WorldWideScience

Sample records for preoperative radiologic evaluation

  1. Preoperative radiological approach for hilar lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ohno, Yoshiharu; Higashino, Takanori; Watanabe, Hirokazu; Yoshimura, Masahiro; Sugimura, Kazuro [Kobe Univ. (Japan). Graduate School of Medicine; Takenaka, Daisuke [Kobe Ekisaikai Hospital (Japan)

    2003-05-01

    Recent advances in CT, MR, and nuclear medicine have made it possible to evaluate morphological and functional information in hilar lung cancer patients more accurately and quantitatively. In this review, we describe recent advances in the radiological approach to hilar lung cancer, focusing on mediastinal invasion, lymph node metastasis, and pulmonary functional imaging. We believe that further basic studies as well as clinical applications of newer MR techniques will play an important role in the management of patients with lung cancer. (author)

  2. Preoperative Evaluation for Noncardiac Surgery.

    Science.gov (United States)

    Cohn, Steven L

    2016-12-06

    This issue provides a clinical overview of preoperative evaluation for noncardiac surgery, focusing on risk factors, elements of evaluation, medication management, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  3. The value of preoperative ultrasound guided fine-needle aspiration cytology of radiologically suspicious axillary lymph nodes in breast cancer

    Directory of Open Access Journals (Sweden)

    Torill Sauer

    2014-01-01

    Full Text Available Background: Preoperative ultrasound (US and eventually US-guided fine-needle aspiration cytology (FNAC of suspicious axillary lymph nodes (ALN is a standard procedure in the work-up of suspicious breast lesions. Preoperative US FNAC may prevent sentinel node biopsy (SNB procedure in 24-30% of patients with early stage breast carcinoma. The aim of this study was to evaluate the institutional results of this preoperative diagnostic procedure. Materials and Methods: A total of 182 cases of preoperative FNAC of suspicious ALN where retrieved from the pathology files. The results were compared with the final histology and staging. False negative (FN FNAC cases were reviewed and possibly missed metastatic cases (2 were immunostained with the epithelial marker AE1/AE3. Results: There were no false positives, whereas 16 cases were FN. In all but one case the FN′s represented sampling error. Half of the 16 FN cases in this series were macrometastases. Discussion: About 83% of the preoperatively aspirated cases were N+, indicating that a radiologically suspicious ALN has a very high risk of being metastatic. Preoperative US guided FNAC from radiologically suspicious ALN is highly efficient in detecting metastases. Depending on national guidelines, a preoperative, positive ALN FNAC might help to stratify the patients as to SNB and/or ALN dissection.

  4. Preoperative evaluation of oesophageal adenocarcinoma.

    Science.gov (United States)

    Khanna, Lauren G; Gress, Frank G

    2015-02-01

    The preoperative evaluation of oesophageal adenocarcinoma involves endoscopic ultrasound (EUS), computed tomography (CT), and positron emission tomography (PET). With routine Barrett's oesophagus surveillance, superficial cancers are often identified. EUS, CT and PET have a limited role in the staging of superficial tumours. Standard EUS has limited accuracy, but high frequency ultrasound miniprobes are valuable for assessing tumour stage in superficial tumours. However, the best method for determining depth of invasion, and thereby stage of disease, is endoscopic mucosal resection. In contrast, in advanced oesophageal cancers, a multi-modality approach is crucial. Accurate tumour staging is very important since the treatment of advanced cancers involves a combination of chemotherapy, radiation, and surgery. EUS is very useful for staging of the tumour and nodes. High frequency ultrasound miniprobes provide the ability to perform staging when the lesion is obstructing the oesophageal lumen. CT and PET provide valuable information regarding node and metastasis staging.

  5. Radiological evaluation of chondroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, T.M.; Hawkins, I.F. Jr.

    1981-04-01

    Eleven new and six recurrent chondroblastomas were studied with multiple radiological imaging methods (plain radiography, conventional tomography, computed tomography, radionuclide bone scanning, and angiography). When the plain radiographic appearance was typical, conventional tomography or computed tomography (CT) was helpful, but other studies were not. Periosteal reaction and angiographic hypervascularity were common and did not indicate cortical breakthrough. For large, aggressive, or atypical lesions, conventional tomography and CT were helpful in delineating anatomic extent, and angiography was of value in demonstrating major vessel displacement. Radionuclide bone scanning was not useful.

  6. Radiologic evaluation of os odontoideum

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Kim, Yong Soo; Park, Hyoung Chun; Oh, Soung Hoon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1988-10-15

    We took an analysis on the clinical and radiologic findings of os odontoideum, which had been regarded as relatively uncommon disease, on 5 patients whom we have recently experienced. Our results were as follows: 1. Os odontoideums were incidentally discovered during the radiologic evaluation of traumatised 4 cases, who had been well being. Another one case of os odontoideum was associated with multiple epiphyseal dysplasia. 2. General radiologic findings of os odontoideum were a round or oval and hypoplastic ossicle separated from the base of odontoid process by wise gap. 3. Alanto-Axial instability was developed in 5 cases of os odontoideum by flexion and extension stress view of lateral cervical spine. 4. Flexion views of lateral cervical spine showed narrowing of anteroposterior diameter of spinal canal which were available at atlantoaxial level on 5 cases of os odontoidum. 5. CT myelogram and cervical myelogram showed anteriorly compressed dural sac and deformed spinal cord by body of axis at the atlanto-axial level.

  7. Radiological anatomy - evaluation of integrative education in radiology.

    Science.gov (United States)

    Dettmer, S; Schmiedl, A; Meyer, S; Giesemann, A; Pabst, R; Weidemann, J; Wacker, F K; Kirchhoff, T

    2013-09-01

    Evaluation and analysis of the integrative course "Radiological Anatomy" established since 2007 at the Medical School Hannover (MHH) in comparison with conventional education. Anatomy and radiology are usually taught separately with a considerable time lag. Interdisciplinary teaching of these associated subjects seems logical for several reasons. Therefore, the integrative course "Radiological Anatomy" was established in the second year of medical education, combining these two closely related subjects. This interdisciplinary course was retrospectively evaluated by consideration of a student questionnaire and staff observations. The advantages and disadvantages of integrative teaching in medical education are discussed. The course ratings were excellent (median 1; mean 1.3 on a scale of 1 to 6). This is significantly (p radiology increased during the course (88 %). According to the students' suggestions the course was enhanced by a visitation in the Department of Radiology and the additional topic central nervous system. Integrative teaching of anatomy and radiology was well received by the students. Both, anatomical and radiological comprehension and the motivation to learn were improved. However, it should be considered, that the amount of work and time required by the teaching staff is considerably increased compared to traditional teaching. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Can radiological characteristics of preoperative cerebral lesions predict postoperative intracranial haemorrhage in endocarditis patients?

    Science.gov (United States)

    Diab, Mahmoud; Guenther, Albrecht; Scheffel, Philipp; Sponholz, Christoph; Lehmann, Thomas; Hedderich, Johannes; Faerber, Gloria; Brunkhorst, Frank; Pletz, Mathias W; Doenst, Torsten

    2016-05-01

    Infective endocarditis (IE) is associated with high mortality (20-40%) and neurological complications (20-50%). Postoperative intracranial haemorrhage (ICH) is a feared complication especially in patients with preoperative cerebral infarcts. The aim of this study was to determine the radiological characteristics of cerebral lesions that could predict the occurrence of postoperative ICH in IE patients. We retrospectively reviewed all charts, brain imaging and follow-up data from patients operated for left-sided endocarditis between January 2007 and April 2013. A total of 308 patients (age 62.0 ± 13.9) underwent surgery for IE. Preoperative cerebrovascular complications were present in 122 patients (39.6%), representing stroke in 87, silent cerebral infarctions in 31 patients and transient ischaemic attacks in 4 patients. Among 118 patients with cerebral lesions, the aetiological classification of the lesions was ischaemic in 63.6%, ischaemic with haemorrhagic transformation (HT) in 17.8%, ischaemic with concomitant microbleeds in 16.1% and intracerebral bleeding in 2.5%. Postoperative ICH occurred in 17 patients and its incidence was slightly higher in patients with preoperative cerebral infarcts compared with those without preoperative cerebral infarcts [7.6 vs 4.2%, respectively, odds ratio (OR) 1.88, 95% confidence interval (CI) 0.70-5.02, P = 0.21]. However, the difference was not statistically significant. Similarly, the incidence of postoperative ICH was higher in cases of HT of ischaemic infarcts than in cases of ischaemic infarcts not complicated with HT (19.0 vs 5.3%). However, the difference was not statistically significant (P = 0.24). The radiological pattern of preoperative cerebral lesions was single in 35.6% and multiple in 60.0% of cases. Multiple cerebral lesions were associated with a non-significantly lower incidence of postoperative ICH than single lesions (5.6 vs 11.9%, respectively, OR: 0.44, CI: 0.11-1.73, P = 0.29). The results suggest that

  9. A retrospective review of cases preoperatively diagnosed by radiologic imaging as cavernous venous malformations.

    Science.gov (United States)

    Jayaram, Anupam; Cohen, Liza M; Lissner, Gary S; Karagianis, Achilles G

    2017-04-03

    The purpose of this study is to examine orbital lesions identified on preoperative radiologic imaging as cavernous venous malformations (CVMs), identify their imaging characteristics, and determine if these may help differentiate CVMs from other intraorbital masses. An IRB-approved retrospective chart review over 30 years was undertaken identifying lesions "consistent with cavernous hemangioma" on radiologic studies, which were subsequently surgically resected with a tissue diagnosis. All radiologic images (CT and MRI) obtained preoperatively were re-reviewed by a single masked neuroradiologist. The pattern of contrast enhancement on sequential MRI views was used to determine whether the enhancing characteristics helped identify CVMs compared to other intraorbital masses. Fifty-seven orbital lesions consistent with a CVM were identified on imaging. Fourteen (25%) of them were resected, of which nine (64%) were found to be CVMs on pathologic examination. Five (36%) were found to be a different lesion, most commonly schwannoma (21%). On imaging, CVMs tended to display heterogeneous progressive enhancement, whereas other tumors, in particular schwannomas, enhanced at their maximum level immediately. Based on these characteristics, on re-review, the masked neuroradiologist was able to differentiate a CVM versus other tumors for all 14 imaging cases. This study suggests that examining the pattern of contrast enhancement may help to correctly differentiate a CVM from other isolated, encapsulated orbital lesions on CT/MR imaging.

  10. Preoperative Evaluation: Estimation of Pulmonary Risk.

    Science.gov (United States)

    Lakshminarasimhachar, Anand; Smetana, Gerald W

    2016-03-01

    Postoperative pulmonary complications (PPCs) are common after major non-thoracic surgery and associated with significant morbidity and high cost of care. A number of risk factors are strong predictors of PPCs. The overall goal of the preoperative pulmonary evaluation is to identify these potential, patient and procedure-related risks and optimize the health of the patients before surgery. A thorough clinical examination supported by appropriate laboratory tests will help guide the clinician to provide optimal perioperative care. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Preoperative evaluation for lung cancer resection

    Science.gov (United States)

    Spyratos, Dionysios; Porpodis, Konstantinos; Angelis, Nikolaos; Papaiwannou, Antonios; Kioumis, Ioannis; Pitsiou, Georgia; Pataka, Athanasia; Tsakiridis, Kosmas; Mpakas, Andreas; Arikas, Stamatis; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Tsiouda, Theodora; Machairiotis, Nikolaos; Siminelakis, Stavros; Argyriou, Michael; Kotsakou, Maria; Kessis, George; Kolettas, Alexander; Beleveslis, Thomas; Zarogoulidis, Konstantinos

    2014-01-01

    During the last decades lung cancer is the leading cause of death worldwide for both sexes. Even though cigarette smoking has been proved to be the main causative factor, many other agents (e.g., occupational exposure to asbestos or heavy metals, indoor exposure to radon gas radiation, particulate air pollution) have been associated with its development. Recently screening programs proved to reduce mortality among heavy-smokers although establishment of such strategies in everyday clinical practice is much more difficult and unknown if it is cost effective compared to other neoplasms (e.g., breast or prostate cancer). Adding severe comorbidities (coronary heart disease, COPD) to the above reasons as cigarette smoking is a common causative factor, we could explain the low surgical resection rates (approximately 20-30%) for lung cancer patients. Three clinical guidelines reports of different associations have been published (American College of Chest Physisians, British Thoracic Society and European Respiratory Society/European Society of Thoracic Surgery) providing detailed algorithms for preoperative assessment. In the current mini review, we will comment on the preoperative evaluation of lung cancer patients. PMID:24672690

  12. IMPORTANCE OF PREOPERATIVE RADIOLOGICAL PLANNING IN THE REHABILITATION OF PATIENTS WITH ENDOPROSTHETIC KNEE ARTHROPLASTY – CASE STUDY

    OpenAIRE

    2016-01-01

    Introduction: The purpose of endoprosthetic knee arthroplasty is to restore joint function; this objective can be attained by positioning correctly the prosthetic elements both in frontal (varus-valgus) and in rotational plane. The new radiological planning protocol introduced since October 2014 in the Orthopaedics Clinic of the Rehabilitation Hospital manages to cover the entire preoperative assessment of frontal and rotational deformities. Case study: The 58-years-old female patient with bi...

  13. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from

  14. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from preo

  15. User questionnaire to evaluate the radiological workspace.

    Science.gov (United States)

    van Ooijen, Peter M A; Koesoema, Allya P; Oudkerk, Matthijs

    2006-01-01

    Over the past few years, an increase in digitalization of radiology departments can be seen, which has a large impact on the work of the radiologists. This impact is not only demonstrated by the increased use of digital images but also by changing demands on the whole reading environment. In this study, we evaluated the satisfaction of our radiologists with our digital Picture Archival and Communication System environment and their workspace. This evaluation was performed by distribution of a questionnaire consisting of a score sheet and some open questions to all radiologists and residents. Out of 25 questionnaires, 12 were adequately answered and returned. Results clearly showed that most problems were present in the area of reading room design and layout and comfort and ergonomics. Based on the results from this study, adaptations were made and the results were also used in the planning of the redesign of the entire department of radiology.

  16. Magnetic resonance angiography in potential live renal donors: a joint radiological and surgical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Subramaniam, M.; Mizzi, A.; Roditi, G. E-mail: Giles.Roditi@northglasgow.scot.nhs.ukgilesroditi@mac.com

    2004-04-01

    AIM: To assess the impact of a joint surgical and radiological audit on the accuracy of contrast-enhanced magnetic resonance angiography (MRA) reports in the evaluation of potential renal donors. MATERIALS AND METHODS: We analysed the records of live renal donors who underwent gadolinium-enhanced MRA as part of the pre-operative evaluation to assess renal vasculature between August 1999 and July 2002 when feedback from surgical findings to radiology had been available. In cases of discrepancy between MRA reports and surgical findings, studies were retrieved from the magnetic resonance imaging (MRI) workstation and subjected to detailed joint clinical and radiological review. Scan quality was assessed and sources of discrepancy were identified. RESULTS: There were 45 donors, 23 men and 22 women with a mean age of 41 years. Reported MRA findings were fully confirmed at surgery in 38 of 45 cases. These images were not analysed further. In seven donors the findings at surgery were discrepant with the radiological reports: there were four cases of 'missed' early branches and three cases of 'missed' accessory arteries. In the first year of the audit there were four discrepant cases out of 18 (22%), all of which were radiological reporting errors. The number of discrepant cases in the second year was two out of 19 cases (11%). Neither of these was a radiological reporting error. There was one 'missed' early renal artery branch in the third year of audit, which was identified on MRA review. CONCLUSION: The study highlights the importance of detecting and clearly reporting not only accessory renal arteries, but also early renal arterial branches in the pre-operative evaluation of renal donors. The accuracy of pre-operative MRA in potential renal donors is high, but radiological reporting of MRA examinations is improved through careful clinical feedback, audit and interdisciplinary co-operation.

  17. Radiologic findings and follow-up evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Tong; Kim, Cheol Hyun; Kim, Hyung Hwan; Shin, Hyeong Cheol; Bae, Won Kyung; Kim, Il Young [Soonchunhyang University, Chonan (Korea, Republic of)

    2003-07-01

    In esophageal perforation, fistulous tracts commonly occur between the esophagus and mediastinal or pleural spaces, but rarely between the esophagus and bronchi. The clinical manifestations and radiologic findings of esophageal perforation are nonspecfic, and diagnosis is the often delayed; esophagography is the standard technique for evaluation of its location and degree. CT is useful in demonstrating the extraluminal manifestations of esophageal perforation and for follow-up after medical treatment, and may depict the various manifestations of perforation, according to the causes.

  18. Essential elements of the preoperative breast reconstruction evaluation

    OpenAIRE

    Cheng, Angela; Losken, Albert

    2015-01-01

    A plethora of options exist for breast reconstruction and preoperative evaluation must be thorough to lead to a successful outcome. We review multiple components of the preoperative assessment including the patient’s history, goals, imaging, and key elements of the physical exam. Consideration for tumor biology, staging, need or response to chemotherapy or radiation therapy is important in deciding on immediate versus delayed reconstruction. It is also important to consider the patient’s anat...

  19. Post-deployment usability evaluation of a radiology workstation

    NARCIS (Netherlands)

    Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi; Oudkerk, Matthijs; van Ooijen, Peter

    2015-01-01

    Objective To evaluate the usability of a radiology workstation after deployment in a hospital. Significance In radiology, it is difficult to perform valid pre-deployment usability evaluations due to the heterogeneity of the user group, the complexity of the radiological workflow, and the complexity

  20. Evaluating the effects of preoperative fasting and fluid limitation.

    Science.gov (United States)

    Tosun, Betül; Yava, Ayla; Açıkel, Cengizhan

    2015-04-01

    The aim of the study was to evaluate the effects of preoperative fasting and fluid limitation in patients undergoing laparoscopic cholecystectomy. Although traditional long-term fasting is not recommended in current preoperative guidelines, this is still a common intervention. Visual analogue scale was used to assess hunger, thirst, sleepiness, exhaustion, nausea and pain; State and Trait Anxiety Inventory was used to assess the preoperative anxiety of 99 patients undergoing elective laparoscopic cholecystectomy. Mean time of preoperative fasting and fluid limitation were, respectively, 14.70 ± 3.14 and 11.25 ± 3.74 h. Preoperatively, 58.60% of the patients experienced moderate anxiety. Patients fasting 12 h or longer had higher hunger, thirst, nausea and pain scores. The mean trait anxiety score of patients fasting 12 h or longer was statistically significantly higher. Receiving nothing by mouth after midnight preoperatively is a persisted intervention and results in discomfort of patients. Clinical protocols should be revised and nurses should be trained in current fasting protocols. © 2014 Wiley Publishing Asia Pty Ltd.

  1. IMPORTANCE OF PREOPERATIVE RADIOLOGICAL PLANNING IN THE REHABILITATION OF PATIENTS WITH ENDOPROSTHETIC KNEE ARTHROPLASTY – CASE STUDY

    Directory of Open Access Journals (Sweden)

    Liliana SAVIN

    2016-10-01

    Full Text Available Introduction: The purpose of endoprosthetic knee arthroplasty is to restore joint function; this objective can be attained by positioning correctly the prosthetic elements both in frontal (varus-valgus and in rotational plane. The new radiological planning protocol introduced since October 2014 in the Orthopaedics Clinic of the Rehabilitation Hospital manages to cover the entire preoperative assessment of frontal and rotational deformities. Case study: The 58-years-old female patient with bilateral gonarthrosis has benefited – in February 2013 from endoprosthetic arthroplasty for the left knee and in April 2015 for the right knee. The two joints were approached differently, it terms of both preoperative and intraoperative imaging protocol and postoperative rehabilitation program. Findings: The radiological control highlights the correct placement of the prosthesis in frontal and rotational plane, the absence of joint instability during right knee flexion and extension and a discrete misplacement in varus, an internal femoral malrotation of 50 and equal external laxity of the gap in flexion for left knee.

