!" torui Katri, joka huomaamattani oli

hiipinyt selkäni taakse.

Nyt oli minun vuoroni punehtua.

"No, jos joskus otin pikku muiskun, tein sen siksi, että sinun teki
niin kovin mielesi."

"Ohoo, isäseni! Vai teki minun mieleni! Tämä menee liian pitkälle!"
soimasi Katri ja antoi nuorille rohkaisevia silmäniskuja aivan kuin
olisi sanonut: muiskailkaa te vaan, ei siitä huulet kulu!

Huomasin enemmät estelyt turhiksi sen jälkeen kun olin näin

häpeällisellä tavalla tullut paljastetuksi, ja jätin nuoret rauhaan.
 Jonkun viikon kuluttua vietettiin nuorten kihlajaisia. Setä Samuli
sai kutsun; hän olisikin muutoin loukkaantunut kauheasti.
Huomatessaan, että poika n:o 2 oli nähnyt päivänvalon, ei hänen
paheksumisellaan ollut mitään rajoja. Hän sanoi paljon muun hyvän
ohella:

"Niinhän se on kuin minä aina olen sanonut: minun

vaatimattomimpiakaan toivomuksiani ei oteta varteen. Ja kuitenkin
olen auttanut teitä yhdessä ja toisessa asiassa. Mutta
kiittämättömyys on maailman palkka!"

Emme voineet puolustaa itseämme. Ainoaksi lohdutukseksi

saatoimme huomauttaa sedälle, että parannus ei kenties vielä ollut
myöhäistä, mutta siihen hän ei tuntunut paljoa luottavan.

Tietysti piti Sirkan kihlajaisissaan laulaa. Sen hän tekikin ilolla, ja

minusta tuntui, ettei hän konsertissakaan ollut sellaisella hartaudella
laulanut.

Katri puuhasi kuin paras emäntä konsanaan. Kesken kaiken hän

kysyi:

"Mutta sanoppa, Sirkka, miten tavoitit niin äkkiä uuden sulhasesi?"

Tyttö nauroi.

"Jättäydyitkö sinä aikoinasi yhden varaan! Minä tunsin tämän

ennen kuin sen edellisen."

Minä huomautin, että nuoret tytöt valinnassaan usein erehtyvät:

jättävät hyvän ja ottavat huonomman. Sirkka sanoi:
 "Valitettavasti minäkin annoin turhamielisyyden johtaa itseäni
harhaan.
Suostuin siihen, jolla oli sileämpi ulkokuori ja liukkaammat sanat.
Onneksi tuli onnettomuus ja paljasti miehen todellisen olemuksen."

Katria alkoi naurattaa.

"Missä se entinen varatuomari nyt on? Hänen isänsä piti olla

valtioneuvos ja ties mitä kaikkea."

"Hän oli yhtä paljon tuomari kuin hänen isänsä valtioneuvos.

Rappiolle joutunut ylioppilas, joka oli laiskotellut yliopistossa muka
lakitiedettä lukien."

Minulla oli puheenvuoro.

"Hän uhkasi vetää minut oikeuteen tulevan vaimonsa omaisuuden

hukkaamisesta. Tähän päivään mennessä ei haastetta ole kuulunut."

Lopuksi en malta olla mainitsematta, että setä osoitti kihlatuille

suurta huomaavaisuutta. Melkein tuntui siltä kuin hän olisi alkanut
kohdistaa toivomuksensa sinnepäin, koska Katri ja minä olimme
pettäneet hänen luottamuksensa. Saattoi pitää päätettynä asiana,
että hän Sirkan hääpäivänä olisi paikalla reumatismineen ja
shekkikirjoineen.

Katri ja minä elimme Sirkan onnessa uudelleen ensi rakkautemme

ja kihlauksemme ihania kevätaikoja…
YHDEKSÄSTOISTA LUKU.

Madonna ja lapsi.

Taaskin oli pari onnellista vuotta vierinyt. Meillä oli sillävälin ollut
sanomalehdessä ilmoitus:

"SYNTYNYT.

Jumala lahjoitti meille terveen pojan.

Katri ja Kalle ———."

Se oli kolmas järjestyksessä. Voitte arvata, miten setä Samuli

irvisti, jos sattui tuon tiedonannon lukemaan, mikä on enemmän kuin
luultavaa, sillä hän tutki hyvin tarkkaan lehtien ilmoitusosaston.