  2. Radiologic Evaluation of Small Lepidic Adenocarcinomas to Guide Decision Making in Surgical Resection.

    Science.gov (United States)

    Wilshire, Candice L; Louie, Brian E; Manning, Kristin A; Horton, Matthew P; Castiglioni, Massimo; Gorden, Jed A; Aye, Ralph W; Farivar, Alexander S; Vallières, Eric

    2015-09-01

    The International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of pulmonary adenocarcinomas identifies indolent lesions associated with low recurrence, superior survival, and the potential for sublobar resection. The distinction, however, is determined on the pathologic evaluation, limiting preoperative surgical planning. We sought to determine whether preoperative computed tomography (CT) characteristics could guide decisions about the extent of the pulmonary resection. We reviewed the preoperative CT scans for 136 patients identified to have adenocarcinomas with lepidic features on the final pathologic evaluation. The solid component on CT was substituted for the invasive component, and patients were radiologically classified as adenocarcinoma in situ, 3 cm or less with no solid component; minimally invasive adenocarcinoma, 3 cm or less with a solid component of 5 mm or less; or invasive adenocarcinoma, exceeding 3 cm or solid component exceeding 5 mm, or both. Analysis of variance, t test, χ(2) test, and Kaplan-Meier methods were used for analysis. The radiologic classification identified 35 adenocarcinomas in situ (26%) and 12 minimally invasive (9%) and 89 invasive adenocarcinoma (65%) lesions. At a 32-month median follow-up, patient outcomes associated with the radiologic classification were similar to the pathologic-based classification: the radiologic classification identified 14 of 16 patients with recurrent disease and all 6 who died of lung cancer. In addition, patients with radiologic adenocarcinoma in situ and minimally invasive adenocarcinoma who underwent sublobar resections had no recurrence and 100% disease-free and overall survival at 5 years. The radiologic classification of patients with lepidic adenocarcinomas is associated with similar oncologic and survival outcomes compared with the pathologic classification and may guide decision making in the approach to surgical resection

  3. Preoperative evaluation of synchronous colorectal cancer using MR colonography

    DEFF Research Database (Denmark)

    Achiam, Michael P; Andersen, Lars Peter Holst; Klein, Mads

    2009-01-01

    it is noninvasive, and most of the colon can be evaluated. Furthermore, it has higher patient acceptance, and no sedation or radiation is used. The purpose of this study was to determine the feasibility of performing MRC preoperatively in an everyday clinical situation in a group of patients who were not offered......RATIONALE AND OBJECTIVES: It is well known that synchronous cancers (incidence, 2%-11%) and polyps (incidence, 12%-58%) occur in patients with colorectal cancer. Magnetic resonance colonography (MRC) seems like the obvious choice as a diagnostic tool in preoperative evaluation, because...

  4. Assessment of patient satisfaction with the preoperative anesthetic evaluation

    Directory of Open Access Journals (Sweden)

    Gebremedhn EG

    2014-09-01

    Full Text Available Endale Gebreegziabher Gebremedhn, Vidhya Nagaratnam Department of Anesthesia, School of Medicine, Gondar College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: The evaluation of patient satisfaction is a core aspect of the continuous quality improvement in anesthesia service that can be affected by the preoperative anesthetist visit. This visit enables the anesthetist to know about the patient's general health status and the nature of surgery, to choose the type of anesthesia, and to discuss perioperative complications and their management with the patient. Patients have sometimes complained about the information given during the preoperative anesthetic evaluation in the University of Gondar teaching and referral hospital. The aim of this study was to determine the level of patient satisfaction with the preoperative anesthetist visit. Methods: A cross-sectional study was conducted from February 15 to April 15, 2013. All consecutive elective patients who were operated upon under anesthesia during the study period were interviewed 24 hours after operation. A pretested questionnaire and checklists, which were developed based on the hospital's anesthetic evaluation sheet, were used for data collection. Results: A total of 116 elective patients were operated upon under anesthesia during the study period. Of these, 102 patients were included in our study, with a response rate of 87.9%. Anesthetists introduced themselves to ~24% patients; provided information about anesthesia to ~32%, postoperative complications to ~21%, postoperative analgesia to ~18, and postoperative nausea and vomiting to ~21%; and spent adequate time with ~74%. Patients' questions were answered by the anesthetist in ~65% of cases, and ~65% of patients had reduced anxiety after the anesthetist visit. The patients' overall satisfaction with the preoperative anesthetist visit was ~65%. Conclusion and recommendation: Patient satisfaction with the

  5. Upper airway imaging and its role in preoperative airway evaluation

    Directory of Open Access Journals (Sweden)

    Jagadish G Sutagatti

    2016-01-01

    Full Text Available Ultrasonography (USG is well-known as a fast, safe, and noninvasive technique. Its application for imaging of the airway is now gaining momentum. The upper airway has a complex anatomy, and its assessment forms a vital part of every preanesthetic evaluation. Ultrasound (US imaging can help in upper airway assessment in the preoperative period. There are various approaches to upper airway USG. The technique has its own advantages, disadvantages, and limitations. This simple yet challenging imaging technique is all set to become an important part of routine preoperative airway evaluation. This article reviews the various approaches to upper airway US imaging, interpretation of the images, limitations, and disadvantages of the technique and its varied clinical applications in the preoperative period. The scientific material presented here was hand searched from textbooks and journals, electronically from PubMed, and Google scholar using text words.

  6. RADIOLOGICAL EVALUATION OF CRANIOVERTEBRAL JUNCTION ANOMALIES

    Directory of Open Access Journals (Sweden)

    Joji Reddy

    2015-08-01

    Full Text Available INTRODUCTION: Detailed discussions of the CVJ are conspicuously absent in many standard textbooks and chapters addressing the skull or cervical spine, since it lies in between these regions . CVJ anomalies are common in India subcontinent. OBJECTIVES : To outline the normal anatomy and various abnormalities of craniovertebral junction. To evaluate the most common developmental and acquired craniovertebral junction abnormalities . CRANIOMETRY AND DIAGNOSIS: Radiological evaluation of CVJ requir es identification of only a few anatomic structures. Over the years multiple lines , planes and angles have been described for assessment of CVJ relationship , initially with radiography and later with polytomography. Two lines have remained particularly use ful for evaluation of CVJ relationship with virtually any imaging modality: the chamberlain`s line and weckenheim ’ s clivus base line . Two angles also continue to be useful: the welcher basal angle and atlanto occipital joint axis angle. PATIENTS AND METHOD S: The prospective study of craniovertebral junction anomalies was carried out at Kurnool medical college , Governament general hospital Kurnool from NOV 2012 to AUG 2014. The patients are subjected to clinical evaluation and radiological evaluation. OBSERV ATIONS AND RESULTS : In our study there is male predominance with male to female ratio of 2:1 . Majority of patients are in the age group of 11 - 40 (73.26%. The commonest symptom seen is weakness of extremities ( 70% with associated numbness (50%. On clinica l examination pyramidal tract involvement noticed in 70% of cases. Basilar invagination is the most common followed by Atlantoocoipital assimilation (40% and AAD (30% . CONCLUSION : Computed tomography and magnetic resonance imaging are invalvable adjuncts to the plain radiographs in the evaluation of the craniovertebral junction anomalies. Chamberlain’s line and McGregor line are the most commonly applied craniometric measurements

  7. Fenestral otosclerosis: significance of preoperative CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Swartz, J.D.; Faerber, E.N.; Wolfson, R.J.; Marlowe, F.I.

    1984-06-01

    Thirty-five consecutive patients with the clinical diagnosis of fenestral otosclerosis were evaluated with high-resolution computed tomography (CT). Twenty-six were diagnosed as having this disorder by CT evidence of abnormal bony excrescences at or adjacent to the oval window. Sections were also evaluated for evidence of plaque formation elsewhere in the lateral wall of the labyrinth and for surgical obstacles such as an abnormally wide cochlear aqueduct, a high jugular vein, and a dehiscent facial nerve. It is concluded that fenestral otosclerosis may be accurately diagnosed with proper CT techniques.

  8. [The 'paper-based' preoperative evaluation: sometimes, a suitable alternative].

    NARCIS (Netherlands)

    Bucx, M.J.L.; Wolff, A.P.; Scheffer, G.J.

    2012-01-01

    In the Netherlands, the majority of elective-surgery patients are evaluated by the anaesthesiologist at the preoperative assessment clinic. We believe that this visit can be omitted in selected patients as it has only minimal benefit, whereas its disadvantages can be substantial. Alternatively, the

  9. Effect of Arthrocentesis on Symptomatic Osteoarthritis of the Temporomandibular Joint and Analysis of the Effect of Preoperative Clinical and Radiologic Features.

    Science.gov (United States)

    Nitzan, Dorrit W; Svidovsky, Jesica; Zini, Avraham; Zadik, Yehuda

    2017-02-01

    To evaluate the long-term outcome of arthrocentesis in patients with symptomatic temporomandibular joint (TMJ) osteoarthritis that was unresponsive to nonsurgical interventions. Seventy-nine patients (83 joints) with symptomatic TMJ osteoarthritis that had not responded to nonsurgical interventions and who underwent arthrocentesis were included in this study. Demographic, clinical, and radiologic data, including assessment of pain, dysfunction, improvement, and satisfaction, and maximal mouth opening were analyzed. The analysis included 67 female patients (84.8%) and 12 male patients (15.2%), 13 to 70 years old, who were followed for 56.9 ± 6.7 months. Sixty-four (81%) reacted favorably to arthrocentesis. For these patients, maximal mouth opening increased from 26.3 ± 0.8 to 39.24 ± 0.9 mm (P < .001). Pain and dysfunction scores decreased from 6.92 ± 0.2 to 2.36 ± 0.3 (P < .001) and from 7.37 ± 0.2 to 2.24 ± 0.4 (P < .001), respectively. Overall score for patient satisfaction with arthrocentesis was 8.78 ± 0.3. The procedure had no lasting complications. Remarkably, the severity of preoperative pain, dysfunction, and range of motion and of radiographic changes did not correlate with the outcome of arthrocentesis. The severity of preoperative or postoperative signs and symptoms was not correlated with the severity of radiographic changes. For most patients, arthrocentesis offers long-term favorable outcomes for symptomatic TMJ osteoarthritis that has not responded to nonsurgical treatments and otherwise would have required surgical arthroplasty. Severity of preoperative clinical and computerized tomographic findings is not predictive for the success of arthrocentesis. In addition, the lack of correlation between the clinical and radiologic findings negates the commonly used Wilkes classification, which presumes that the clinical signs and symptoms deteriorate together with radiologic changes. Copyright © 2016 American Association of Oral and

  10. Evaluation of Stress Scores Throughout Radiological Biopsies

    Directory of Open Access Journals (Sweden)

    Turkoglu

    2016-06-01

    Full Text Available Background Ultrasound-guided biopsy procedures are the most prominent methods that increase the trauma, stress and anxiety experienced by the patients. Objectives Our goal was to examine the level of stress in patients waiting for radiologic biopsy procedures and determine the stress and anxiety level arising from waiting for a biopsy procedure. Patients and Methods This prospective study included 35 female and 65 male patients who were admitted to the interventional radiology department of Kartal Dr. Lütfi Kirdar training and research hospital, Istanbul between the years 2014 and 2015. They filled out the adult resilience scale consisting of 33 items. Patients who were undergoing invasive radiologic interventions were grouped according to their phenotypic characteristics, education level (low, intermediate, and high, and biopsy features (including biopsy localization: neck, thorax, abdomen, and bone; and the number of procedures performed, 1 or more than 1. Before the biopsy, they were also asked to complete the depression-anxiety-stress scale (DASS 42, state-trait anxiety inventory scale (STAI-I, and continuous anxiety scale STAI-II. A total of 80 patients were biopsied (20 thyroid and parathyroid, 20 thorax, 20 liver and kidney, and 20 bone biopsies. The association between education levels (primary- secondary, high school and postgraduate and the number of biopsies (1 and more than 1 with the level of anxiety and stress were evaluated using the above-mentioned scales. Results Evaluation of sociodemographic and statistical characteristics of the patients showed that patients with biopsy in the neck region were moderately and severely depressed and stressed. In addition, the ratio of severe and extremely severe anxiety scores was significantly high. While the STAI-I and II scores were lined up as neck > bone > thorax > abdomen, STAI-I was higher in neck biopsies compared to thorax and abdomen biopsies. Regarding STAI-I and II scales, patients

  11. Diagnosis of cystocele--the correlation between clinical and radiological evaluation.

    Science.gov (United States)

    Altman, Daniel; Mellgren, Anders; Kierkegaard, Jonas; Zetterström, Jan; Falconer, Christian; López, Annika

    2004-01-01

    In patients with genital prolapse involving several compartments simultaneously, radiologic investigation can be used to complement the clinical assessment. Contrast medium in the urinary bladder enables visualization of the bladder base at cystodefecoperitoneography (CDP). The aim of the present study was to evaluate the correlation between clinical examination using the Pelvic Organ Prolapse Quantification system (POP-Q) and CDP. Thirty-three women underwent clinical assessment and CDP. Statistical analysis using Pearson's correlation coefficient ( r) demonstrated a wide variability between the current definition of cystocele at CDP and POP-Q ( r=0.67). An attempt to provide an alternative definition of cystocele at CDP had a similar outcome ( r=0.63). The present study demonstrates a moderate correlation between clinical and radiologic findings in patients with anterior vaginal wall prolapse. It does not support the use of bladder contrast at radiologic investigation in the routine preoperative assessment of patients with genital prolapse.

  12. [Evaluation of preoperative anxiety in patients requiring glaucoma filtration surgery].

    Science.gov (United States)

    Lemaitre, S; Blumen-Ohana, E; Akesbi, J; Laplace, O; Nordmann, J-P

    2014-01-01

    Preoperative anxiety is often expressed by patients requiring filtration surgery for their glaucoma. So far, there has been no scale for screening this group of patients for preoperative anxiety. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-evaluation questionnaire which has been used in specialties other than ophthalmology and which makes it possible to identify the adult patients with a high level of preoperative anxiety over an upcoming surgical procedure. The purpose of this study is to estimate the preoperative anxiety in glaucoma patients requiring filtration surgery. We performed a prospective study of 36 adult patients with chronic glaucoma not responding to medical treatment and who were about to undergo filtration surgery (trabeculectomy or deep sclerectomy). The APAIS questionnaire was given to the patients after discussing the indication for surgery. A global anxiety score (ranging from 4 to 20) above 10 defined patients with a high level of preoperative anxiety. We attempted to identify among these patients the factors related to filtration surgery which caused them anxiety (lack of control of intraocular pressure, risk of blindness, presence of the filtering bleb). In our sample of patients, we found that glaucoma was a source of anxiety. That was also true for the surgical procedure, though most patients believe that once the decision had been made, their psychological status was not modified by the upcoming procedure. The patient-clinician relationship is important in any chronic disease, all the more so in glaucoma, since this disease remains asymptomatic for a long time. When filtration surgery is necessary, the patients are going to express less preoperative anxiety if they trust their physician and if individualized information has been given to them The French version of the APAIS is a quick scale, easily completed, that can be recommended for evaluating anxiety and patients' need for information prior to filtering

  13. Inadequate preoperative colonic evaluation for synchronous colorectal cancer

    DEFF Research Database (Denmark)

    Achiam, M P; Burgdorf, S K; Wilhelmsen, M

    2009-01-01

    synchronous lesions in 11-44%. The purpose of this study was to review all patients having surgery for CRC in our department since 2001, and to evaluate the extent of the perioperative colonic evaluation. MATERIALS AND METHODS: The records of all patients operated for CRC between Jan. 2001 and Dec. 2007...... in our department were reviewed. Only patients with CRC were included. Information regarding pre-, per- and postoperative colonic evaluation were obtained and occurrences of SC were evaluated. RESULTS: Of the 534 patients included 124 (23%) patients had an impassable stenosis. Full preoperative colonic...

  14. Inadequate preoperative colonic evaluation for synchronous colorectal cancer

    DEFF Research Database (Denmark)

    Achiam, M P; Burgdorf, S K; Wilhelmsen, M

    2009-01-01

    BACKGROUND AND AIMS: Synchronous cancers (SC) are well known (2-11%) in patients with colorectal carcinoma (CRC). One study has shown that intraoperative palpation can miss up to 69% of the SC while other studies have shown altered planned surgical procedure due to preoperatively diagnosed......-operation and one patient had pulmonary embolism as a complication to re-operation. CONCLUSIONS: The results show that many patients (78%) never underwent FPCE, but also that many of these patients never had a full postoperative colonic evaluation. SC being overlooked can lead to increased morbidity...... and the possibility of advanced staging of the cancer which is also exemplified in this study....

  15. User questionnaire to evaluate the radiological workspace

    NARCIS (Netherlands)

    van Ooijen, Peter M. A.; Koesoema, Allya P.; Oudkerk, Matthijs

    2006-01-01

    Over the past few years, an increase in digitalization of radiology departments can be seen, which has a large impact on the work of the radiologists. This impact is not only demonstrated by the increased use of digital images but also by changing demands on the whole reading environment. In this st

  16. Relationship between lower third molar and mandibular canal; Preoperative evaluation using CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Itou, Masaki; Miyagishima, Toshio; Onizuka, Hiroyuki (Fujieda City Shida General Hospital, Shizuoka (Japan)); Takagi, Norio

    1994-01-01

    The mandibular canal is often closely related to the lower third molars. During the surgical removal of the third molar, the inferior alveolar nerve in the canal is sometimes damaged leading to impaired sensation in the lower lip. This is one of the most unpleasant postoperative complications. The buccolingual relationship between the lower third molar and the mandibular canal cannot be diagnosed by ortho-pantomography although preoperative evaluation must be carried out radiologically. In present study, the relationship was determined by using CT scan. Forty-seven lower third molars of 35 patients were evaluated preoperatively by CT scan. The mandibular canal of all cases overlapped with the third molar on ortho-pantomography. CT scan was taken in two ways. The first was the Tragion-Menton plane which was nearly parallel to the canal at the apex of the third molar. The second was the plane of the axis of the third molar. Axial CT scan was taken when the third molar erupted horizontally, and coronal CT scan was done when the molar erupted vertically. CT scan examination exactly revealed the position of the mandibular canal in relation to the root of the third molar. The canal was located buccally to the roots in 55 percent of cases, apicobuccally in 6 percent, apically in 23 percent, apicolingually in 6 percent, lingually in 2 percent, and between roots in 6 percent. The results of the present study were consistent with previous reports. In 12 cases, the inferior alveolar neurovascular bundle was visible during operation. It was visible in only 2 of 22 cases when the canal was located buccally. It was visible, on the other hand, in all cases in which the canal was located apicolingually, lingually, and between roots. It also tended to be visible when the canal overlapped more strongly with the third molar on preoperative ortho-pantomography. (author).

  17. Evaluation healing of jejunal anastomosis in preoperative dexamethasone treated dogs

    Directory of Open Access Journals (Sweden)

    A.S. Al-Qadhi

    2015-06-01

    Full Text Available The objective of this study is to evaluate the healing process of jejunal anastomosis by the aid of histopathology and measurement of bursting pressure of anastomosis site in thirty two adult preoperatively with dexamethasone. The animals were randomly divided into 2 equal groups: Group 1: consists of 16 dogs underwent apposition end-to-end jejunal anastomosis using simple interrupted suture technique which in turn divided into 2 subgroups: subgroup A: consists of 8 dogs treated preoperatively for 15 days with dexamethasone at a dose of (0.2mg/kg given I/M. Subgroup B: control group consists of 8 dogs not treated with dexamethasone. Group 2: consists of 16 dogs underwent inverted end-to-end jejunal anastomosis using continuous Lembert suture pattern that also divided into 2 subgroups: subgroup A: consists of 8 dogs treated preoperatively for 15 days with dexamethasone at a dose of (0.2mg/kg given I/M. subgroup B: control group consists of 8 dogs not treated with dexamethasone. The result of bursting pressure measurement showed higher tensile strength in the control groups (445±9.6 in comparison with the steroidal groups (255±25.3 for both techniques. The histopathological study showed that the healing was good in all groups but the rupture that occur due to shedding the pressure lead to non discrimination between which is better in terms of healing. Massonʼs trichrome showed that collagen content of subgroups taking dexamethasone was lower than that of subgroups not treated with dexamethasone.

  18. Real-time MRI navigated ultrasound for preoperative tumor evaluation in breast cancer patients: Technique and clinical implementation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ah Young; Seo, Bo Kyoung [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of)

    2016-09-15

    Real-time magnetic resonance imaging (MRI) navigated ultrasound is an image fusion technique to display the results of both MRI and ultrasonography on the same monitor. This system is a promising technique to improve lesion detection and analysis, to maximize advantages of each imaging modality, and to compensate the disadvantages of both MRI and ultrasound. In evaluating breast cancer stage preoperatively, MRI and ultrasound are the most representative imaging modalities. However, sometimes difficulties arise in interpreting and correlating the radiological features between these two different modalities. This pictorial essay demonstrates the technical principles of the real-time MRI navigated ultrasound, and clinical implementation of the system in preoperative evaluation of tumor extent, multiplicity, and nodal status in breast cancer patients.

  19. Real-Time MRI Navigated Ultrasound for Preoperative Tumor Evaluation in Breast Cancer Patients: Technique and Clinical Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ah Young; Seo, Bo Kyoung [Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355 (Korea, Republic of)

    2016-11-01

    Real-time magnetic resonance imaging (MRI) navigated ultrasound is an image fusion technique to display the results of both MRI and ultrasonography on the same monitor. This system is a promising technique to improve lesion detection and analysis, to maximize advantages of each imaging modality, and to compensate the disadvantages of both MRI and ultrasound. In evaluating breast cancer stage preoperatively, MRI and ultrasound are the most representative imaging modalities. However, sometimes difficulties arise in interpreting and correlating the radiological features between these two different modalities. This pictorial essay demonstrates the technical principles of the real-time MRI navigated ultrasound, and clinical implementation of the system in preoperative evaluation of tumor extent, multiplicity, and nodal status in breast cancer patients.

  20. Evaluation of gastrointestinal bleeding: Update of current radiologic strategies

    Institute of Scientific and Technical Information of China (English)

    Parth; J; Parekh; Ross; C; Buerlein; Rouzbeh; Shams; Harlan; Vingan; David; A; Johnson

    2014-01-01

    Gastrointestinal bleeding(GIB) is a common presenta-tion with significant associated morbidity and mortality, the prevalence of which continues to rise with the ever-increasing aging population. Initial evaluation includes an esophagoduodeonscopy and/or colonoscopy, which may fail to reveal a source. Such cases prove to be a dilemma and require collaboration between gastroen-terology and radiology in deciding the most appropriate approach. Recently, there have been a number of ra-diologic advances in the approach to GIB. The purpose of this review is to provide an evidence-based update on the most current radiologic modalities available and an algorithmic approach to GIB.

  1. Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients.

    Science.gov (United States)

    Serbest, Sancar; Tiftikçi, Uğur; Askın, Aydogan; Yaman, Ferda; Alpua, Murat

    2017-07-01

    The aim of this study was to examine the potential relationship between subjective sleep quality and degree of pain in patients with rotator cuff repair. Thirty-one patients who underwent rotator cuff repair prospectively completed the Pittsburgh Sleep Quality Index, the Western Ontario Rotator Cuff Index, and the Constant and Murley shoulder scores before surgery and at 6 months after surgery. Preoperative demographic, clinical, and radiologic parameters were also evaluated. The study analysed 31 patients with a median age of 61 years. There was a significant difference preoperatively versus post-operatively in terms of all PSQI global scores and subdivisions (p Rotator Cuff Scale and the Constant and Murley shoulder scores (p ˂ 0.001). Sleep disorders are commonly seen in patients with rotator cuff tear, and after repair, there is an increase in the quality of sleep with a parallel improvement in shoulder functions. However, no statistically significant correlation was determined between arthroscopic procedures and the size of the tear and sleep quality. It is suggested that rotator cuff tear repair improves the quality of sleep and the quality of life. IV.

  2. [Evaluation of a preoperative virtual tour for parents and children].

    Science.gov (United States)

    Tourigny, Jocelyne; Chartrand, Julie

    2009-03-01

    A Canadian pediatric center has set a preoperative virtual tour on its website. This tour was evaluated by a descriptive study, in terms of utilization, efficacy and usefulness. The tour was utilized by 49.6% of the 123 families. Children of these families had a significant increase in knowledge from Time I (preop clinic) to Time 2 (day of surgery). Children and youth who did not use the tour reported themselves as more anxious the day of surgery but not significantly. There was no significant change in parents. The internet is a useful tool in families' preparation but cannot replace a direct interaction. Other researches are necessary in order to evaluate the impact of this type of preparation on the quality of care and on the child's recovery.

  3. Preoperative evaluation with T-staging system for hilar cholangiocarcinoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma.METHODS: From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging.RESULTS: The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage (P < 0.05). The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%,50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0%respectively; the survival of different stage patients differed markedly (P < 0.001). Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection (28 mo vs 18 mo;P < 0.05). The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy (91.4% vs 68%; P < 0.05 ). And it was also higher in detecting port vein involvement (90% vs54.5%; P < 0.05).CONCLUSION: The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability,the likelihood of metastatic disease, and survival.A concomitant partial hepatectomy would help to attain curative resection and the possibility of longterm survival. MRCP/MRA coupled with color Doppler Ultrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma.

  4. Role of multimodality cardiac imaging in preoperative cardiovascular evaluation before noncardiac surgery

    Directory of Open Access Journals (Sweden)

    Fathala Ahmed

    2011-01-01

    Full Text Available The preoperative cardiac assessment of patients undergoing noncardiac surgery is common in the daily practice of medical consultants, anesthesiologists, and surgeons. The number of patients undergoing noncardiac surgery worldwide is increasing. Currently, there are several noninvasive diagnostic tests available for preoperative evaluation. Both nuclear cardiology with myocardial perfusion single photon emission computed tomography (SPECT and stress echocardiography are well-established techniques for preoperative cardiac evaluation. Recently, some studies demonstrated that both coronary angiography by gated multidetector computed tomography and stress cardiac magnetic resonance might potentially play a role in preoperative evaluation as well, but more studies are needed to assess the role of these new modalities in preoperative risk stratification. A common question that arises in preoperative evaluation is if further preoperative testing is needed, which preoperative test should be used. The preferred stress test is the exercise electrocardiogram (ECG. Stress imaging with exercise or pharmacologic stress agents is to be considered in patients with abnormal rest ECG or patients who are unable to exercise. After reviewing this article, the reader should develop an understanding of the following: (1 the magnitude of the cardiac preoperative morbidity and mortality, (2 how to select a patient for further preoperative testing, (3 currently available noninvasive cardiac testing for the detection of coronary artery disease and assessment of left ventricular function, and (4 an approach to select the most appropriate noninvasive cardiac test, if needed.

  5. Radiology

    OpenAIRE

    Vassallo, Pierre

    2004-01-01

    Radiology is the fastest developing field of medicine and these unprecedented advances have been mainly due to improving computer technology. Digital imaging is a technology whereby images are acquired in a computer format, so that they can be easily stored and recalled for display on any computer workstation. Digital image acquisition has been used in ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) from the start. The use of digital imaging in conventional X-rays, k...

  6. Radiological evaluation congenital gastrointestinal tract anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Hee; Kim, Ock [Hanil Hospital, Seoul (Korea, Republic of); Jang, Jung Wha [Seoul Nationl Hospital, Seoul (Korea, Republic of)

    1983-06-15

    With the improvements, during recent years, in the control of the infections and nutritional diseases the subject of congenital malformation becomes of increasing importance. The radiologic signs are crucial for prompt diagnosis of anomalies of alimentary tract and with early identification of resulting complication, surgical therapy is usually life-saving. 30 cases of congenital anomalies of alimentary tract in infants were reviewed in respect of age, sex, incidence and radiological findings. The results are summarized as follows; 1, The most common lesion was hypertrophic pyloric stenosis, followed by congenital megacolon and anorectal anomaly, tracheoesophageal fistula, intestinal atresia. 2. Male outnumbered female in most congenital anomalies of alimentary tract. 25 cases were under the age of 1 month. 3. Common symptoms of upper gastrointestinal tract obstruction are vomiting and abdominal distension. In the obstruction of lower gastrointestinal tract, abdominal distension and failure of meconium passage were noted. 4. Roentgenologic findings were as follows, a. Chest A-P and lateral view: In tracheoesophageal fistula, saccular dilatation of upper esophagus and displacement of trachea anterolaterally were the most common finding. b. Simple abdomen: Obstructive pattern of proximal portion of duodenum shows in 11 cases, of distal bowel shows in 16 cases. Duodenal atresia showed 'double bubble' sign, hypertrophic pyloric stenosis showed marked gastric distension, paucity of air in small bowel and increases gastric peristalsis were the most common findings. Hirschsprung's disease showed absenced of rectal gas almostly. The variable length between blind hindgut to anus was seen in anorectal anomalies. c. Esophagogram: Blind sac of upper esophagus was seen at the 4th thoracic spinal level and displacement of trachea anterolaterally. 1 case of tracheoesophageal fistula had an intact esophageal lumen. d. Upper G-I series: In hypertrophic pyloric

  7. Discrepancy between preoperative MRI evaluation and intraoperative or postoperative pathological findings for the extent of local invasion in maxillary squamous cell carcinoma.

    Science.gov (United States)

    Lee, D J; Lee, M J; Kwon, K H; Chung, E J; Yoon, D Y; Rho, Y S

    2014-06-01

    Preoperative radiological evaluation of the extent of local invasion in maxillary squamous cell carcinoma (SCC) is very important in planning curative surgery. The aim of this study was to examine the accuracy of preoperative radiological evaluation with magnetic resonance imaging (MRI) for the extent of local invasion in maxillary SCC. A retrospective study was conducted of 33 patients who underwent a maxillectomy for maxillary SCC. We compared the MRI findings for 18 structures around the maxillary sinus with intraoperative or postoperative pathological findings. Discrepancies were found between preoperative MRI findings and intraoperative or postoperative pathological findings for 22 patients (66.7%). Overall, the specificity, sensitivity, positive predictive value, and negative predictive value of MRI were 83.4%, 83.0%, 64.5%, and 90.4%, respectively. The receiver operating characteristic curve showed that MRI evaluation of the posterolateral structures including the pterygoid plate, pterygoid muscle, and infratemporal fossa had a lower area under the curve (0.614) and a significantly lower accuracy when compared with the other structures (P = 0.294, 95% confidence interval 0.405-0.822). In conclusion, as the accuracy of preoperative MRI evaluation of the posterolateral structures is low, careful evaluation of local extension to the posterolateral structures is needed when planning curative surgery for maxillary SCC. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. CLINICAL AND RADIOLOGICAL EVALUATION ON DEVELOPMENTAL HIP DYSPLASIA AFTER SALTER AND OMBRÉDANNE PROCEDURE

    Science.gov (United States)

    da Rocha, Válney Luiz; Thomé, André Luiz Coelho; da Silva Castro, Daniel Labres; de Oliveira, Leandro Zica; de Moraes, Frederico Barra

    2015-01-01

    Objective: To evaluate the clinical and radiological medium-term results from surgical treatment of developmental hip dysplasia through Salter innominate bone osteotomy and Ombrédanne femoral shortening. Methods: Fourteen patients were evaluated, with surgical treatment on 18 hips (seven right-side hips and eleven left-side hips) using the proposal technique, performed between 1998 and 2008. The Dutoit and Severin criteria were used respectively for clinical and radiographic evaluations. Results: The average preoperative index for the seven right-side hips was 43.3° (40° to 50°), and this was corrected through surgery to an average of 31.57° (24° to 42°). The average preoperative index for the eleven left-side hips was 42.1° (36° to 56°), and this was corrected through surgery to an average of 30.36° (20° to 44°). There was a statistically significant difference between the preoperative and postoperative acetabular indexes, with P > 0.05. The clinical evaluation showed that there were seven excellent hips (38.9%), eight good ones (44.4%), three fair hips (16.7%) and no poor ones (0%). By grouping the hips rated good and excellent as satisfactory and those rated poor and fair as unsatisfactory, 83.3% of the results were seen to be favorable. There were no statistically significant correlations between occurrences of complications and patient age at the time of surgery or between complications and the preoperative acetabular index (p > 0.05). The complications observed consisted of one case each of subluxation, osteonecrosis and osteonecrosis together with subluxation. Conclusion: The combined procedure of Salter and Ombrédanne is a viable option for treating developmental hip dysplasia after patients have started to walk. PMID:27027068

  9. CLINICAL AND RADIOLOGICAL EVALUATION ON DEVELOPMENTAL HIP DYSPLASIA AFTER SALTER AND OMBRÉDANNE PROCEDURE.

    Science.gov (United States)

    da Rocha, Válney Luiz; Thomé, André Luiz Coelho; da Silva Castro, Daniel Labres; de Oliveira, Leandro Zica; de Moraes, Frederico Barra

    2011-01-01

    To evaluate the clinical and radiological medium-term results from surgical treatment of developmental hip dysplasia through Salter innominate bone osteotomy and Ombrédanne femoral shortening. Fourteen patients were evaluated, with surgical treatment on 18 hips (seven right-side hips and eleven left-side hips) using the proposal technique, performed between 1998 and 2008. The Dutoit and Severin criteria were used respectively for clinical and radiographic evaluations. The average preoperative index for the seven right-side hips was 43.3° (40° to 50°), and this was corrected through surgery to an average of 31.57° (24° to 42°). The average preoperative index for the eleven left-side hips was 42.1° (36° to 56°), and this was corrected through surgery to an average of 30.36° (20° to 44°). There was a statistically significant difference between the preoperative and postoperative acetabular indexes, with P > 0.05. The clinical evaluation showed that there were seven excellent hips (38.9%), eight good ones (44.4%), three fair hips (16.7%) and no poor ones (0%). By grouping the hips rated good and excellent as satisfactory and those rated poor and fair as unsatisfactory, 83.3% of the results were seen to be favorable. There were no statistically significant correlations between occurrences of complications and patient age at the time of surgery or between complications and the preoperative acetabular index (p > 0.05). The complications observed consisted of one case each of subluxation, osteonecrosis and osteonecrosis together with subluxation. The combined procedure of Salter and Ombrédanne is a viable option for treating developmental hip dysplasia after patients have started to walk.

  10. Evaluation of medical radiation exposure in pediatric interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, Valeria Coelho Costa; Navarro, Marcus Vinicius Teixeira; Oliveira, Aline da Silva Pacheco, E-mail: vccnavarro@gmail.com [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Salvador, BA (Brazil); Maia, Ana Figueiredo [Universidade Federal de Sergipe (UFS), Aracaju, SE (Brazil); Oliveira, Adriano Dias Dourado [Sociedade Brasileira de Hemodinamica e Cardiologia Intervencionista, Salvador, BA (Brazil)

    2012-07-15

    Objective: To evaluate pediatric radiation exposure in procedures of interventional radiology in two hospitals in the Bahia state, aiming at contributing to delineate the scenario at the state and national levels. The knowledge of exposure levels will allow an evaluation of the necessity of doses optimization, considering that peculiarities of radiology and pediatrics become even more significant in interventional radiology procedures which involve exposure to higher radiation doses. Materials and Methods: A total of 32 procedures were evaluated in four rooms of the two main hospitals performing pediatric interventional radiology procedures in the Bahia state. Air kerma rate and kerma-area product were evaluated in 27 interventional cardiac and 5 interventional brain procedures. Results: Maximum values for air kerma rate and kerma-area product and air kerma obtained in cardiac procedures were, respectively, 129.9 Gy.cm{sup 2} and 947.0 mGy; and, for brain procedures were 83.3 Gy.cm{sup 2} and 961.0 mGy. Conclusion: The present study results showed exposure values up to 14 times higher than those found in other foreign studies, and approximating those found for procedures in adults. Such results demonstrate excessive exposure to radiation, indicating the need for constant procedures optimization and evaluation of exposure rates. (author)

  11. Radiology education. The evaluation and assessment of clinical competence

    Energy Technology Data Exchange (ETDEWEB)

    Hibbert, Kathryn M.; Van Deven, Teresa [The Univ. of Western Ontario, London, ON (Canada). Dept. of Medical Imaging; Chhem, Rethy K. [Medical Univ. of Vienna (Austria). Dept. of Radiology; Nagasaki Univ. (Japan). Atomic Bomb Disease Inst.; Wang, Shih-chang (eds.) [Univ. of Sydney Westmead Hospital (Australia). Dept. of Radiology; Royal Australian and New Zealand College of Radiologists, Sydney (Australia). Faculty of Radiodiagnosis

    2012-11-01

    Third volume of a trilogy devoted to radiology education and improvement of medical imaging students' learning, teaching, and scholarship. Reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education. Includes a series of rich case studies. Written by an international group of experienced educators and medical professionals. This book reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education, highlighting emerging practices and work done in the field. The sometimes conflicting assessment and evaluation needs of accreditation bodies, academic programs, trainees, and patients are carefully considered. The final section of the book examines assessment and evaluation in practice, through the development of rich case studies reflecting the implementation of a variety of approaches. This is the third book in a trilogy devoted to the scholarship of radiology education and is the culmination of an important initiative to improve medical imaging students' learning, teaching, and scholarship by bringing together experienced educators and medical professionals. The previous two books focused on the culture and the learning organizations in which our future radiologists are educated and on the application of educational principles in the education of radiologists. Here, the trilogy comes full circle: attending to the assessment and evaluation of the education of its members has much to offer back to the learning of the organization.

  12. An audit of documented preoperative evaluation of surgery patients ...

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia 2015; 21(4):23-28 ... The information obtained from the standardised PAR form in each patient's file was audited using a ... inadequate preoperative assessment and management were.

  13. MRI for the preoperative evaluation of femoroacetabular impingement.

    Science.gov (United States)

    Li, Angela E; Jawetz, Shari T; Greditzer, Harry G; Burge, Alissa J; Nawabi, Danyal H; Potter, Hollis G

    2016-04-01

    Femoroacetabular impingement (FAI) refers to a condition characterized by impingement of the femoral head-neck junction against the acetabular rim, often due to underlying osseous and/or soft tissue morphological abnormalities. It is a common cause of hip pain and limited range of motion in young and middle-aged adults. Hip preservation surgery aims to correct the morphological variants seen in FAI, thereby relieving pain and improving function, and potentially preventing early osteoarthritis. The purpose of this article is to review the mechanisms of chondral and labral injury in FAI to facilitate an understanding of patterns of chondrolabral injury seen on MRI. Preoperative MRI evaluation of FAI should include assessment of osseous morphologic abnormalities, labral tears, cartilage status, and other associated compensatory injuries of the pelvis. As advanced chondral wear is the major relative contraindication for hip preservation surgery, MRI is useful in the selection of patients likely to benefit from surgery. Teaching points • The most common anatomical osseous abnormalities predisposing to FAI include cam and pincer lesions. • Morphological abnormalities, labral lesions, and cartilage status should be assessed. • In cam impingement, chondral wear most commonly occurs anterosuperiorly.• Pre-existing advanced osteoarthritis is the strongest predictor of poor outcomes after FAI surgery. • Injury to muscles and tendons or other pelvic structures can coexist with FAI.

  14. Post-deployment usability evaluation of a radiology workstation

    NARCIS (Netherlands)

    Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A.; Oudkerk, Matthijs; Van Ooijen, Peter M. A.

    2016-01-01

    Objectives: To determine the number, nature and severity of usability issues radiologists encounter while using a commercially available radiology workstation in clinical practice, and to assess how well the results of a pre-deployment usability evaluation of this workstation generalize to clinical

  15. Laparoscopic splenectomy: color Doppler flow imaging for preoperative evaluation

    Institute of Scientific and Technical Information of China (English)

    XU Wei-li; LI Suo-lin; WANG Yan; SHI Bao-jun; LI Meng; LI Ying-chao; ZHONG Zhi-yong; LI Zhen-dong

    2009-01-01

    Background Laparoscopic splenectomy (LS) is currently the standard approach for resection of a normal-sized spleen.However, this method becomes technical challenge in cases of splenomegaly due to intraoperative hemorrhage. A complete understanding of the splenic vessel anatomy is important to facilitate the difficult laparoscopic procedure. In this retrospective study, we examined the role of color Doppler flow imaging (CDFI) in splenic vessel anatomy and evaluated its value for LS.Methods Forty-eight patients who underwent splenectomy for various hematologic and autoimmune disorders from May 2004 to December 2007 were enrolled in this study. Twenty-three patients underwent preoperative CDFI examination that included examination of the anatomic type of splenic pedicle, the adjacent relationship between the splenic vessel and pancreas, and spleen size (CDFI group). In the remaining 25 patients, ultrasonic inspections of the splenic vessel were not performed (non-CDFI group). Laparoscopic splenectomies in the CDFI group were performed in accordance with the information provided by the preoperative CDFI in each patient. In the non-CDFI group, LS was performed according to the conventional method. In the CDFI group, the constituent ratios of the above-mentioned parameters by CDFI were compared with those recorded during LS using the chi square test. The effectiveness of the technique on surgery in both groups was compared with an independent sample Student's ttest.Results All laparoscopic splenectomies in both groups were performed successfully. However, 2 cases in the non-CDFI group were converted to LS with the assistance of micro-incision because the branches of the splenic vein were inadvertently torn. Two anatomic types of splenic pedicle and four different adjacent relationships between the splenic vessel and pancreas were detected by CDFI. About 80% of spleens fit the criteria of megalosplenia. There were no statistically significant differences between the

  16. Radiological evaluation of percutaneous endoscopic lumbar discectomy: a three-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seung Eun; Lee, Sang Ho; Ahn, Yong; Shin, Song Woo; Jo, Byung June; Park, Jee Young [Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Inje University College of Medicine, Seoul (Korea, Republic of)

    2006-05-15

    We wanted to analyze the radiological changes of the patients who underwent percutaneous endoscopic lumbar discectomy (PELD) for treating soft disc herniation. We retrospectively reviewed 30 patients (32 cases) who were observed for a minimum of 3 years after they underwent PELD. The authors investigated the postoperative radiological changes after PELD and the related clinical outcomes. All the patients received plain X-rays, CT and MRI both preoperatively and at the final follow-up. The radiological parameters were evaluated, including the disc height, the disc signal intensity, the subchondral marrow signal intensity, the sagittal plane instability and the facet joint osteoarthritis. The average amount of removed disc was 1.363 g and a significant correlation was detected between the narrowing of disc height and the amount of removed disc. Although the disc height and the disc height ratio were significantly decreased (-0.97 mm and 86.9%, respectively), the angle of sagittal rotation was well maintained. There were 18 (56.3%) cases of disc signal changes, six cases (18.8%) of subchondral marrow signal changes, and three cases (9.4%) of facet joint osteoarthritis. The success rate was 90.6%. Although disc height narrowing was observed, there was no postoperative instability and the overall clinical outcome was satisfactory. Our results show that PELD is a useful and minimal invasive procedure for the selected patients who are suffering with lumbar disc herniation.