Sirkkaa on jo vuoden sanottu tohtorinrouva Valtimoksi. Hän jatkaa

uutterasti lauluopintojaan ja esiintyy usein omissa konserteissa tai
avustajana monenlaisissa tilaisuuksissa. Tohtori Valtimo on etevä
amatööri, joka soittelee viulua ja säestää vaimoansa. Heidän
onnestaan ei puutu muuta kuin… Mutta kunhan aika tulee…
 Viisastuneena katkerista kokemuksistani epäilin ryhtyä
toistamiseen vakinaisen kodin perustamiseen, mutta kun sain tietää
eräästä luotettavien henkilöiden muodostamasta asunto-
osakeyhtiöstä, liityin siihen kuitenkin osakkaaksi. Enkä ole
kauppaani katunut. Tohtori Valtimokin on yhtiömiehenä ja lähimpänä
naapurinamme. Me muodostamme yhteisen suuren perheen, joten
meillä on joka päivä tilaisuus kuulla Sirkan laulua ja hänellä leikkiä
lastemme kanssa, joita hän niin paljon rakastaa.

Teimme juuri muuttoa uuteen taloon. Saimme vielä kerran ahertaa

oman kodin rakentamispuuhissa; se oli rasittava tehtävä, mutta
samalla rakas ja toivoa herättävä. Huonekalut olivat jo järjestetyt, ja
Katri asetteli uutimia paikoilleen. Minä autoin häntä pitäen kiinni
tuolia, jolla hän seisoi. Ikkunastamme oli laaja, ihana näköala yli
meren rannattoman ulapan. Aurinko meni lännessä mailleen, ja illan
varjot alkoivat laskeutua yli meluavan kaupungin.

Tuntui kuin olisi joulu tai juhannus ovella.

Saatuaan työnsä valmiiksi hypähti Katri alas ja horjahtui

putoamaan syliini. Laskin hänet hellästi maahan.

Istuuduimme sohvalle ja katselimme ääneti toisiamme. Poveamme

paisutti onni niin syvä ja täyteläinen, että mitkään sanat eivät kykene
sitä ilmaisemaan. Vihdoinkin, vihdoinkin olivat murheen mustat pilvet
poistuneet ja riemun päivä paistoi täydeltä terältään.

"Minusta tuntuu kuin olisi onnemme tullut aivan odottamatta",

puhkesi
Katri vihdoin puhumaan.
 "Odottamatta, niin, mutta ei aivan ansiotta. Olemmehan ostaneet
sen vuosien pettymyksillä ja raskailla kärsimyksillä."

Hämärtyvässä huoneessa näin kyyneleen päilyvän Katrin

silmänurkassa.

"Kun muistelen menneitä, raskaita aikoja, tuntuu minusta kuin

kaikki olisi pahaa unta tai kauhea painajainen."

"Samoin minustakin. Ja tuntuu lisäksi kuin ei meidän sopisi syyttää

ketään tai olla katkera kellekään. Kaikki on ollut meidän
hyväksemme. Sillä se, joka on kestänyt onnettomuuden, ymmärtää
oikein käyttää onneakin."

Katri nyökkäsi ääneti ja ymmärtävästi ja sanoi hiljaa:

"Oletko antanut anteeksi niille, jotka ovat olleet syyllisiä

kärsimyksiimme?"

Minä nyökkäsin vuorostani.

"Sillekin, joka istuu…"

Sen nimen paljas muisto riitti täyttämään minut kauhulla. Vastasin:

"Se kurja hylkiö oli tietämättään Sallimuksen kädessä välikappale,

jonka avulla uusi onnemme luotiin."

Me istuimme kauan. Sydämeni oli niin täysi, että oli vaikea olla
puhumatta.

"Miten olisi minun käynyt, ellet sinä olisi ollut minua tukemassa,
Katri! Sinua minun tulee kiittää kaikesta."
 Hän vastasi:

"Muistatko hetkeä, jolloin päätimme mennä naimisiin ja puhelimme

toimeentulostamme? Sinä arvelit, että alussa tulisimme paljaalla
rakkaudella toimeen."

"Ja sinä vakuutit, että rakkaus auttaa meitä vaikeuksissa. Nyt

huomaan, miten oikeassa sinä olit. Rakkaus se antoi meille voimaa
elämään silloin kun kaikki olivat meidät hyljänneet ja velkojat,
haastemiehet ja ulosottajat olivat ainoat, jotka meitä käynnillään
kunnioittivat."

Esikoisemme, joka jo käveli, vaikka mieluummin neljällä jalalla,

konttasi sisään ja alkoi kiskoa pöytäliinaa. "Katri kielsi, mutta
poikavekara ei ollut millänsäkään vaan raastoi kaikin voimin. Silloin
Katri torui:

"Jos ei Kullervo tottele, niin huijari tulee!"

Säikähtyneenä juoksi lapsi äitinsä luo, kätki päänsä helmaan ja

jokelsi;

"Tulekot huijati nyt?"