  17. Radiological evaluation of the acromioclavicular joint

    Energy Technology Data Exchange (ETDEWEB)

    Vaeaetaeinen, U.; Maekelae, A. (Kuopio Univ. Central Hospital (Finland). Dept. of Surgery); Pirinen, A. (Kuopio Univ. Central Hospital (Finland). Dept. of Radiology)

    1991-02-01

    X-ray measurement of the acromioclavicular (AC) joint may cause difficulties because of different projections and the lack of a reproducible measurement. In order to find the ideal measurement to estimate the state of the AC joint, 28 healthy adult volunteers were X-rayed. The least vulnerable measurement for errors in projection was the distance between the coracoid process and the upper part of the clavicle. The effect of stress was evaluated; the range of normal AC joint laxity was determined as 3 mm. (orig.).

  18. Evaluating the effect of preoperative oral gabapentin on ...

    African Journals Online (AJOL)

    2010-05-02

    May 2, 2010 ... 0riginal Research: Preoperative oral gabapentin in patients ... having pain scores ≥ 5 received rescue analgesia in the form of intravenous tramadol 0.5 mg.kg-1. If the ... decreases postoperative pain scores at zero hour and the rescue ... decreased physical and social function, as well as ... 2% lignocaine.

  19. Mucocele of the appendix. Radiological findings

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Shingo; Satani, Kenichiro; Ozuki, Taizo [Tokyo Medical Coll. (Japan); Shindou, Hiroaki; Saguchi, Toru; Koizumi, Kiyoshi; Katsumata, Kenji [Tokyo Medical Coll. (Japan). Hachioji Medical Center; Kotake, Fumio [Tokyo Medical Coll., Ami, Ibaraki (Japan). Kasumigaura Hospital

    2002-04-01

    Radiological findings of CT and MRI were evaluated in 11 cases of mucocele of the appendix. Mucocele is a rare disease entity and preoperative diagnosis is very important. The radiological findings were a well defined cystic mass with a wall of variable thickness. Nodular lesion in the wall of the mucocele may be a suggestive finding of malignant case of mucocele. (author)

  20. EVALUATING EMERGENCY RESPONSE MODELS OF RADIOLOGICAL DISPERSION IN COMPLEX TERRAIN

    OpenAIRE

    Dyer, L.L.; Pascoe, J.H.

    2008-01-01

    Abstract: Operational airborne releases of trace quantities of the radioactive noble gas Ar-41 from the HIFAR Nuclear Research Reactor located in Sydney, Australia are valuable for evaluating emergency response models incorporating radiological dispersion. The Australian Nuclear Science and Technology Organisation (ANSTO), where the reactor is located, has a network of meteorological stations and GR-150 environmental gamma dose detectors placed in complex terrain within a 5km radius ...

  1. Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation

    Directory of Open Access Journals (Sweden)

    Charikleia Triantopoulou

    2016-01-01

    Full Text Available The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts. The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3–4 mm. This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure—consistency (areas of necrosis—hemorrhage—fibrosis—inflammation, the degree of vessels’ infiltration, the size of pancreatic and common bile duct and the distance from resection margins. Missed findings by imaging or pitfalls were recorded and we tried to explain all discrepancies between radiology evaluation and the histopathological findings. Radiologic-pathologic correlation is extremely important, adding crucial information on imaging limitations and enabling quality assessment of surgical specimens. The deep knowledge of different pancreatic tumors’ consistency and way of extension helps to improve radiologists’ diagnostic accuracy and minimize the radiological-surgical mismatching, preventing patients from unnecessary surgery.

  2. Dose Evaluation and Quality Criteria in Dental Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Gori, C.; Rossi, F.; Stecco, A.; Villari, N.; Zatelli, G

    2000-07-01

    Radioprotection in dental radiology is of particular interest in the framework of the Revised Medical Exposure Directive for the great number of examinations involving the adult as well as the paediatric population (Article 9: Special Practice). The present study is intended to find the quality criteria of orthodontic imaging and for evaluating the dose absorbed within the dental and maxillary volume in connection with radiological examinations performed with either spiral CT, dental panoramic tomography or teleradiography. The X ray dose to organs sited in the body, neck, ocular and intracranial area was measured using lithium fluoride dosemeters, positioned in a Rando phantom. Quality criteria have been established by an expert radiologist considering the diagnostic information obtained in the images. The dosimetric data obtained were comparable with other authors', although with some differences due to technical characteristics. These result data are useful for choosing the patient's diagnostic path, considering the radiobiological risk associated with increasing orthodontic imaging. (author)

  3. Radiological evaluation of tuberculous spondylitis with computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seung Soo; Kim, Chung Hyun; Cho, June Sik; Rhee, Byung Chull [Chung-Nam National University College of Medicine, Daejeon (Korea, Republic of)

    1986-10-15

    Spinal tuberculosis is curable disease, and early diagnosis is mandatory for early treatment. We reviewed conventional radiographers and computed tomograms (CT) from Histopathologically confirmed 30 cases of spinal tuberculosis, and compared these findings with radiologic findings from 2 cases of pyogenic spondylitis and 4 cases of metastasis. The results were as follows: 1. The frequent site of involvement were thromboembolic junction and low lumbar vertebrae, and the most frequent type is multisegmented subligamentous type (93.3%). 2. CT was not of great use in the differential diagnosis of the tuberculosis. Dominant CT findings of tuberculous spondylitis were anterior vertebral body destruction, paravertebral soft-tissue mass and thick walled abscess formation occasionally containing calcification and disc space narrowing in the setting of an indolent or relatively benign course. 3. CT is the best modality for imaging the extent and anatomy of the destructive process, the degree of canal encroachment, and the change of adjacent vital structure. So CT was particularly useful in pre-operative planning of debridement and stabilization surgery. 4. The most common causes of neurologic manifestations in tuberculous spondylitis were the compression of spinal cord by sequestrated bony fragments and disc material, granulation tissue or abscess in the spinal canal.

  4. Evaluation of radiation protection conditions in intraoral radiology

    Energy Technology Data Exchange (ETDEWEB)

    Miguel, Cristiano; Barros, Frieda Saicla; Rocha, Anna Silvia Penteado Setti da, E-mail: miguel_cristianoch@yahoo.com.br [Universidade Tecnologica Federal do Parana (PPGEB/UTFPR), Curitiba, PR (Brazil). Programa de Pos-graduacao em Engenharia Biomedica; Tilly Junior, Joao Gilberto [Universidade Federal do Parana (UNIR/UFPR), Curitiba, PR (Brazil). Hospital de Clinicas. Unidade de Imagem e Radioterapia; Almeida, Claudio Domingues de [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Dept. de Fisica Medica

    2016-04-15

    Introduction: The dental radiology represents about 20% of human exposure to radiation in radio diagnostic. Although the doses practiced in intraoral dentistry are considered low, they should not be ignored due to the volume of the performed procedures. This study presents the radiation protection conditions for intraoral radiology in Curitiba - PR. Methods: Data was collected through a quantitative field research of a descriptive nature during the period between September of 2013 and December of 2014. The survey sample consisted of 97 dentists and 130 intraoral equipment. The data related to the equipment was collected using structured questions and quality control evaluations. The evaluations of the entrance skin dose, the size of the radiation field and the total filtration were performed with dosimetry kits provided and evaluated by IRD/CNEN. The exposure time and voltage were measured using noninvasive detectors. The occupational dose was verified by thermoluminescent dosimeters. The existence of personal protection equipment, the type of image processing and knowledge of dentists about radiation protection were verified through the application of a questionnaire. Results: Among the survey's results, it is important to emphasize that 90% of the evaluated equipment do not meet all the requirements of the Brazilian radiation protection standards. Conclusion: The lack of knowledge about radiation protection, the poor operating conditions of the equipment, and the image processing through visual method are mainly responsible for the unnecessary exposure of patients to ionizing radiation. (author)

  5. Evaluation of radiation protection conditions in intraoral radiology

    Directory of Open Access Journals (Sweden)

    Cristiano Miguel

    Full Text Available Abstract Introduction: The dental radiology represents about 20% of human exposure to radiation in radio diagnostic. Although the doses practiced in intraoral dentistry are considered low, they should not be ignored due to the volume of the performed procedures. This study presents the radiation protection conditions for intraoral radiology in Curitiba - PR. Methods Data was collected through a quantitative field research of a descriptive nature during the period between September of 2013 and December of 2014. The survey sample consisted of 97 dentists and 130 intraoral equipments. The data related to the equipments was collected using structured questions and quality control evaluations. The evaluations of the entrance skin dose, the size of the radiation field and the total filtration were performed with dosimetry kits provided and evaluated by IRD/CNEN. The exposure time and voltage were measured using noninvasive detectors. The occupational dose was verified by thermoluminescent dosimeters. The existence of personal protection equipment, the type of image processing and knowledge of dentists about radiation protection were verified through the application of a questionnaire. Results Among the survey's results, it is important to emphasize that 90% of the evaluated equipments do not meet all the requirements of the Brazilian radiation protection standards. Conclusion The lack of knowledge about radiation protection, the poor operating conditions of the equipments, and the image processing through visual method are mainly responsible for the unnecessary exposure of patients to ionizing radiation.

  6. Importance of Radiological Evaluation of Global Spinal Balance Together with Lower Limb Alignment in Planning Lumbar Spine Deformity Surgery ? Illustrative Case Presentation

    OpenAIRE

    Głowacki, Mariusz; Walecki, Jerzy; Kołakowski, Przemysław; Kolońska, Danuta

    2017-01-01

    Summary Background The presented case illustrates the critical role of a detailed preoperative radiological evaluation in complex spine surgery. Case Report A 49-year-old patient was admitted for a revision surgery after L3?L5 fusion. Preoperative assessment showed preserved sagittal balance, coronal imbalance and valgus knee deformity. The patient reported pain of 8?10 in VAS (Visual Analogue Scale) and had an ODI (Oswestry Disability Index) of 60%. The first step of the surgery was L2?S1 fu...

  7. Preoperative radiological diagnosis by {sup 99m}Tc{center_dot}MIBI-{sup 99m}Tc subtraction scintigraphy for primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Inouye, Takahiro; Tomita, Toshiki; Shinden, Seiichi; Takagi, Hitoshi [Tochigi Prefecture Saiseikai Utsunomiya Hospital (Japan); Kano, Shigeru

    1996-04-01

    Preoperative radiological diagnosis constitutes the most important factor for the surgical treatment of hyperparathyroidism. In this regard, MRI is useful for detecting the abnormal parathyroid, but it is often difficult to localize it using MRI only. It is thus necessary to combine this procedure with excellent subtraction scintigraphy. We performed both {sup 201}Tl-{sup 99m}Tc and {sup 99m}Tc{center_dot}MIBI-{sup 99m}Tc subtraction scintigraphy in seven patients with primary hyperparathyroidism and compared them the radiological results. Five patients presented parathyroid adenomas and the rest hypertrophy of the parathyroid. We could detect the abnormal parathyroid in four patients (57.1%) by {sup 201}Tl-{sup 99m}Tc subtraction scintigraphy and in six patients (85.7%) by {sup 99m}Tc{center_dot}MIBI-{sup 99m}Tc subtraction scintigraphy. We therefore believe that {sup 99m}Tc{center_dot}MIBI-{sup 99m}Tc subtraction scintigraphy will become an essential examination for primary hyperparathyroidism rather than the presently employed {sup 201}Tl-{sup 99m}Tc subtraction scintigraphy. (author).

  8. Klatskin tumor: Diagnosis, preoperative evaluation and surgical considerations.

    Science.gov (United States)

    Molina, Víctor; Sampson, Jaime; Ferrer, Joana; Sanchez-Cabus, Santiago; Calatayud, David; Pavel, Mihai Calin; Fondevila, Constantino; Fuster, Jose; García-Valdecasas, Juan Carlos

    2015-11-01

    Hiliar cholangiocarcinoma is the most common type of cholangiocarcinoma, an represent around 10% of all hepatobiliary tumors. It is an aggressive malignancy, resectable in around 47% of the patients at diagnosis. Complete resection is the most effective and only potentially curative therapy, with a survival rate of less than 12 months in unresectable cases. Axial computerized tomography and magnetic resonance are the most useful image techniques to determine the surgical resectability. Clinically, jaundice and pruritus are the most common symptoms at diagnosis;preoperative biliary drainage is recommended using endoscopic retrograde cholangiography or percutaneous transhepatic cholangiography. Surgery using extended liver resections with an en bloc resection of the liver with vascular reconstruction is the technique with the highest survival. Complete resection with histologically negative resection margins (R0), nodal involvement and metastases are the most important prognostic factors.

  9. Magnetic resonance cisternography for preoperative evaluation of arachnoid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Awaji, M. [Niigata University, Department of Radiology, Faculty of Medicine, Niigata (Japan); Okamoto, K. [Niigata University, Center for Integrated Human Brain Science, Brain Research Institute, Niigata (Japan); Nishiyama, K. [Niigata University, Department of Neurosurgery, Brain Research Institute, Niigata (Japan)

    2007-09-15

    With a high likelihood of clinical improvement and low rates of complications, minimally invasive neuroendoscopic surgery is becoming the treatment of choice for symptomatic or growing arachnoid cysts. In neuroendoscopic surgery, visualization of anatomical landmarks is essential in achieving successful fenestration without complications. Because of the restricted visual field in neuroendoscopic surgery, preoperative anatomical assessment is very helpful. Magnetic resonance cisternography (MRC) with high spatial resolution and contrast, using for example 3-D Fourier transformation constructive interference in steady state (CISS) or fast imaging employing steady-state acquisition (FIESTA) sequences, is able to detect the arachnoid cyst wall and neighboring anatomical structures as the anatomical landmarks. We retrospectively reviewed T2-weighted (T2-W) fast spin-echo images, and the MRC and intraoperative findings. Axial and coronal T2-W images (6 and 3 mm thickness, respectively) and axial and coronal 0.8 mm thick MRC images with CISS or FIESTA were obtained from four patients with arachnoid cysts treated by neuroendoscopic surgery. Intraoperative findings were reviewed on videotape recorded during the procedures. At the brain surface, the arachnoid cyst wall could be detected clearly in any of the four patients on MRC images, and was only partly seen in the fourth patient T2-W images. Adjacent important anatomical structures including vessels and cranial nerves, and an enough space for cystocisternostomy were identified on MRC images, and the findings were consistent with the findings during neuroendoscopic surgery. Preoperative identification of the arachnoid cyst wall and surrounding anatomical structures by MRC may help avoid complications and allow safer neuroendoscopic surgery. (orig.)

  10. Radiological Evaluation of Temporomandibular Joint Disorders Followed by Clinical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won; You Dong Soo [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1989-11-15

    The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4 : 1. 2. The most common clinical findings was the pain on open mouth position (42.43%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. 7. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

  11. Evaluation of radiation protection in interventional radiology; Evaluation de la radioprotection en radiologie interventionnelle

    Energy Technology Data Exchange (ETDEWEB)

    Le Pape, I.; Aget, H. [Centre Hospitalie Universitaire de Tours, 37 (France); Rondeau du Royer, C. [Inspection Regional du Travail de la region Centre (France)

    1998-07-01

    The interventional radiology, relatively to the conventional radiology exposes particularly to ionizing radiations, because of the time of utilisation of the radioscopy. It is important to optimize the risk according to the ALARA principle. The efforts must be made on the following fields: the radiation protection means, the periodic and systematic monitoring of material, a regular evaluation of operators irradiation, the training of non radiologist operators, the respect of the legislation on the maximum permissible dose equivalents. (N.C.)

  12. MRI diagnosis and preoperative evaluation for pure epidural cavernous hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Jie; Xu, Yi-Kai; Yang, Rui-Meng; Yu, Tian; Lin, Bing-Quan [Nanfang Hospital, Southern Medical University, Department of Diagnostic Imaging Center, Guangzhou, Guangdong (China); Li, Long [Guangdong Provincial Corps Hospital, Chinese People' s Armed Police Forces, Department of Radiology, Guangzhou, Guangdong (China); Ye, Xiang-Hua [Nanfang Hospital, Southern Medical University, Department of Radiotherapy, Guangzhou, Guangdong (China); Zhang, Nan [Nanfang Hospital, Southern Medical University, Department of Pathology, Guangzhou, Guangdong (China)

    2009-11-15

    The aims of the study were to summarize the characteristics of the spinal epidural cavernous hemangioma, especially for the MRI, and to improve the accurate rate of the preoperative diagnosis. The clinical and medical imaging data of six patients with pure spinal epidural cavernous hemangioma proved by operation and pathology were analyzed retrospectively. The level was thoracic (n = 2), thoracolumbar (n = 1), lumbar (n = 1), and sacral (n = 2). The tumor showed lobulated contour, and the areas the tumors appeared were dorsal side of spinal cord (n = 2), ventral side (n = 1), and lateral side (n = 3). In all six patients, the lesions were isointense to the spinal cord on T{sub 1}-weighted images and hyperintense on T{sub 2}-weighted images and showed homogeneously strong enhancement on contrast-enhanced T{sub 1}-weighted images. The characteristic MRI features were named as the ''wafting-silk'' sign. Widening of the intervertebral neural foramen (n = 4) and erosion of the adjacent bones (n = 3) can be observed. MRI of the epidural cavernous hemangioma showed the characteristic lobulated contour, which encircled the spinal cord. T{sub 1}WI on the MRI presented as isointense and T{sub 2}WI presented as hyperintense and a homogeneously strong enhancement, so we first proposed the sign of wafting silk. The widening of the intervertebral neural foramen and erosion of the adjacent bones can easily be observed. MR imaging has an important role in the detection and diagnosis of pure spinal epidural cavernous hemangioma. (orig.)

  13. Evaluation of the field size in dental diagnostic radiology system

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, P.S.; Potiens, M.P.A. [Instituto de Pesquisas Energeticas e Nucleares, Sao Paulo (Brazil)

    2006-07-01

    In this work the field size of a dental X rays machine was evaluated considering the recommendation of the Brazilian Health Ministry Regulation 453 which established basic lines of radiological protection in medical and dental diagnostic radiology. The diameter of the field should not be superior to 6 cm in the localized end point, limiting the radiated area and protecting the head-neck region. The measurements were carried out in a dental X rays machine, Dabi Atlante, model Spectro 70X Seletronic. For the field size or useful beam determination, the intra-oral films were positioned on a plain surface to be exposed in four stages and two focus-film distances (FFD), 20 cm and 27.5 cm: 1) with spacer cone; 2) without spacer cone; 3) with spacer cone and film-holding device; 4) without spacer cone and film-holding device. The results show that the diameter of the field size is satisfactory only for FFD = 20 cm. When the film-holding device is used, which is recommended by the Regulation 453, item 5.8 d(ii), the diameter of the field size exceeds the maximum recommended value of 6 cm. (authors)

  14. An attempt to evaluate the risks associated with radiological terror

    Energy Technology Data Exchange (ETDEWEB)

    Paschoa, A.S.; Dantas, B.M., E-mail: bmdantas@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2014-07-01

    The evaluation of the risk of a terrorist attack has been made frequently by multiplying the probability of occurrence of a terrorist attempt by the probability of its success and a quantity which represents the consequences of a successful attack. In the case of a radiological attack the consequences will vary in case the action will be active or passive. Thirteen radionuclides were examined for their potential uses in credible threats or terrorist attacks based on their availability from laboratories and hospitals. Taking into account the dose conversion coefficients published by the International Atomic Energy Agency, those radionuclides with higher dose effectiveness for ingestion are the following: {sup 210}Po; {sup 226}Ra and {sup 241}Am. Other radionuclides which can be used in threats and terror attacks, like {sup 137}Cs for example have also been examined. The risks associated with the selected radionuclides have been tentatively ranked as high, medium, or low. The probability used to evaluate risks depends on the motivation of the terrorist and the capacity, which implies availability or the actual possibility of obtaining a particular radionuclide. On the other hand, whenever a list of radionuclides to be used in a malevolent action is available to a terrorist, the choice of the most adequate will depend also on the action to be undertaken. This work ranks risks associated with radiological terror based on physical, chemical, radio-toxicological and other relevant data on radionuclides, which were either already used in terror attacks, or were pointed out as adequate to be used in such malevolent actions. (author)

  15. [Heart rate and blood pressure are not good parameters to evaluate preoperative anxiety.].

    Science.gov (United States)

    Conceição, Diogo Bruggemann da; Schonhorst, Leonardo; Conceição, Mário José da; Oliveira Filho, Getúlio Rodrigues de

    2004-12-01

    Surgical patients are subject to different levels of preoperative distress. Anxious patients may present unfavorable psychophysical reactions, such as hypertension and tachycardia. This study aimed at evaluating the level of preoperative anxiety in a population of surgical patients, and at detecting heart rate and blood pressure changes and their relationship with age, gender, education and previous surgical experience. Participated in this randomized study 145 adult patients of both genders, physical status ASA I - III, perfectly oriented in time and space, literate and scheduled for elective surgeries, to whom the Amsterdam preoperative anxiety questionnaire was applied during preanesthetic evaluation. Patients with scores > 11 were considered anxious. Age, gender, education, systolic and diastolic blood pressure, heart rate, previous surgical experience and history of hypertension were recorded. Sixty-nine patients (47.58%) were considered anxious, while 76 (52.41%) were considered not anxious. There were no significant differences between anxious and non-anxious patients in age, systolic and diastolic blood pressure, and heart rate. Among anxious patients 68.12% were females and 31.88% were males (p preoperative anxiety. Females are more anxious then males in the preoperative period.

  16. The Clinical and Radiological Evaluation of Canine Cranial Cruciate Ligament Rupture Treatment with Tibial Plateau Leveling Osteotomy

    Directory of Open Access Journals (Sweden)

    Didar AYDIN KAYA

    2016-01-01

    Full Text Available Tibial plateau leveling osteotomy (TPLO is one of the tibial osteotomy techniques for canine cranial cruciate ligament rupture. The purpose of this study is to evaluate the clinically and radiologically findings of the patients with cranial cruciate ligament rupture treated by tibial plateau leveling osteotomy. In our clinical study, treatment of cranial cruciate ligament rupture in 18 dogs with a total of 20 stifles was performed. Cases were diagnosed with cranial cruciate ligament rupture, technical measurements for the operations are determined and the cases were prepared for the operation during the preoperative period of the clinical and radiological examinations. Following the operation, postoperative clinical and radiological evaluations were performed on the 10th, 30th, 60th, 90th and 120th days. At the end of the study, it was observed that the dogs retained stifle joint motion ability, early healing of the osteotomy side in the postoperative period, all stifle joint functions were retained after a period. It was determined that this method of operation can securely (in regards to joint stabilization be performed on especially in large breed dogs.

  17. Preoperative psychological evaluation of transplant patients: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Kumnig M

    2015-06-01

    Full Text Available Martin Kumnig,1 Sheila Jowsey-Gregoire2 1Center for Advanced Psychology in Plastic and Transplant Surgery (CAPPTS, Department of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria; 2Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA Abstract: Psychological assessments are crucial for the evaluation and optimization of the suitability of transplant patients. The interdisciplinary evaluation in modern transplantation medicine focuses on important psychosocial issues, such as assessing patients’ characteristics that predict best postoperative outcome after solid organ transplantation. When assessing patients for reconstructive hand transplantation, the psychological evaluation should identify whether reconstructive hand transplantation is the best treatment option to regain functionality and sensation, to resolve body image concerns, and to improve health-related quality of life (HRQOL for each patient. These psychosocial issues in transplantation medicine are receiving increased attention; however, standardized psychological evaluation and follow-up protocols are still being developed. Previously published reports in transplantation medicine have attempted to identify psychosocial factors important in the evaluation of transplant patients and that predict psychosocial outcomes. This review will provide an overview of recent investigations in solid organ and vascularized composite allotransplantation (VCA, including the domains of evaluation, pre- and posttransplant follow-up, psychiatric complications, evaluation of body image, and HRQOL. Recent work highlights the potential for a multicenter research approach utilizing standardized assessment strategies and emphasizing the need for a shared assessment approach to understand psychosocial outcomes. For example, the Chauvet Workgroup convened in 2014 in Paris with stakeholders in the assessment of psychosocial factors to discuss key areas and propose an

  18. Clinical and radiological evaluation of sinus-lifting results with digital volume tomography

    OpenAIRE

    A.M. Panin; A.Yu. Vasiljev; Vishnyakov, V.V.; N.S. Serova; A.A. Kharlamov

    2010-01-01

    Modern techniques of radiological examination form the basis for additional diagnostic and planning methods of surgical treatment in oral surgery and implantology. Assessment of maxillary sinus condition and sinuslifting results is a part of preoperative examination before dental implantation. The estimated results of digital volume tomography after sinuslifting have shown that 51,1% of patients have lack of volume of implant on the medial wall of the sinus. That does not allow placing dental...

  19. Magnetoencephalography in the preoperative evaluation for epilepsy surgery.

    Science.gov (United States)

    Anderson, Christopher T; Carlson, Chad E; Li, Zhimin; Raghavan, Manoj

    2014-05-01

    People with pharmacoresistant epilepsy are often candidates for resective epilepsy surgery. The presurgical evaluation for epilepsy aims to localize the epileptic network that initiates seizures (which should be disrupted or removed) and determine its spatial relationship to eloquent cortex (which should be preserved). Noninvasive functional imaging techniques play an increasingly important role in planning epilepsy surgery and assessing the feasibility, risks, and benefits of surgery. Magnetoencephalography (MEG) can be a very useful part of a comprehensive presurgical evaluation as it can model the sources of epileptiform activity and localize eloquent cortices within the same study. This review is designed to assist anyone in the field of neurology or related disciplines understand some methods and terminology relevant to clinical MEG. Every effort is made to present the information in nontechnical, approachable ways so that readers will come away with a basic understanding of how to interpret MEG findings when the reported data on one of their patients are presented to them.

  20. Developing and Evaluating Virtual Cardiotomy for Preoperative Planning in Congenital Heart Disease

    DEFF Research Database (Denmark)

    Sørensen, Thomas Sangild; Beerbaum, Philipp; Mosegaard, Jesper;

    2009-01-01

    Careful preoperative planning is of outmost importance -- in particular when considering complex corrective surgery on congenitally malformed hearts. As an aid to such decisionsmaking we describe a system for virtual reconstruction of patient-specific morphology from 3D-capable imaging modalities...... such as MRI and CT. We introduce and illustrate the concept of virtual cardiotomy as a new tool to preoperatively evaluate the feasibility of different surgical strategies by investigating the anatomical spatial relations through any number of virtual incisions. Ve review the technical and clinical...

  1. [Preoperative evaluation and predictors of mortality in lung cancer resection].

    Science.gov (United States)

    Rojas, Andrés; Opazo, Marcela; Hernández, Marcela; Ávila, Paulina; Villalobos, Daniel

    2015-06-01

    Surgical resection of lung cancer, the only available curative option today, is strongly associated with mortality. The goal during the perioperative period is to identify and evaluate appropriate candidates for lung resection in a more careful way and reduce the immediate perioperative risk and posterior disability. This is a narrative review of perioperative risk assessment in lung cancer resection. Instruments designed to facilitate decision-making have been implemented in recent years but with contradictory results. Cardiovascular risk assessment should be the first step before a potential lung resection, considering that most of these patients are old, smokers and have atherosclerosis. Respiratory mechanics determined by postoperative forced expiratory volume in the first second (FEV1), the evaluation of the alveolar-capillary membrane by diffusing capacity of carbon monoxide and cardiopulmonary function measuring the maximum O2 consumption, will give clues about the patient's respiratory and cardiac response to stress. With these assessments, the patient and its attending team can reach a treatment decision balancing the perioperative risk, the chances of survival and the pulmonary long-term disability.

  2. Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.

    Science.gov (United States)

    Marshall, Nina L; Spooner, Muirne; Galvin, P Leo; Ti, Joanna P; McElvaney, N Gerald; Lee, Michael J

    2011-01-01

    A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.

  3. Evaluation of radiation protection conditions in intraoral radiology

    OpenAIRE

    Cristiano Miguel; Frieda Saicla Barros; Anna Silvia Penteado Setti da Rocha; João Gilberto Tilly Junior; Cláudio Domingues de Almeida

    2016-01-01

    Abstract Introduction: The dental radiology represents about 20% of human exposure to radiation in radio diagnostic. Although the doses practiced in intraoral dentistry are considered low, they should not be ignored due to the volume of the performed procedures. This study presents the radiation protection conditions for intraoral radiology in Curitiba - PR. Methods Data was collected through a quantitative field research of a descriptive nature during the period between September of 2013 a...

  4. Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery

    OpenAIRE

    Costa, Jean Allan; Almeida, Maria Lucia Pereira; Estrada, Tereza Cristina Duque; Werneck,Guilherme Lobosco; Rocha, Alexandre Marins; Rosa,Maria Luiza Garcia; Ribeiro, Mario Luiz; Mesquita, Claudio Tinoco

    2016-01-01

    Background The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries. Objectives To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk. Methods A total of 211 patients referred for elective surgeries, without suspic...

  5. Morphologic assessment of thoracic deformities for the preoperative evaluation of pectus excavatum by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lollert, A.; Funk, J.; Tietze, N.; Laudemann, K.; Dueber, C.; Staatz, G. [Medical Center of the Johannes Gutenberg University, Department of Diagnostic and Interventional Radiology, Section Pediatric Radiology, Mainz (Germany); Turial, S. [Medical Center of the Johannes Gutenberg University, Department of Pediatric Surgery, Mainz (Germany)

    2014-10-15

    To assess whether MRI is a suitable modality for the preoperative assessment and quantification of pectus excavatum. A total of 69 patients (57 male, 12 female; median age 15 years, range 5-35 years) with pectus excavatum were evaluated preoperatively using standardized MRI sequences on 1.5- and 3-Tesla systems (T2-HASTE/inspiration and expiration, T1-VIBE, T2-TRUFI free-breathing, T2-BLADE). The MR sequences were analysed for quality semiquantitatively. The Haller index, correction index, sternal rotation angle and asymmetry index were assessed; correlations between these indices and changes in inspiration and expiration were evaluated. T2-HASTE was the best sequence to assess pectus excavatum morphology, with a higher quality at 3 T than at 1.5 T. All indices could be assessed in every patient. A total of 37 patients had a symmetric deformity, 32 patients an asymmetric deformity. The Haller index correlated significantly (p < 0.001) with the correction index, both becoming higher in expiration. The asymmetry index correlated with the sternal rotation angle (p < 0.001) and did not change significantly in expiration (p = 0.28). Thoracic MRI is suitable for the preoperative evaluation of patients with pectus excavatum. An exact morphologic assessment is possible without radiation exposure as well as the determination of several indices to quantify the deformities. (orig.)

  6. Clinical and Radiological Evaluation of Children with Subacute Sclerosan Panencephalitis

    Directory of Open Access Journals (Sweden)

    Ahmet İrdem

    2004-01-01

    Full Text Available A total of 65 children with Subacute Sclerosing Panencephalitis (SSPE who admittedto our clinic between September 1998 and December 2002 were retrospectively evaluated interms of clinical and radiological findings.The most common symptoms and findings at admission were myoklonia (31 patients, 47%, behaveral changes (18 patients, 27.7 % and convulsion (8 patients, 12 %. There was atrauma history initiating symptoms in 14 patients (21.5 %. Neurological symptoms presentedsignificantly earlier in patients who had measles before 2 years of age compared to others(p0.05. The clinical stage of the patients at admission was determined based on Risk veHaddad classification. The most frequent stage was IIA (21 patients, 32.2%, IIC (17patients, 26.2% and IIB (16 patients, 24.6%. At the follow-up period, 46 (71% patients wasdepended to bed. The mean time interval between SSPE initiation age and bed dependencywas 4.68 ± 4.05 months (1-17 months.Of the 31 patients who underwent cranial magnetic rezonans imaging (MRI, 15patients (48.38% had pathological findings, the most frequent findings were cortical vesubcortical lesions. Of the 24 patients who underwent cranial tomographi, 22 (91.6% werenormal. Of the remaining two, one had atrophy and the other had increase in contrast. All ofthe patients underwent rutine EEG test. Fifty-four (83.1% of these had periodic complexhigh slow wave activity.The clinical findings and Electro Encephalographi results are important parameters inthe diagnosis of SSPE. Cranial tomographi is not useful in the diagnosis of SSPE. However,cranial MRI findings is pathologic only in the half of the patients.

  7. Radiologic evaluation of facial injury; Avaliacao radiologica dos traumatismos faciais

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Ricardo Pires de; Volpato, Richard [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Servico de Diagnostico por Imagem]. E-mail: richard_volpato@uol.com.br; Nascimento, Lia Paula [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil)

    2003-03-01

    A detailed radiological investigation of the maxillofacial injuries is essential to achieve good treatment results. The images should identify every lesion and guide the treatment, thus improving esthetic and functional results. With the aim of simplifying the diagnostic task, the face may be seen as a five regions structure that may suffer a regional fracture or combined fractures involving the adjacent regions. These regions represent areas of focus for pre surgical planning and are as follows: nasal, orbital, zygomatic, maxillary, and mandibular. In order to understand the injury mechanisms and their consequences it is useful to know the supporting buttresses, which are divided in five sagittal planes, three horizontal planes and two coronal planes. We reviewed the cases of patients with facial trauma treated at Complexo Hospitalar Heliopolis, Sao Paulo, Brazil. A review of the relevant issues concerning radiological investigation of these injuries is presented. This study allowed standardization and ordering of the radiological investigation in patients with facial trauma. (author)

  8. Evaluation of pre-operative staging of renal cell cancer with cine MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Uematsu, Hidemasa; Inoue, Hiroshi; Hayashi, Koji; Kitagawa, Akane; Yamamori, Sanae; Ishitoya, Satoshi; Ogura, Keiji [Rakuwakai Otowa Hospital, Kyoto (Japan); Yamada, Hiroki; Ishii, Yasushi

    1994-12-01

    To assess the utility of single section cine MR images in evaluation of extrarenal invasion of renal cell cancer. Six patients who subsequently underwent definitive surgery were examined. Sequential twenty FLASH images were acquired in coronal and parasagittal single section during one respiratory cycle. These images were evaluated in cine-loop mode to assess tumoral movement with adjacent structures. Cine MR images showed that the tumor in one patient were fixed to the spleen and the tumors in five patients showed free movement. At pathologic examination, cine MR findings were proved correct in all patients. Cine MR images may be useful for pre-operative evaluation of extrarenal invasion. (author).

  9. False-negative results of breast MR computer-aided evaluation in patients with breast cancer: correlation with clinicopathologic and radiologic factors.

    Science.gov (United States)

    Shin, YunKyung; Sohn, Yu-Mee; Seo, Mirinae; Han, Kyunghwa

    To investigate clinicopathologic and radiologic factors associated with false-negative results of magnetic resonance computer aided evaluation (MR-CAE) of breast MR imaging (MRI) in breast cancer patients. A total of 135 breast cancer patients who underwent preoperative breast MR-CAE were included. False-negative and true-positive MR-CAE results were compared in terms of clinicopathologic and radiologic features. Univariate and multivariate analyses were used to evaluate independent factors associated with false-negative results. Six of 135 cancer patients (4.4%) were false negative on MRI. Breast cancer with false-negative results on MR-CAE was classified as a lower BI-RADS category on breast ultrasound than true-positive results on MR-CAE. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.

    LENUS (Irish Health Repository)

    Marshall, Nina L

    2011-09-01

    A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.

  11. A Methodology for Evaluating System Performance for Radiological/Nuclear Counterterrorism Systems - Full Paper

    Energy Technology Data Exchange (ETDEWEB)

    Bredt, Ofelia P.; Holter, Gregory M.; Wood, Thomas W.

    2005-04-28

    Various countermeasure systems could be deployed against radiological/nuclear terrorism. The need to compare various systems and configurations has resulted in development of a method for estimating performance of such systems. This paper presents one such performance evaluation method.

  12. Chronic depression: development and evaluation of the luebeck questionnaire for recording preoperational thinking (LQPT

    Directory of Open Access Journals (Sweden)

    Kühnen Tanja

    2011-12-01

    Full Text Available Abstract Background A standardized instrument for recording the specific cognitive psychopathology of chronically depressed patients has not yet been developed. Up until now, preoperational thinking of chronically depressed patients has only been described in case studies, or through the external observations of therapists. The aim of this study was to develop and evaluate a standardized self-assessment instrument for measuring preoperational thinking that sufficiently conforms to the quality criteria for test theory. Methods The "Luebeck Questionnaire for Recording Preoperational Thinking (LQPT" was developed and evaluated using a german sample consisting of 30 episodically depressed, 30 chronically depressed and 30 healthy volunteers. As an initial step the questionnaire was subjected to an item analysis and a final test form was compiled. In a second step, reliability and validity tests were performed. Results Overall, the results of this study showed that the LQPT is a useful, reliable and valid instrument. The reliability (split-half reliability 0.885; internal consistency 0.901 and the correlations with other instruments for measuring related constructs (control beliefs, interpersonal problems, stress management proved to be satisfactory. Chronically depressed patients, episodically depressed patients and healthy volunteers could be distinguished from one another in a statistically significant manner (p Conclusion The questionnaire fulfilled the classical test quality criteria. With the LQPT there is an opportunity to test the theory underlying the CBASP model.

  13. Multi-slice CT angiography by triple-phase enhancement in preoperative evaluation of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    XIAO Xi-gang; HAN Xue; SHAN Wei-dong; LI An-yuan

    2005-01-01

    Background Triple-phase enhancement of multi-slice computed tomography (MSCT) has markedly improved the diagnostic accuracy of hepatocellular carcinoma (HCC), and MSCT angiography (MSCTA) has been proved useful in detecting vascular anatomy noninvasively. This study aimed to explore the value of MSCTA by triple-phase enhancement in preoperative evaluation of HCC.Methods Fifty-six consecutive cases of primary HCC scheduled for resection were studied with MSCTA by triple-phase enhancement. The raw data images were processed on a workstation for multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction. The findings after processing of the data were compared with those after surgery or intraoperative sonography. Results The false positive rate of MSCTA by triple-phase enhancement was 10.1% and its false negative rate was 4.3% in detecting HCC. No significant difference was observed in MSCTA and surgery or intraoperative sonography in detecting vascular anatomy anomalies and pathologic variations, whereas significant difference was found in detecting bile duct invasion with MSCT compared to intraoperative sonography.Conclusions MSCTA by triple-phase enhancement not only improves the detection of HCC, but also provides valuable preoperative information about hepatic vascular architecture and parenchyma. MSCTA by triple-phase enhancement is worthy of application as a non-invasive method in preoperative evaluation of HCC.

  14. Computational evaluation of a pencil ionization chamber in a standard diagnostic radiology beam

    Energy Technology Data Exchange (ETDEWEB)

    Mendonca, Dalila Souza Costa; Neves, Lucio Pereira; Perini, Ana Paula, E-mail: anapaula.perini@ufu.br [Universidade Federal de Uberlandia (UFU), MG (Brazil). Instituto de Fisica; Santos, William S.; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Belinato, Walmir [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Vitoria da Conquista, BA (Brazil)

    2016-07-01

    In this work a pencil ionization chamber was evaluated. This evaluation consisted in the determination of the influence of the ionization chamber components in its response. For this purpose, the Monte Carlo simulations and the spectrum of the standard diagnostic radiology beam (RQR5) were utilized. The results obtained, showed that the influence of the ionization chamber components presented no significant influence on the chamber response. Therefore, this ionization chamber is a good alternative for dosimetry in diagnostic radiology. (author)

  15. Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports.

    Science.gov (United States)

    Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M; Pawlik, Michael T; Stroszczynski, Christian; Schreyer, Andreas G

    2015-05-01

    To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6% of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2%), histology (12.4%), and blood analysis (9.6%). When radiology was the 'final problem solver', it was mainly CT (51.6%) and MRI (30.6%). In 52.2% of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. • Radiology was the most important specialty for finding the final diagnosis. • CT was the most successful problem-solving imaging modality followed by MRI. • MRI and CT had the best solution rates of more than 30%.

  16. 3-dimensional echocardiography and its role in preoperative mitral valve evaluation.

    Science.gov (United States)

    Andrawes, Michael N; Feinman, Jared W

    2013-05-01

    Echocardiography plays a key role in the preoperative evaluation of mitral valve disease. 3-dimensional echocardiography is a relatively new development that is being used more and more frequently in the evaluation of these patients. This article reviews the available literature comparing the use of this new technology to classic techniques in the assessment of mitral valve pathology. The authors also review some of the novel insights learned from 3-dimensional echocardiography and how they may be used in surgical decision making and planning.

  17. Current radiological techniques used to evaluate unilateral partial ureteral obstruction: an experimental rabbit study.