"Ei, jos Kullervo on kiltti, niin huijari ei tule."

"Miksi olet ruvennut peloittelemaan lasta huijarista puhumalla?

Näethän, miten se vapisee", sanoin minä.

Hän silitti hellästi lapsen päätä ja sanoi:

"Minusta on mieletöntä säikyttää lapsia möröillä ja pöröillä, joita ei

ole olemassa. Huijari sitävastoin on todellinen, ja on hyödyllistä jo
lapsena oppia tuntemaan, että se on kauhea olento, joka tekee
pahaa."

Sitte hän meni ja toi sylyksen puita ja latoi pesään. Olimme siksi
vanhanaikaisia, että pidimme runollista, räiskyvää takkavalkeata
kaikkia kehuttuja keskuslämmityslaitoksia parempana.

Pian leimusi pesässä iloinen tulennos. Aioin sytyttää lampun,

mutta Katri sanoi, että hämärässä istuminen oli rattoisaa, etenkin
kun me vietimme ensi iltaa kodissamme.

Nuorin lapsi heräsi. Hän otti pienokaisen syliinsä, siirsi tuolin takan
ääreen ja istui antaen loimottavan pystyvalkean lämmittää lasta.

Ilta oli pimennyt. Kadulla syttyi lyhty toisensa perästä. Meren pinta
välkehti iltaruskon sammuvassa hohteessa, ulapalla kynti laiva
aaltoja kymmenien tulien tuikkiessa.

Kun taas käännyin ja loin katseeni Katriin, joka istui lapsi sylissä
syrjittäin minuun, näin kuvan, joka monin verroin voitti edellisen.
Siinä oli jotakin niin tutunomaista, kodikasta, elettyä, että minä aivan
hätkähdin ja kysyin itseltäni, missä olin ennen nähnyt samanlaista.
Äkkiä, vaistomaisesti minulta pääsi huudahdus:

"Madonna!"

Katri katsoi minuun hymyillen:

"Joko sinä taas uneksit?"

"En, tämä on todellisuutta, ihanaa todellisuutta. Asetu niinkuin olit

äsken, niin olet ihan ilmetty… Kas niin! Nyt on arvoitus selvinnyt:
madonna olet sinä!"
 Katri nauroi:

"Sädekehää vain vailla, — pyhyyden loistetta."

"Rakkauden ja uskollisuuden sädekehä ympäröi päätäsi. Pitäkööt

pyhimykset ja enkelit kruununsa, minun silmissäni sinulla on loisto,
jota ei mikään maallinen eikä taivaallinen kirkkaus himmennä."

Huone oli pimennyt. Vain hiilivalkean himmenevä hehku levitti

salamyhkäistä kimmellystään. Minä tunsin sillä hetkellä sielussani
jotain niin korkeata, suurta, pyhää, että tuntuisi loukkaukselta yrittää
pukea sitä sanoihin.

Nyt kuulin liikuntaa seinän takaa. Sirkka oli palannut kaupungiltapa

käveli huoneessa, hyräillen ihanalla äänellään. Sitte hän avasi
pianiinon. Muutaman valmistavan akordin jälkeen hän alkoi laulaa —
laulaa madonnalaulua. Kuulimme selvään:

"On ilta, päivä mailleen käy,

mut ystävääni ei vain näy.
Oi etkö helly itkustain!
Madonna, kuule huutoain!"

Ihmeellinen liikutus valtasi minut.

"Katri, kuulehan! Noin kauniisti hän ei ole ikänä madonnasta

laulanut."

Katri nyökkäsi hiljaa. Taas soi laulu:

"Oot puhdas yli kaikkien,

mut minä kurja syntinen.
 Ah, jospa pyhyytes ma sain!
Madonna, kuule huutoain!"

Kuului muutama vihlova sointu, mikä kohta suli vienoon,

hyräilevään pianissimoon, jonka kaiku etääntyi, kuoli pois kuin
väsynyt laine rannan ruohikossa…

Hiilloskin oli riutunut. Sen viimeinen hohde kajasti Katrin kasvoille

ja siitä lapseen.

"Nyt tiedän varmaan, että madonna tuottaa onnea", sanoin minä.

Hän vastasi hymyillen:

"Ehkä on niin. Sen minä ainakin tiedän, että madonna on itse

onnellinen, sillä se rakastaa."

Ja hän puristi lasta rintoihinsa niinkuin Jumalan äiti kuvassa.

"Sinä olet oikeassa: madonna rakastaa, siksi se on onnellinen",

sanoin minä. "Rakkaus yksin tekee onnelliseksi!"
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