    Science.gov (United States)

    Yazıcı, Mehmet; Celebi, Suleyman; Kuzdan, Özgür; Koçan, Hüseyin; Ayyıldız, Halil Suat; Bayrak, İlkay Koray; Bilgici, Meltem Ceyhan; Yapıcı, Oktay; Kefeli, Mehmet; Arıtürk, Ender

    2015-07-01

    The aim of this study was to evaluate functional and prognostic benefits of Doppler ultrasonography (DU), diuretic renal scintigraphy (DRS), and magnetic resonance urography (MRU) during diagnosis and follow-up of ureteropelvic junction obstruction (UPJO) and to examine apoptosis rates caused by UPJO in an experimental rabbit model. Twenty-four rabbits were divided randomly into two groups. The left kidneys of 15 rabbits from the first group underwent Ulm-Miller surgery to create UPJO, whereas the left kidneys of nine rabbits from the second group underwent sham surgery. A pressure flow study (Whitaker's test) was done during postoperative week 6. Based on the Whitaker test, the DU, DRS, and MRU findings were compared. The number of apoptotic renal cells was counted after death. The Whitaker test run during postoperative week 6 revealed obstructions in 15 rabbits from group 1; the nine rabbits of the sham group had no obstructions. Sensitivity and specificity of DRS were 93.3 and 88.8 %, respectively, and those of MRU were 93.3 and 88.8 %, respectively. The postoperative mean RI values were significantly higher than the preoperative values, associated with sensitivity of 86.6 % and specificity of 77.5 % for detecting UPJO. DRS, MRU, and RI could not predict UPJO in one (8 %), one (8 %), and two (16 %) kidneys, respectively. Likelihood ratio (LR) was 8.4 for MRU and scintigraphy, while for RI, LR was 3.9. Pathology specimens revealed that all kidneys with UPJO underwent apoptosis, and the number of apoptotic cells was significantly higher on the UPJO-created side than on the contralateral and in the sham group (p < 0.05). No test predicted all apoptosis related to UPJO. The RI, DRS, and DMRU results correlated with the pressure flow results for detecting UPJO. No single radiological technique predicted all initial UPJO-created kidneys that concluded with apoptosis. Further studies are required to seek with better methods for diagnosing an obstruction or to define a

  18. THE POSTOPERATIVE RADIOLOGICAL EVALUATION OF THE OXFORD MICROPLASTY® UNICOMPARTMENTAL KNEE REPLACEMENT INSTRUMENTATION

    Directory of Open Access Journals (Sweden)

    L. Hong-Chul

    2015-01-01

    Full Text Available Introduction. Recently, new model of Oxford mobile-bearing unicompartmental knee arthroplasty (UKA, Oxford Microplasty®, Zimmer Biomet, IN, USA was launched to improve previous version (Oxford Phase 3, Biomet, IN, USA. Still, there are few reports demonstrating the results of this noble UKA prosthesis in the literature. Thus, the aim of this study is to report and assess the postoperative radiological outcomes of the Oxford Microplasty ® instrument. Materials and methods. From March 2013 to October 2013, twenty-one patients (23 knees underwent mobile UKA for medial compartment osteoarthritis using this noble instrument. Postoperative radiological outcomes were measured for operated lower limb alignment and implant position, and they were compared with those of 64 UKAs using the Oxford Phase 3 which had been performed from January 2010 to August 2012. Pre-and post-operative deformity of the knee in the coronal plane, the location of the mechanical axis with respect to the center of the tibial surface, positioning of the tibial and femoral components and varus and valgus alignment for the tibial and femoral components were evaluated. Results. In the Microplasty® patients, preoperative HKA angle was 172.8±2.5° and postoperative HKA angle increased to 177.7±2.8° (p<0.001. There were no significant differences in postoperative HKA angle between Oxford Phase 3 and Microplasty group (178.4° vs. 177.7°, p>0.05. There were no significant differences in postoperative limb alignment and component position between the Microplasty group and Oxford Phase 3 group except femoral component flexion (11.9±2.1° vs. 2.6±4.1°, p<0.001. In addition, there were not any outliers in measurements of the components in the Microplasty group. Conclusion. UKA using Oxford Microplasty® includes noble tools including femoral sizing spoon, G-clamp, longer IM rod, two-peg femoral component, and IM link system to help with ease of use, precision, efficiency, and

  19. Evaluating Compliance with Institutional Preoperative Testing Guidelines for Minimal-Risk Patients Undergoing Elective Surgery

    Directory of Open Access Journals (Sweden)

    Arunotai Siriussawakul

    2013-01-01

    Full Text Available Background. Few investigations preoperatively are important for low-risk patients. This study was designed to determine the level of compliance with preoperative investigation guidelines for ASA I patients undergoing elective surgery. Secondary objectives included the following: to identify common inappropriate investigations, to evaluate the impact of abnormal testing on patient management, to determine factors affecting noncompliant tests, and to estimate unnecessary expenditure. Methods. This retrospective study was conducted on adult patients over a one-year period. The institute’s guidelines recommend tests according to the patients’ age groups: a complete blood count (CBC for those patients aged 18–45; CBC, chest radiograph (CXR and electrocardiography (ECG for those aged 46–60; and CBC, CXR, ECG, electrolytes, blood glucose, blood urea nitrogen (BUN, and creatinine (Cr for patients aged 61–65. Results. The medical records of 1,496 patients were reviewed. Compliant testing was found in only 12.1% (95% CI, 10.5–13.9. BUN and Cr testings were the most frequently overprescribed tests. Overinvestigations tended to be performed on major surgery and younger patients. Overall, overinvestigation incurred an estimated cost of US 200,000 dollars during the study period. Conclusions. The need to utilize the institution’s preoperative guidelines should be emphasized in order to decrease unnecessary testing and the consequential financial burden.

  20. Evaluation of two selection tests for recruitment into radiology specialty training.

    Science.gov (United States)

    Patterson, Fiona; Knight, Alec; McKnight, Liam; Booth, Thomas C

    2016-07-11

    This study evaluated whether two selection tests previously validated for primary care General Practice (GP) trainee selection could provide a valid shortlisting selection method for entry into specialty training for the secondary care specialty of radiology. We conducted a retrospective analysis of data from radiology applicants who also applied to UK GP specialty training or Core Medical Training. The psychometric properties of the two selection tests, a clinical problem solving (CPS) test and situational judgement test (SJT), were analysed to evaluate their reliability. Predictive validity of the tests was analysed by comparing them with the current radiology selection assessments, and the licensure examination results taken after the first stage of training (Fellowship of the Royal College of Radiologists (FRCR) Part 1). The internal reliability of the two selection tests in the radiology applicant sample was good (α ≥ 0.80). The average correlation with radiology shortlisting selection scores was r = 0.26 for the CPS (with p radiology but would benefit from further refinement for use in radiology to ensure that the test specification is relevant. The evidence on whether the SJT may be appropriate for shortlisting in radiology is limited. However, these results may be expected to some extent since the SJT is designed to measure non-academic attributes. Further validation work (e.g. with non-academic outcome variables) is required to evaluate whether an SJT will add value in recruitment for radiology specialty training and will further inform construct validity of SJTs as a selection methodology.

  1. Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer.

    Science.gov (United States)

    Allensworth, S K; Langstraat, C L; Martin, J R; Lemens, M A; McGree, M E; Weaver, A L; Dowdy, S C; Podratz, K C; Bakkum-Gamez, J N

    2013-09-01

    Preoperative thrombocytosis has been implicated as a negative prognostic marker for epithelial ovarian cancer (EOC). We assessed whether thrombocytosis is an independent risk factor for EOC recurrence and death. Perioperative patient characteristics and process-of-care variables (National Surgical Quality Improvement Program (NSQIP)-defined) were retrospectively abstracted from 587 women who underwent EOC staging between 1/2/03-12/29/08. Thrombocytosis was defined as platelet count > 450 × 10(9)/L. Disease-free survival (DFS) and overall survival (OS) were determined using Kaplan-Meier methods. Associations were evaluated with Cox proportional hazards regression and hazard ratios (HR). The incidence of preoperative thrombocytosis was 22.3%. DFS was 70.8% and 36.0% at 1 and 3 years. OS was 83.3% and 54.3% at 1 and 3 years. Ascites, lower hemoglobin, advanced disease, and receipt of perioperative packed red blood cell transfusion were independently associated with thrombocytosis. Older age and the presence of coronary artery disease were associated with lower likelihood of thrombocytosis. Overall, thrombocytosis was an independent predictor of increased risk of recurrence. Among early stage (I/II) cases, there was a 5-fold increase in the risk of death and nearly 8-fold risk of disease recurrence independently associated with thrombocytosis. Preoperative thrombocytosis portends worse DFS in EOC. In early stage disease, thrombocytosis is a potent predictor of worse DFS and OS and further assessment of the impact of circulating platelet-derived factors on EOC survival is warranted. Thrombocytosis is also associated with extensive initial disease burden, measurable residual disease, and postoperative sequelae. Preoperative platelet levels may have value in primary cytoreduction counseling. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Clinical and radiological evaluation in vertebral artery dissections

    Directory of Open Access Journals (Sweden)

    Murat Çabalar

    2013-04-01

    Full Text Available In recent years, vertebral artery dissection (VAD is reported more frequently as a cause of young cerebrovascular accidents. It can occur spontaneously or following a neck manipulation and trauma. The patients were 3 females (mean age: 35±26 years and 7 males (mean age: 37.71±4.96 years. Only 2 patients described neck trauma. Cerebellar findings were prominent in all cases. On radiological investigation, vascular changes of vertebral arteries were detected bilaterally in 2 cases, right in 5 and left in 3 cases. All the cases were treated with anticoagulant therapy and cured but 1 with sequela. Prognosis of vertebral artery dissection is generally good by early diagnosis and treatment. In this article, we reported clinical and radiological properties of 10 vertebral artery dissection cases.

  3. Importance of Radiological Evaluation of Global Spinal Balance Together with Lower Limb Alignment in Planning Lumbar Spine Deformity Surgery - Illustrative Case Presentation.

    Science.gov (United States)

    Głowacki, Mariusz; Walecki, Jerzy; Kołakowski, Przemysław; Kolońska, Danuta

    2017-01-01

    The presented case illustrates the critical role of a detailed preoperative radiological evaluation in complex spine surgery. A 49-year-old patient was admitted for a revision surgery after L3-L5 fusion. Preoperative assessment showed preserved sagittal balance, coronal imbalance and valgus knee deformity. The patient reported pain of 8-10 in VAS (Visual Analogue Scale) and had an ODI (Oswestry Disability Index) of 60%. The first step of the surgery was L2-S1 fusion with decompression and spine deformity correction. The second step involved anti-valgus osteotomy of the right tibial bone. The assessment of global spinal balance together with lower extremity alignment should be strongly recommended.

  4. Cricoarytenoid joint involvement in rheumatoid arthritis: radiologic evaluation.

    Science.gov (United States)

    Greco, Antonio; Fusconi, Massimo; Macri, Gian Franco; Marinelli, Caterina; Polettini, Elisabetta; Benincasa, Anna Teresa; de Vincentiis, Marco

    2012-01-01

    Rheumatoid arthritis rarely involves the cricoarytenoid joint. The possible consequent symptom includes hoarseness, dysphagia, odynophagia, dysfunctional dysphonia, and acute dyspnea. Etiologic diagnosis is possible with high-resolution computed tomography, which can show spacing of the articular cartilage, density and volume alterations, and subluxation of the cartilage. However, these radiologic signs are not pathognomonic for rheumatoid arthritis, and they should be combined with anamnestic data.

  5. Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports

    Energy Technology Data Exchange (ETDEWEB)

    Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M.; Stroszczynski, Christian; Schreyer, Andreas G. [University Hospital Regensburg, Institute of Radiology, Regensburg (Germany); Pawlik, Michael T. [Intensive Care and Emergency Medicine, Institute of Anaesthesiology, Regensburg (Germany)

    2015-05-01

    To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6 % of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2 %), histology (12.4 %), and blood analysis (9.6 %). When radiology was the 'final problem solver', it was mainly CT (51.6 %) and MRI (30.6 %). In 52.2 % of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. (orig.)

  6. Preoperative Magnetic Resonance Imaging Evaluation in Patients with Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Lee, Choon Sung; Kim, Nam Heun; Noh, Hyun Min; Lee, Mi Young; Yoon, So Jung; Lee, Dong-Ho

    2017-01-01

    Study Design Retrospective case series. Purpose The purpose of this study was to examine the incidence of neural axis abnormalities and the relevant risk factors in patients with adolescent idiopathic scoliosis (AIS). Overview of Literature The use of preoperative magnetic resonance imaging (MRI) to assess the whole spine in patients with idiopathic scoliosis is controversial, and indications for such MRI evaluations have not been definitively established. However, we routinely use whole-spine MRI in patients with scoliosis who are scheduled to undergo surgical correction. Methods A total of 378 consecutive patients with presumed AIS who were admitted for spinal surgery were examined for neural axis abnormalities using MRI. To differentiate patients with normal and abnormal MRI findings, the following clinical parameters were evaluated: age, sex, menarcheal status, rotation angle (using a scoliometer), coronal balance, shoulder height difference, and low back pain. We radiographically evaluated curve type, thoracic or thoracolumbar curve direction, curve magnitude and flexibility, apical vertebral rotation, curve length, coronal balance, sagittal balance, shoulder height difference, thoracic kyphosis, and the Risser sign. Results Neural axis abnormalities were detected in 24 patients (6.3%). Abnormal MRI findings were significantly more common in males than in females and were associated with increased thoracic kyphosis. However, there were no significant differences in terms of the other measured parameters. Conclusions Among the patients with presumed AIS who received preoperative whole-spine MRI, 6.3% had neural axis abnormalities. Males and patients with increased thoracic kyphosis were at a higher risk. PMID:28243367

  7. Evaluation of Conventional Imaging Techniques on Preoperative Localization in Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Mesut Ozkaya

    2015-02-01

    Full Text Available We aimed to evaluate the diagnostic and preoperative localization capacity of 99mTc methoxyisobutylnitrile (MIBI parathyroid scintigraphy and ultrasonography (USG in enlarged parathyroid glands in the primary hyperparathyroidism (pHPT as well as the relationship between the success rate of these techniques and biochemical values. In this study, we retrospectively evaluated 39 patients with clinical and biological evidence of pHPT who referred to the university hospital for MIBI parathyroid scintigraphy. Patients were examined with USG and double-phase MIBI parathyroid scintigraphy for the detection of enlarged parathyroid glands. Preoperative serum intact parathyroid hormone (iPTH levels, calcium (Ca, phosphate and alkaline phosphatase measurements were obtained. A total of 45 parathyroid lesions in 39 patients were reviewed. Thirty-four patients had a single adenoma and 5 patients with multi-gland disease had 11 abnormal parathyroid glands including three adenomas, whereas the remaining 8 glands showed hyperplasia. The overall sensitivities of MIBI parathyroid scintigraphy, USG and combined techniques were 85.3%, 72.5% and 90.4%, respectively; the positive predictive values (PPV were 89.7%, 85.2% and 92.6%, respectively. The most successful approach for detection of enlarged parathyroid glands in hyperparathyroidism is the concurrent application of USG and MIBI parathyroid scintigraphy modalities. The concomitancy of thyroid diseases decreases the sensitivity of both MIBI parathyroid scintigraphy and USG in enlarged parathyroid glands.

  8. Evaluation of static and dynamic MRI for assessing response of bone sarcomas to preoperative chemotherapy: Correlation with histological necrosis

    Directory of Open Access Journals (Sweden)

    Priyadarshi Amit

    2015-01-01

    Full Text Available Objectives: Preoperative chemotherapy plays a key role in management of bone sarcomas. Postoperative evaluation of histological necrosis has been the gold standard method of assessing response to preoperative chemotherapy. This study was done to evaluate the efficacy of static and dynamic magnetic resonance imaging (MRI for assessing response preoperatively. Materials and Methods: Our study included 14 patients (12 osteosarcomas and 2 malignant fibrous histiocytomas with mean age of 21.8 years, treated with preoperative chemotherapy followed by surgery. They were evaluated with static and dynamic MRI twice, before starting chemotherapy and again prior to surgery. Change in tumor volume and slope of signal intensity - time curve were calculated and correlated with percentage of histological necrosis using Pearson correlation test. Results: The change in dynamic MRI slope was significant (P = 0.001. Also, ≥60% reduction in slope of the curve proved to be an indicator of good histological response [positive predictive value (PPV =80%]. Change in tumor volume failed to show significant correlation (P = 0.071. Although it showed high negative predictive value (NPV = 85.7%, PPV was too low (PPV = 57.14%. Conclusions: Dynamic MRI correctly predicts histological necrosis after administration of preoperative chemotherapy to bone sarcomas. Hence, it can be used as a preoperative indicator of response to neoadjuvant chemotherapy. On the other hand, volumetric assessment by static MRI is not an effective predictor of histological necrosis. This study proves the superiority of dynamic contrast-enhanced study over volumetric study by MRI.

  9. Critical evaluation of German regulatory specifications for calculating radiological exposure

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, Claudia; Walther, Clemens [Hannover Univ. (Germany). Inst. of Radioecology; Smeddinck, Ulrich [Technische Univ. Braunschweig (Germany). Inst. of Law

    2015-07-01

    The assessment of radiological exposure of the public is an issue at the interface between scientific findings, juridical standard setting and political decision. The present work revisits the German regulatory specifications for calculating radiological exposure, like the already existing calculation model General Administrative Provision (AVV) for planning and monitoring nuclear facilities. We address the calculation models for the recent risk assessment regarding the final disposal of radioactive waste in Germany. To do so, a two-pronged approach is pursued. One part deals with radiological examinations of the groundwater-soil-transfer path of radionuclides into the biosphere. Processes at the so-called geosphere-biosphere-interface are examined, especially migration of I-129 in the unsaturated zone. This is necessary, since the German General Administrative Provision does not consider radionuclide transport via groundwater from an underground disposal facility yet. Especially data with regard to processes in the vadose zone are scarce. Therefore, using I-125 as a tracer, immobilization and mobilization of iodine is investigated in two reference soils from the German Federal Environment Agency. The second part of this study examines how scientific findings but also measures and activities of stakeholders and concerned parties influence juridical standard setting, which is necessary for risk management. Risk assessment, which is a scientific task, includes identification and investigation of relevant sources of radiation, possible pathways to humans, and maximum extent and duration of exposure based on dose-response functions. Risk characterization identifies probability and severity of health effects. These findings have to be communicated to authorities, who have to deal with the risk management. Risk management includes, for instance, taking into account acceptability of the risk, actions to reduce, mitigate, substitute or monitor the hazard, the setting of

  10. The clinical and radiological evaluation of pyogenic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Jun; Kim, Kyung Joo; Yoo, Jung Keun; Kim, Young Chul; Hur, Don [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    1984-12-15

    Pyogenic arthritis remain a difficult problem, despite the availability of a wide range of powerful modern antibiotics. Early and correct diagnosis is imperative to assure the prompt initiation of an effective therapeutic regimen and the prevent of late sequela. Careful clinical, laboratory and roentgenological analysis are fundamental to early and precise diagnosis. Therefore, plain roentgenogram should not be overlooked. A radiological and clinical observation was made in 51 cases of pyogenic arthritis admitted to Chosun University Hospital during the period from January 1976 to December 1983 and following results were obtained. 1. Among the 51 cases, 36 cases (70.6%) were male and 15 cases (29.4%) were females. The most prevalent age was 5 to 9 (27.6%). 2. Symptom duration less than 5 days was in 21 cases (41.2%) and more than 31 days was in 6 cases (11.7%). 3. The most common symptom on admission was pain around the involved joint and others are limitation of motion, swelling, tenderness, fever, local heating and erythema. 4. The underlying causes were composed of unknown in 21 cases (41.2%), trauma in 18 cases (35.3%), infections focus in 8 cases (15.7%) and iatrogenic reason 4 cases (7.8%). 5. The most commonly affected joint was hip joint (45.1%). The other affected sites in order of frequency were knee, ankle, shoulder, S-I and elbow joint. In infants and children, hip and knee joint are commonly affected: in adults, knee joint is most is most commonly affected. 6. In laboratory findings, the number of W.B.C and E.S.R were increased in 56.9%. Symptom duration more than 31 days in 5 cases were increased E.S.R only. Causative microorganism was isolated in 31 cases: the most common microorganism was Staphylococcus aureus in 22 cases. Others are B-hemolytics Stretoocccus, Enterobacteriaceae species and Pseudomonas aeruginosa. 7. In 26 cases (50.9%) of the patients, roentgenographic findings was negative. The most common radiological findings was soft tissue

  11. The evaluation of radiological and clinical findings of bronchiectasis

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Jung Keun; Kang, Sung Ihn; Kim, Kil Jung; Ko, Seung Sook; Kim, Young Sook; Kim, Young Chul [Chosun University College of Medicine, Kwangju (Korea, Republic of)

    1985-10-15

    Bronchiectasis means a permanent abnormal dilatation off one or more large bronchi owing to destruction of the elastic and muscular components of the bronchial wall. Radiological study is the most important and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for the precise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases of bronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years from January 1980 to December 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34 cases (70.8%) were male and 14 cases (29.2%) were female. Peak incidence was in second decade. 2. Chronic cough productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts of pneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases (47.9%). Others are no sign in 17 cases (35.4%), wheezing in 11 cases (22.9%) and digit clubbing in 3 cases (6.3%). 3. The presumed causes were composed of not known in 30 cases (62.5%)> and complications of measles in 7 cases (14.6%), pertussis in 5 cases (10.4%) and pneumonia in 4 cases (8.3%). Two cases were Kartagener's syndrome and unilateral hyperlucent lung. 4. Plain chest common radiological findings was accentuation of lung marking in 36 cases (85.7%), the others are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies, decreased affected lung volume, air-fluid, level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases (22.9%) and the disease was much more often involved left lung than right. The most commonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segment of the lower lobe. The type of bronchiectasis is cylindrical in 22 cases (45.8%), varicose in

  12. Radiological evaluation of dysmorphic thorax of paternal uniparental disomy 14.

    Science.gov (United States)

    Miyazaki, Osamu; Nishimura, Gen; Kagami, Masayo; Ogata, Tsutomu

    2011-08-01

    The "coat-hanger" sign of the ribs with a bell-shaped thorax has been known as a radiological hallmark of the paternal uniparental disomy 14 (upd(14)pat). To quantitatively determine the differences in thoracic deformity between upd(14)pat and other bone diseases with thoracic hypoplasia and to establish the age-dependent evolution. The subjects comprised 11 children with upd(14)pat. The angle between the 6th posterior rib and the horizontal axis was measured (coat hanger angle; CHA). The ratio of the mid- to widest thorax diameter (M/W ratio) was calculated for the bell-shaped thorax. CHA ranged from +28.5 to 45° (mean; 35.1° ± 5.2) in upd(14)pat, and from -19.8 to 21° (-3.3 ± 13°) in bone dysplasias (p thorax is significant only in the neonatal period.

  13. Evaluating variability and uncertainty in radiological impact assessment using SYMBIOSE.

    Science.gov (United States)

    Simon-Cornu, M; Beaugelin-Seiller, K; Boyer, P; Calmon, P; Garcia-Sanchez, L; Mourlon, C; Nicoulaud, V; Sy, M; Gonze, M A

    2015-01-01

    SYMBIOSE is a modelling platform that accounts for variability and uncertainty in radiological impact assessments, when simulating the environmental fate of radionuclides and assessing doses to human populations. The default database of SYMBIOSE is partly based on parameter values that are summarized within International Atomic Energy Agency (IAEA) documents. To characterize uncertainty on the transfer parameters, 331 Probability Distribution Functions (PDFs) were defined from the summary statistics provided within the IAEA documents (i.e. sample size, minimal and maximum values, arithmetic and geometric means, standard and geometric standard deviations) and are made available as spreadsheet files. The methods used to derive the PDFs without complete data sets, but merely the summary statistics, are presented. Then, a simple case-study illustrates the use of the database in a second-order Monte Carlo calculation, separating parametric uncertainty and inter-individual variability. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Radiologic Evaluation of Small Renal Masses (II: Posttreatment Management

    Directory of Open Access Journals (Sweden)

    J. Santos

    2008-01-01

    Full Text Available The increase in the detection of small renal masses (SRMs and their best knowledge leads to a change in the therapeutic management of these lesions. The use of a less aggressive surgical technique or even an expectant attitude is the current tendency, in order to preserve as much renal function as possible. Imaging techniques are essential in the followup of these lesions. It allows us to know the postsurgical changes and possible complications due to treatment and the presence of local recurrence and metastases. Furthermore, a close radiological followup of SRM related to ablative treatments is mandatory. The purpose of this article is to reveal the imaging features of complications due to surgical or ablative treatments, local recurrence and metastasis, as well as their followup.

  15. Radiologic Evaluation of Small Renal Masses (I: Pretreatment Management

    Directory of Open Access Journals (Sweden)

    A. Marhuenda

    2008-01-01

    Full Text Available When characterizing a small renal mass (SRM, the main question to be answered is whether the mass represents a surgical or nonsurgical lesion or, in some cases, if followup studies are a reasonable option. Is this a task for a urologist or a radiologist? It is obvious that in the increasing clinical scenario where this decision has to be made, both specialists ought to work together. This paper will focus on the principles, indications, and limitations of ultrasound, CT, and MRI to characterize an SRM in 2008 with a detailed review of relevant literature. Special emphasis has been placed on aspects regarding the bidirectional information between radiologists and urologists needed to achieve the best radiological approach to an SRM.

  16. Diagnostic pitfalls in the preoperative 18F-FDG PET/CT evaluation of a case of giant malignant solitary fibrous tumor of the pleura.

    Science.gov (United States)

    Lococo, F; Rapicetta, C; Ricchetti, T; Cavazza, A; Filice, A; Treglia, G; Tenconi, S; Paci, M; Sgarbi, G

    2014-01-01

    Solitary fibrous tumor of the pleura (SFTP) is an uncommon entity, generally with an indolent behavior. Nevertheless, some malignant forms have been rarely reported. These, often have an aggressive biological behavior with pathological findings of invasiveness. The preoperative diagnosis and evaluation of the grade of malignancy are extremely challenging. Herein we report a case of a 64-year-old man who presented with a left giant intra-thoracic mass imaged with fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG/PET-CT) and sampled via fine-needle aspiration biopsy (FNAB). Imaging and FNAB findings showed suspicion of a benign form of SFTP. Surgical radical resection of the giant mass was performed. The definitive histological diagnosis showed a malignant SFTP. Based on this report, we take the opportunity to briefly discuss the insidious pitfalls concerning the radiological and (18)F-FDG/PET-CT features as well as cyto/histological findings in the pre-operative diagnostic work-up examination of this rare entity. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  17. The usefulness of myocardial SPECT for the preoperative cardiac risk evaluation in noncardiac surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Lee, Dong Soo; Kang, Won Jon; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-02-01

    We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. 118 patients ( M: F=66: 52, 62.7{+-}10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest Tl-201/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heat failure and unstable angina) were surveyed through perioperative periods (14.6{+-}5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.

  18. The Preoperative Evaluation of Infective Endocarditis via 3-Dimensional Transesophageal Echocardiography.

    Science.gov (United States)

    Yong, Matthew S; Saxena, Pankaj; Killu, Ammar M; Coffey, Sean; Burkhart, Harold M; Wan, Siu-Hin; Malouf, Joseph F

    2015-08-01

    Transesophageal echocardiography continues to have a central role in the diagnosis of infective endocarditis and its sequelae. Recent technological advances offer the option of 3-dimensional imaging in the evaluation of patients with infective endocarditis. We present an illustrative case and review the literature regarding the potential advantages and limitations of 3-dimensional transesophageal echocardiography in the diagnosis of complicated infective endocarditis. A 51-year-old man, an intravenous drug user who had undergone bioprosthetic aortic valve replacement 5 months earlier, presented with prosthetic valve endocarditis. Preoperative transesophageal echocardiography with 3D rendition revealed a large abscess involving the mitral aortic intervalvular fibrosa, together with a mycotic aneurysm that had ruptured into the left atrium, resulting in a left ventricle-to-left atrium fistula. Three-dimensional transesophageal echocardiography enabled superior preoperative anatomic delineation and surgical planning. We conclude that 3-dimensional transesophageal echocardiography can be a useful adjunct to traditional 2-dimensional transesophageal echocardiography as a tool in the diagnosis of infective endocarditis.

  19. Preoperative Evaluation with fMRI of Patients with Intracranial Gliomas

    Directory of Open Access Journals (Sweden)

    Ioannis Z. Kapsalakis

    2012-01-01

    Full Text Available Introduction. Aggressive surgical resection constitutes the optimal treatment for intracranial gliomas. However, the proximity of a tumor to eloquent areas requires exact knowledge of its anatomic relationships to functional cortex. The purpose of our study was to evaluate fMRI’s accuracy by comparing it to intraoperative cortical stimulation (DCS mapping. Material and Methods. Eighty-seven patients, with presumed glioma diagnosis, underwent preoperative fMRI and intraoperative DCS for cortical mapping during tumor resection. Findings of fMRI and DCS were considered concordant if the identified cortical centers were less than 5 mm apart. Pre and postoperative Karnofsky Performance Scale and Spitzer scores were recorded. A postoperative MRI was obtained for assessing the extent of resection. Results. The areas of interest were identified by fMRI and DCS in all participants. The concordance between fMRI and DCS was 91.9% regarding sensory-motor cortex, 100% for visual cortex, and 85.4% for language. Data analysis showed that patients with better functional condition demonstrated higher concordance rates, while there also was a weak association between tumor grade and concordance rate. The mean extent of tumor resection was 96.7%. Conclusions. Functional MRI is a highly accurate preoperative methodology for sensory-motor mapping. However, in language mapping, DCS remains necessary for accurate localization.

  20. Psoriatic Arthritis in Psoriasis Patients: Evaluation of Clinical and Radiological Features

    Directory of Open Access Journals (Sweden)

    Hatice Reşorlu

    2016-08-01

    Full Text Available Objective: The purpose of this study was to perform radiological and clinical determination of the presence of psoriatic arthritis (PsA in patients with psoriasis and to evaluate associations with clinical findings. Materials and Methods: The medical files of 72 patients with psoriasis presenting to our clinic between years 2009-2014 with a pre-diagnosis of PsA were reviewed retrospectively. Hand, foot and sacroiliac joint radiograms were evaluated by a radiologist who was blinded to the patient’s clinical status and who is experienced on musculoskeletal radiology. Patients with psoriasis were divided into two groups according to the presence of arthritis which was determined based on radiographic findings or on Classification Criteria for Psoriatic Arthritis (CASPAR criteria. All patients’ demographic characteristics, length of disease, nail involvement, smoking-alcohol consumption were recorded. Results: The mean age of all patients was 47.24±14.61 years, and the mean duration of disease was 14.13±11.92 years. Smoking and alcohol consumptions were determined in 54.2% (n=39 and 23.6% (n=17 of the cases, respectively. Nail involvement was determined in 56.9% (n=41 of the cases. PsA was determined based on radiological findings in 58.3% (n=42 of the patients. The mean age and age at onset of disease were higher in PsA (+ patients than in radiologically non-PsA subjects. Based on clinical findings, PsA based on CASPAR criteria was determined in only 18.1% (n=13 of all patients. Conclusion: A higher level of PsA was determined using radiological evaluation in this study. The main cause of this condition is the existence of asymptomatic-subclinical patients. A detailed medical history should therefore be taken from patients, and good clinical evaluation is very important. Radiological and clinical evaluation should be performed together in the diagnosis.

  1. Evaluation of use of e-Learning in undergraduate radiology education: A review

    Energy Technology Data Exchange (ETDEWEB)

    Zafar, Saad, E-mail: saad.zafar@riphah.edu.pk [Riphah International University, Islamabad (Pakistan); Safdar, Saima, E-mail: saima.safdar@riphah.edu.pk [Riphah International University, Islamabad (Pakistan); Zafar, Aasma N., E-mail: aasmarad@gmail.com [Radiology Department, Senior Registrar Shifa College of Medicine and Assistant Consultant Shifa International Hospital, Islamabad (Pakistan)

    2014-12-15

    Highlights: • We have systematically reviewed the literature on use of e-Learning in Radiology at the undergraduate level. • Kirkpatrick's Learning Model is used to evaluate the learning outcomes of the reported studies. • There is an increase in positive response for learning management systems used in blended learning environments. • There are wide range of technologies being used for e-Learning including use of audio response system and customized PAC solutions. • There is a clear trend toward highly interactive, self directed learning environment to support the concept of life long independent learners. - Abstract: Purpose: The aim of this review is to investigate the evaluative outcomes present in the literature according to Kirkpatrick's learning model and to examine the nature and characteristics of the e-Learning interventions in radiology education at undergraduate level. Materials and methods: Four databases (PubMed, MEDLINE, Embase, Eric) are searched for publications related to the application of e-Learning in undergraduate radiology education. The search strategy is a combination of e-Learning and Mesh and non Mesh radiology and undergraduate related terms. These search strategies are established in relation to experts of respective domains. The full text of thirty pertinent articles is reviewed. Author's country and study location data is extracted to identify the most active regions and year's are extracted to know the existing trend. Data regarding radiology subfields and undergraduate year of radiology education is extracted along with e-Learning technologies to identify the most prevalent or suitable technologies or tools with respect to radiology contents. Kirkpatricks learning evaluation model is used to categorize the evaluative outcomes reported in the identified studies. Results: The results of this analysis reveal emergence of highly interactive games, audience response systems and designing of wide range of

  2. The Usefulness of the Preoperative Magnetic Resonance Imaging Findings in the Evaluation of Tarsal Tunnel Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyun Jin; Lee, Sheen Woo; Jeong, Yu Mi; Choi, Hye Young; Kim, Hyung Sik [Dept. of Radiology, Gil Hospital, Gacheon University College of Medicine, Incheon (Korea, Republic of); Park, Hong Gi; Kwak, Ji Hoon [Dept. of Orthopedic Surgery, Gil Hospital, Gacheon University College of Medicine, Incheon (Korea, Republic of)

    2012-02-15

    The purpose of this study was to access the diverse conditions that lead to the clinical manifestations of tarsal tunnel syndrome and evaluate the usefulness of magnetic resonance imaging (MRI) in preoperative evaluation. Thirty-three patients who underwent ankle MRI and surgery under the impression of tarsal tunnel syndrome were retrospectively analyzed. The findings on ankle MRI were categorized into space occupying lesions within the tarsal tunnel, space occupying lesions of the tunnel wall, and non-space occupying lesions. Associated plantar muscle atrophy was also evaluated. Medical records were reviewed for correlation of nerve conduction velocity (NCV) and surgical findings. There were 21 space occupying lesions of the tarsal tunnel, and eight lesions of tarsal tunnel wall. There were three cases with accessory muscle, three with tarsal coalition, five with ganglion cysts, one neurogenic tumor, five flexor retinaculum hypertrophy, three varicose veins, and nine with tenosynovitis of the posterior tibialis, flexor digitorum longus, or flexor hallucis longus tendon. One patient was found to have a deltoid ligament sprain. Of the 32, eight patients experienced fatty atrophic change within any one of the foot muscles. NCV was positive in 79% of the MRI-positive lesions. MRI provides detailed information on ankle anatomy, which includes that of tarsal tunnel and beyond. Pathologic conditions that cause or mimic tarsal tunnel syndrome are well demonstrated. MRI can enhance surgical planning by indicating the extent of decompression required, and help with further patient management. Patients with tarsal tunnel syndrome can greatly benefit from preoperative MRI. However, it should be noted that not all cases with tarsal tunnel syndrome have MRI-demonstrable causes.

  3. Interim radiological safety standards and evaluation procedures for subseabed high-level waste disposal

    Energy Technology Data Exchange (ETDEWEB)

    Klett, R.D.

    1997-06-01

    The Seabed Disposal Project (SDP) was evaluating the technical feasibility of high-level nuclear waste disposal in deep ocean sediments. Working standards were needed for risk assessments, evaluation of alternative designs, sensitivity studies, and conceptual design guidelines. This report completes a three part program to develop radiological standards for the feasibility phase of the SDP. The characteristics of subseabed disposal and how they affect the selection of standards are discussed. General radiological protection standards are reviewed, along with some new methods, and a systematic approach to developing standards is presented. The selected interim radiological standards for the SDP and the reasons for their selection are given. These standards have no legal or regulatory status and will be replaced or modified by regulatory agencies if subseabed disposal is implemented. 56 refs., 29 figs., 15 tabs.

  4. Radiological evaluation of multiple progressive intracranial arterial occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Whan; Choi, Byung Ihn; Ha, Sung Whan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1980-12-15

    Multiple Progressive intracranial Arterial Occlusion (MPIAO) is a rare cerebrovascular disease and its clinical diagnosis is nearly impossible and diagnosis depends upon neuroradiological studies. Among neuroradiological studies, cerebral angiography is mandatory in diagnosis and in localization of stenotic or occlusive vascular lesion, visualization of collateral channels and aid the surgical management. Five cases MPIAO which were proved by cerebral angiography at Capital Armed Forces General Hospital during last 5 years are presented, with analysis of radiological findings as well as clinical assessment. The results are as follows; 1. Age distribution ranges from 23 to 46. For cases are male and one female. 2. Cardinal clinical symptoms are headache and vomiting, and neurological manifestations are hemiplegia and speech disturbance. 3. All cases show the characteristic angiographic findings of MPIAO which are occlusion or stenosis at the distal internal carotid artery, proximal part of anterior and middle cerebral arteries with fine collateral network in basal ganglia area, leptomeningeal anastomosis and transdural external-internal carotid anastomoses. The major region of occlusion or stenosis is first portion of anterior and middle cerebral arteries. In one case, the lesion is seen in cervical portion of internal carotid artery. There is no evidence of occlusion or stenosis in vertebral angiogram. 4. In 2 cases, computed tomography was done. One case shows the findings of cerebral infarction and the other intracerebral hematoma.

  5. Using 3 Tesla magnetic resonance imaging in the pre-operative evaluation of tongue carcinoma.

    Science.gov (United States)

    Moreno, K F; Cornelius, R S; Lucas, F V; Meinzen-Derr, J; Patil, Y J

    2017-09-01

    This study aimed to evaluate the role of 3 Tesla magnetic resonance imaging in predicting tongue tumour thickness via direct and reconstructed measures, and their correlations with corresponding histological measures, nodal metastasis and extracapsular spread. A prospective study was conducted of 25 patients with histologically proven squamous cell carcinoma of the tongue and pre-operative 3 Tesla magnetic resonance imaging from 2009 to 2012. Correlations between 3 Tesla magnetic resonance imaging and histological measures of tongue tumour thickness were assessed using the Pearson correlation coefficient: r values were 0.84 (p Tesla magnetic resonance imaging had 83 per cent sensitivity, 82 per cent specificity, 82 per cent accuracy and a 90 per cent negative predictive value for detecting cervical lymph node metastasis. In this cohort, 3 Tesla magnetic resonance imaging measures of tumour thickness correlated highly with the corresponding histological measures. Further, 3 Tesla magnetic resonance imaging was an effective method of detecting malignant adenopathy with extracapsular spread.

  6. Role of multislice CT and magnetic resonance cholangiography in preoperative evaluation of potential donor in living related liver transplantation

    Directory of Open Access Journals (Sweden)

    Hossam M. Abdel-Rahman

    2016-03-01

    Conclusion: Multislice CT is a valuable tool in the evaluation of potential living liver donors that provides complete information on the hepatic vascular anatomy, the liver parenchyma, and volumetric measurements. MRC with a 3.0-T MR system demonstrates the preoperative biliary evaluation very well with a high accuracy rate.

  7. CLINICAL EVALUATION OF EFFECTIVENESS OF ITRACONAZOLE IN PREOPERATIVE AND REFRACTORY POSTOPERATIVE PATIENTS OF ALLERGIC FUNGAL SINUSITIS

    Directory of Open Access Journals (Sweden)

    Ch. Venkatasubbaiah

    2016-07-01

    Full Text Available BACKGROUND Allergic Fungal Sinusitis (AFS is a noninvasive type of fungal sinusitis, clinically and pathologically a unique entity of chronic rhinosinusitis. The aetiology, pathogenesis, and treatment of AFS are subject to controversy. In spite of aggressive endoscopic surgery, pre- and postoperative steroids and immunotherapy recurrence rates are high. Many additions are made to its original description and management since its early description in 1980. The aim of the present paper was to evaluate clinically. The response to high-dose itraconazole before endoscopic sinus surgery and in refractory postoperative patients. Related literature was reviewed in the light of the present study. MATERIALS AND METHODS A 2 year prospective study conducted on 68 AFS patients divided into two groups to clinically evaluate the results after using oral itraconazole preoperatively in one group and in refractory postoperative period in another. RESULTS The mean age of patients with typical AFS was 36±3.9 years. Patients with AFS with an average follow up of 21 months were included. Recurrence was 6/34 (17.64% in itraconazole group and revision FESS done in 3/34 (08.82%. Recurrence in patients without itraconazole was 16/34 (47.05% and refractory to conventional treatment, but responded to itraconazole in 14/16 (87.50%. Revision surgery required in 2/16 (12.50% after starting oral itraconazole. No side effects or reactions were observed in a total of 7920 doses administered. CONCLUSION Itraconazole is well tolerated by patients and effective in shrinking the polyposis preoperatively with low recurrence. Postoperative refractory AFS is amenable in (87.50% of patients avoiding repeat FESS. Overall, low recurrence rate and minimizing revision surgery when compared to patients treated without itraconazole was evident in the study.

  8. Clinical and radiological evaluation of hybrid hip replacement in various disorders of hip

    Directory of Open Access Journals (Sweden)

    Dhaon B

    2005-01-01

    Full Text Available Background: High rates of loosening of cemented implants led to change in technique of fixation of the implant. Methods: Fifty-nine hips were operated in 42 patients with non-cemented acetabular and cemented femoral components between January 1999 and July 2003. The average age of the patient was 45.2 years in our study. Preoperative diagnosis was avascular necrosis (28, ankylosing spondylitis (18, fracture neck femur (9, rheumatoid arthritis (2 and osteoarthritis (2. Results: At an average follow up of 3.6 years (range 1.2-5.8 years excellent to good results were obtained 92% according to Harris hip criteria. No radiological loosening was noted in any femoral or acetabular component on follow up. One poor result was seen in a case of bilateral ankylosing spondylitis operated on one side. Conclusion: Hybrid THA provides a viable and highly acceptable method of treatment of diseases of hip in young patients.

  9. Radiological evaluation of intestinal obstruction in neonate and infant

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, D. S.; Lim, K. Y.; Kim, S. J.; Kim, J. D.; Rhee, H. S. [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1980-12-15

    281 cases of neonatal and infantile intestinal obstruction confirmed by clinical and surgical procedure from 1975 till 1979 were reviewed radiologically. The result was as follows; 1. Intussusception was the most common cause of intestinal obstruction under one year of age (173/281: 61.56%), and other causes of descending order were infantile hypertrophic pyloric stenosis (20: 7.11%), congenital megacolon (19: 6.76%), anorectal malformation (17: 6.05%), meconium plug syndrome (17: 6.05%), hernia (12: 4.27%), band adhesion (8: 2.85%), rotation anomaly (5: 1.78%), small bowel atresia (3: 1.07%), Meckel's diverticulum (3: 1.07%), duodenal atresia (2: 0.71%), meconium ileus (1: 0.36%) and annular pancreas (1: 0.36%). Congenital type of intestinal obstruction (we classified intussusception acquired and others congenital) occupied 38.44%. 2. The ratio of male to female was 3: 1, congenital type 4.69 : 1 and acquired 2.39 : 1. 3. Vomiting, bloody stool, fever and abdominal distention were the most 4 symptoms. 4. The frequency of typical mechanical ileus pattern on plain abdomen films was 226 cases(80.43%) paralytic ileus or normal finding was 52 cases (18.51%) and pneumoperitoneum with ileus sign was 3 cases (1.06%). 5. Barium meal or enema was performed in 228 cases and narrowing or obstructed site was found in 213 cases of them (93.42%); intussusception 100% (173/173), infantile hypertrophic pyloric stenosis 93.33% (14/15) and congenital megacolon 82.35% (14/17). 6. Only 10 cases had associated disease such as Mongolism, thoracic kyphosis and scoliosis, microcolon, prematurity, ileocolic fistula, undescended testicle and hydrocele. 7. Meconium plug syndrome, duodenal atresia, small bowel atresia, mecondium ileus and annular pancreas were developed early after birth with average onset age of 3.6 days.

  10. Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography.

    Science.gov (United States)

    Ciolina, F; Sedati, P; Zaccagna, F; Galea, N; Noce, V; Miraldi, F; Cavarretta, E; Francone, M; Carbone, I

    2015-10-01

    In patients affected by aortic valve stenosis (AS) it is mandatory to rule out coronary artery disease (CAD). The role of retrospectively ECG-gated 64-slice CT angiography (64-SCTA) was assessed in patients with AS referred for surgical valve replacement. Forty-two patients with AS underwent ECG-gated 64-SCTA of thoracic aorta, including the heart and coronary arteries, before surgical valve replacement. Images were evaluated by two independent readers and compared with surgical findings in terms of aortic valve calcification grading, valvular morphology, aortic valve annulus and sino-tubular junction diameters, and valvular area planimetry. Quantitative evaluation of cusps opening was also performed. Finally, the presence of CAD, thoracic aortic aneurysm and left ventricle hypertrophy were assessed. Visualization of the aortic valve without motion artefacts was possible in 38 patients (90.5%). Valvular morphology was correctly assessed in all cases (100%). 64-SCTA correctly determined aortic valve calcification grading and the aortic valve annulus and sinotubular junction diameters in 100% of cases. The aortic valve planimetric area was assessed in 38 cases (90.5%). Ascending aortic aneurysms requiring surgical replacement were detected in 12 patients (28.6%). Significant left ventricle hypertrophy was found in 30 patients (71%). Preoperative evaluation of patients undergoing surgical replacement for AS with 64-SCTA is feasible. 64-SCTA can rule out CAD and evaluate the status of the aortic valve and thoracic aorta in the same examination, obtaining relevant information for surgical planning.

  11. Effects of the platelet rich plasma on apexogenesis in young monkeys: Radiological and hystologycal evaluation

    Directory of Open Access Journals (Sweden)

    Petrović Vanja

    2012-01-01

    Full Text Available Platelet-reach plasma (PRP is an attractive tool in regenerative medicine due to its ability to stimulate proliferation and differentiation of stem cells. Since dental pulp derived stem cells are recognized as central in apexogenesis, the aim of the study was to evaluate radiologically and histologically effects of PRP on apexogenesis in teeth with immature roots. The study included eight monkeys (Cercopithecus Aethiops divided in two equal groups for evaluation 3 and 12 months after treatment. All participants obtained the same treatment including pulpotomy and after-treatment with: hydroxiapatite (HA-incisor and HA+canine PRP. Radiological evaluation was performed using the long cone paralleling technique for recording of defined parameters and histological evaluation was performed using tissue removed en block for the observation of parameters related to apexogenesis. The results obtained radiologically and histologically have shown increase in bridge formation in HA+PRP (75% group after 3 months comparing to HA group (50%. Contrary to that, after 12 months there were no significant differences between groups. The root delay was not registered in the HA+PRP group contrary to HA group where it was registered in 25% after 12 months. Results of the study suggest that PRP is a powerful tool for intensive and rapid apexogenesis since it offers clear and comprehensive results (mostly in the first three months which are early radiologically visible without any failure in the proposed requests.

  12. Radiological evaluation of long term complications of oral rehabilitations of thin ridges with titanium blade implants

    Directory of Open Access Journals (Sweden)

    P. Diotallevi

    2014-03-01

    Full Text Available Aim: The aim of this study was to assess the sensitivity of orthopantomography (OPT in the diagnosis of long term complications in oral rehabilitations with blade implants. Materials and methods A total of 235 blade implants in 189 patients, inserted between 1988 and 2003, were retrospectively analyzed. The records consisted of a first OPT taken between January and December 2010, and a second one 12 months after. The evaluation of implant health considered: integrity of the blade, normal radiological representation of the bone around the implant, dense and cortical appearance of bone around the implant collar. The evaluation of radiological complications considered: implant fracture, bone resorption around the implant, recession of the bone around the implant collar. Results The sensitivity of the panoramic evaluation was equal to 100%. The complications detected were 5 cases of periimplantitis, 9 cases of bone pericervical bone recession and 3 cases of fracture of the implant body. In cases of pericervical bone resorption the following radiological check up 12 months after the first one showed the progression of the disease in 6 out of 9 cases, with irreversible implant failure. In subjects with a radiological pattern of implant health there were no complications in the subsequent check up after 12 months. In the subjects with complications the specificity was equal to 100%. Conclusion The radiographic evaluation by the means of OPT has shown high sensitivity in the diagnosis of long term complications of oral rehabilitations with blade implants and allows prompt therapeutic interventions. Radiological complications appeared mostly in the long term check ups and mainly consisted in recession of the bone around the neck or around the entire implant. More rarely implant fractures occurred, which, in the case of blades, sometimes were not associated with any clinical symptoms: therefore, postsurgical evaluation should not be separated from

  13. Role of contrast-enhanced MR venography in the preoperative evaluation of parasagittal meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Bozzao, Alessandro; Finocchi, Vanina; Romano, Andrea; Ferrante, Michele; Fasoli, Fabrizio; Fantozzi, Luigi Maria [S. Andrea Hospital, Neuroradiological Section, Rome (Italy); Trillo, Giuseppe; Ferrante, Luigi [S. Andrea Hospital, Neurosurgical Section, Rome (Italy)

    2005-09-01

    Parasagittal meningiomas (PSM) may pose a difficult surgical challenge since venous patency and collateral anastomoses have to be clearly defined for correct surgical planning. The aim of this study was to assess the diagnostic value of contrast-enhanced (CE) magnetic resonance venography (MRV) in the preoperative evaluation of venous infiltration and collateral venous anastomoses in patients with PSM. CE-MRV was compared with phase-contrast (PC) magnetic resonance (MR) angiography, conventional angiography (when available), and surgery as a reference. Twenty-three patients undergoing surgery for meningiomas located adjacent to the superior sagittal sinus were prospectively evaluated. All the patients underwent both conventional MR examination and MRV. This was performed by means of PC and CE techniques. Both sets of angiograms (CE and PC) were evaluated by two expert neuroradiologists to assess (1) patency of the sinus (patent/occluded), (2) the extent of occlusion (in centimeters), and (3) the number of collateral anastomoses close to the insertion of the meningioma. Eight patients underwent digital subtraction angiography (DSA). All patients were operated on, and intraoperative findings were taken as the gold standard to evaluate the diagnostic value of MRA techniques. PC-MRV showed a flow void inside the sinus compatible with its occlusion in 15 cases, whereas CE-MRV showed the sinus to be occluded in five cases. CE-MRV data were confirmed by surgery, showing five patients to have an occlusion of the superior sagittal sinus. The PC-MRV sensitivity was thus 100% with a specificity of 50%. In those cases in which both MRV techniques documented occlusion of the sinus, the extent of occlusion was overestimated by PC compared with CE and surgery. CE-MRV depicted 87% of collateral venous anastomoses close to the meningioma as subsequently confirmed by surgery, while PC showed 58%. In the preoperative planning for patients with meningiomas located close to a venous

  14. Design and validation of an oral health questionnaire for preoperative anaesthetic evaluation

    Directory of Open Access Journals (Sweden)

    Gema Ruíz-López del Prado

    Full Text Available Abstract Background and objectives: Dental injuries incurred during endotracheal intubation are more frequent in patients with previous oral pathology. The study objectives were to develop an oral health questionnaire for preanaesthesia evaluation, easy to apply for personnel without special dental training; and establish a cut-off value for detecting persons with poor oral health. Methods: Validation study of a self-administered questionnaire, designed according to a literature review and an expert group's recommendations. The questionnaire was applied to a sample of patients evaluated in a preanaesthesia consultation. Rasch analysis of the questionnaire psychometric properties included viability, acceptability, content validity and reliability of the scale. Results: The sample included 115 individuals, 50.4% of men, with a median age of 58 years (range: 38-71. The final analysis of 11 items presented a Person Separation Index of 0.861 and good adjustment of data to the Rasch model. The scale was unidimensional and its items were not biased by sex, age or nationality. The oral health linear measure presented good construct validity. The cut-off value was set at 52 points. Conclusions: The questionnaire showed sufficient psychometric properties to be considered a reliable tool, valid for measuring the state of oral health in preoperative anaesthetic evaluations.

  15. How accurate is preoperative evaluation of pelvic organ prolapse in women undergoing vaginal reconstruction surgery?

    Directory of Open Access Journals (Sweden)

    Haim Krissi

    Full Text Available OBJECTIVE: To evaluate the differences between the in-office and intraoperative techniques used to evaluate pelvic organ prolapse. MATERIALS AND METHODS: A prospective study included 25 women undergoing vaginal reconstruction surgery including vaginal hysterectomy for pelvic organ prolapse. The outpatient pelvic and site-specific vaginal examination was performed in the lithotomy position with the Valsalva maneuver. Repeated intraoperative examination was performed under general anesthesia with standard mild cervical traction. The Pelvic Organ Prolapse Quantification system (POPQ was used for both measurements and staging. The values found under the two conditions were compared. RESULTS: The intraoperative POPQ-measurements values were significantly higher than the outpatient values for apical wall prolapse in 17/25 (68% women and for anterior wall prolapse in 8/25 (32% women. There was not a significant difference in the posterior wall where increase in staging was shown in 3/25 (12% patients. CONCLUSIONS: Clinicians and patients should be alert to the possibility that pelvic organ measurements performed under general anesthesia with mild traction may be different from preoperative evaluation.

  16. [Design and validation of an oral health questionnaire for preoperative anaesthetic evaluation].

    Science.gov (United States)

    Ruíz-López Del Prado, Gema; Blaya-Nováková, Vendula; Saz-Parkinson, Zuleika; Álvarez-Montero, Óscar Luis; Ayala, Alba; Muñoz-Moreno, Maria Fe; Forjaz, Maria João

    Dental injuries incurred during endotracheal intubation are more frequent in patients with previous oral pathology. The study objectives were to develop an oral health questionnaire for preanaesthesia evaluation, easy to apply for personnel without special dental training; and establish a cut-off value for detecting persons with poor oral health. Validation study of a self-administered questionnaire, designed according to a literature review and an expert group's recommendations. The questionnaire was applied to a sample of patients evaluated in a preanaesthesia consultation. Rasch analysis of the questionnaire psychometric properties included viability, acceptability, content validity and reliability of the scale. The sample included 115 individuals, 50.4% of men, with a median age of 58 years (range: 38-71). The final analysis of 11 items presented a Person Separation Index of 0.861 and good adjustment of data to the Rasch model. The scale was unidimensional and its items were not biased by sex, age or nationality. The oral health linear measure presented good construct validity. The cut-off value was set at 52 points. The questionnaire showed sufficient psychometric properties to be considered a reliable tool, valid for measuring the state of oral health in preoperative anaesthetic evaluations. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  17. Design and validation of an oral health questionnaire for preoperative anaesthetic evaluation.

    Science.gov (United States)

    Ruíz-López Del Prado, Gema; Blaya-Nováková, Vendula; Saz-Parkinson, Zuleika; Álvarez-Montero, Óscar Luis; Ayala, Alba; Muñoz-Moreno, Maria Fe; Forjaz, Maria João

    Dental injuries incurred during endotracheal intubation are more frequent in patients with previous oral pathology. The study objectives were to develop an oral health questionnaire for preanaesthesia evaluation, easy to apply for personnel without special dental training; and establish a cut-off value for detecting persons with poor oral health. Validation study of a self-administered questionnaire, designed according to a literature review and an expert group's recommendations. The questionnaire was applied to a sample of patients evaluated in a preanaesthesia consultation. Rasch analysis of the questionnaire psychometric properties included viability, acceptability, content validity and reliability of the scale. The sample included 115 individuals, 50.4% of men, with a median age of 58 years (range: 38-71). The final analysis of 11 items presented a Person Separation Index of 0.861 and good adjustment of data to the Rasch model. The scale was unidimensional and its items were not biased by sex, age or nationality. The oral health linear measure presented good construct validity. The cut-off value was set at 52 points. The questionnaire showed sufficient psychometric properties to be considered a reliable tool, valid for measuring the state of oral health in preoperative anaesthetic evaluations. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  18. Evaluation of the response to preoperative chemotherapy with PET image in osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Dae Geun

    2001-01-01

    F18 FDG PET scan has an advantage in evaluating the biologic status of the tumors. The purpose of this study is evaluate the role of PET scan in pre- and postchemotherapeutic osteosarcomas and correlate the findings with pathologic examination. 18 cases of osteosarcomas had biopsy and preoperative chemotherapy at our department. All case had initial MRI and PET scan and those were repeated after 2 cycles of chemotherapy. Under PET image parameters such as VOI(volume of interest), total activity(SUV), ratio of pre- and postchemotherapy SUV, T/N(tumor/normal tissue) ratio were analyzed. There was a significant correlation between the calculated necrosis in PET and observed one on pathologic specimen(r2=0.78, P<0.05). Cross correlation among identified variables revealed meaningful result between SUV2/SUV1 ratio and tumor necrosis(r2=0.57, P=0.025). As the SUV2/SUV1 decrease, so much more the tumor necrosis was. F18 FDG PET scan could get objective data such as volume, degree of necrosis and total activity and was also useful in estimating the contribution of chemotherapy in tumor necrosis over the innate necrosis before treatment.

  19. Preoperative evaluation of patients submitted to pneumonectomy for lung carcinoma: role of exercise testing.

    Science.gov (United States)

    Villani, Fabrizio; Busia, Alessandra

    2004-01-01

    The aim of the present investigation was to evaluate which parameters of preoperative spirometry, arterial blood gas, radionuclide lung scanning and cardiopulmonary exercise test are the best predictor of postoperative morbidity and mortality in patients submitted to pneumonectomy. The study was conducted in 150 patients (mean age, 57.1). Forty-four patients (29.3%) had postoperative complications. Four patients (2.7%) died within one month of the pneumonectomy. Patients with complications had significantly lower ppoFEV1 as percentage of predicted and lower VO2 max, and those who died also had a significant decrease in PaO2 during exercise. Moreover, among patients with obstructive pulmonary disease (FEV1VO2 max in complicated patients. The present data support the suggestion that exercise testing could be a useful adjunct in the evaluation of postoperative risk for pneumonectomy, especially in patients with obstructive pulmonary disease. In particular, patients with VO2 max <50% of predicted should be considered at high risk of morbidity from cardiopulmonary causes.

  20. EEG, MRI, and SPECT in epilepsy. Relative contributions to preoperative evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Gaku [Luoyang Medical Coll. Associated Hospital (China); Hoshida, Tohru; Goda, Kazuo; Hashimoto, Hiroshi; Nakase, Hiroyuki; Hirabayashi, Hidehiro; Kawaguchi, Shoichiro; Morimoto, Tetsuya; Sakaki, Toshisuke

    1998-07-01

    We comparatively assessed detection of epileptogenic areas on preoperative evaluation in 33 patients with intractable partial epilepsy using scalp interictal and ictal electroencephalography (EEG), magnetic resonance imaging (MRI), and interictal single photon emission computed tomography (SPECT). There are 22 temporal and 11 extratemporal lobe epilepsies. All or almost of their seizures have stopped after resective surgery for more than 12 months follow-up period, averaged 43 months. MRI studies demonstrated 21 organic lesions, 11 mesial temporal sclerosis and one patient showed normal brain tissue. Scalp EEG could correctly identify the focus in 14 of 33 cases (42%), interictal SPECT in 18 of 26 (69%), MRI in 29 of 33 (88%), interictal scalp EEG-video monitoring in 17 of 24 (71%), and ictal scalp EEG-video monitoring in 15 of 22 (68%). Although neuroimaging studies, especially MRI, are useful to detect not only localization of epileptic lesions but also epileptogenic focus, for example, mesial temporal sclerosis, the exact localization of epileptogenic areas could be done by comprehensive evaluation including ictal scalp EEG-video monitoring. (author)

  1. [Evaluation of the Internet presence of diagnostic radiology units at German universities].

    Science.gov (United States)

    Seitz, J; Siegmund, M; Völk, M; Feuerbach, S; Strotzer, M

    2002-09-01

    Analyzing the availability and the contents of the internet homepages of the radiological departments of German universities. In June and July 2001 the internet homepages of 36 radiological departments of German universities were evaluated in a study. A medical student experienced in using the world wide web examined the websites concerning the following criteria: research, teaching, informations for patients, clinical topics and general information. Additionally an evaluation of the technical standard of the presentation was performed. 31 of the 36 radiological departments presented a homepage in the world wide web. The subject research was presented by 29 institutes. Also 29 departments provided information concerning teaching in their presentations. In 24 cases informations especially for patients were given. In all topics there is a huge variety of the quality and quantity of the provided information throughout the different institutions. 21 homepages available without restriction during the study period; 3 were nearly completely under construction. Multimedia techniques were only used in 2 homepages. The structural hierarchy of the webpages was in the average only two or three levels. Only 6 providers presented an additional version of their homepage in english. In the moment the possibility of internet-presentation is sub-optimal used by the responsible persons of the radiological institutions. The main emphasis is on research and teaching. There is nearly no use of multimedial elements in the presentations. Only a minority of the homepages can be read by international viewers because of the lack of an english version of the pages.

  2. Evaluation of Personal Shields Used in Selected Radiology Departments

    Directory of Open Access Journals (Sweden)

    Mohsen Salmanvandi

    2015-05-01

    Full Text Available Introduction The purpose of this study was to evaluate personal shields in radiation departments of hospitals affiliated to Mashhad University of Medical Sciences. Materials and Methods First, the information related to 109 personal shields was recorded and evaluated by imaging equipment. Afterwards, the equivalent lead thickness (ELT of 62 personal shields was assessed, using dosimeter and standard lead layers at 100 kVp. Results In this study, 109 personal shields were assessed in terms of tears, holes and cracks. The results showed that 18 shields were damaged. Moreover, ELT was evaluated in 62 shields. As the results indicated, ELT was unacceptable in 8 personal shields and lower than expected in 9 shields. Conclusion According to the results, 16.5% of personal shields had defects (tears, holes and cracks and 13% of them were unacceptable in terms of ELT and needed to be replaced. Therefore, regular quality control of personal shields and evaluation of new shields are necessary at any radiation department.

  3. Evaluation of radiology as a tool to diagnose pulmonic lesions in calves, for example prior to experimental infection studies

    DEFF Research Database (Denmark)

    Tegtmeier, Conny; Arnbjerg, J.

    2000-01-01

    The aim of the study was to evaluate radiology as a technique to visualize pulmonary lesions in young calves, e.g. as a selection criterion for research animals in order to eliminate animals with lung lesions Drier to experimental studies of pneumonia. Five calves with acute clinical signs...... of pneumonia were included in a direct comparative study of radiological and post mortem findings. Also, a number of animals with no signs of pneumonia were included as controls. The study revealed good agreement between the radiological and post mortem findings. Thus, in conclusion, radiology should...

  4. Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery

    Science.gov (United States)

    Costa, Jean Allan; Almeida, Maria Lucia Pereira; Estrada, Tereza Cristina Duque; Werneck, Guilherme Lobosco; Rocha, Alexandre Marins; Rosa, Maria Luiza Garcia; Ribeiro, Mario Luiz; Mesquita, Claudio Tinoco

    2016-01-01

    Background The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries. Objectives To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk. Methods A total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study. Assessment of patients was conducted by conventional echocardiogram using the ultraportable V Scan (GE) device right after the pre-anesthetic clinical evaluation. We assessed the clinical impact of echocardiography results by using a questionnaire addressed to the anesthetist. Results Mean age of patients was 68.9 ± 7.0 years, 154 were women. The most frequent surgeries were: a) facectomy - cataract - 18; b) inguinal hernia surgery - 18; c) Cholecystectomy - 16. We found 58 normal tests (27.5%), 70 (33.2%) with mild valve reflux, and 83 (39.3%) with relevant abnormality, such as increase in heart chamber size, global and/or segmental contractile dysfunction, significant valve dysfunction or other unspecified. Test results caused delay of surgical procedure for a more detailed cardiac evaluation in 20 (9.5%) patients, and change in anesthetic management in 7 (3.3%). Conclusion There was a considerable clinical impact with the use of the ultraportable echocardiography, since one out of every ten patients evaluated had their clinical management changed due to the detection of previously unsuspected, significant heart diseases, with the potential for severe complications. PMID:27982268

  5. Usability evaluation of Laboratory and Radiology Information Systems integrated into a hospital information system.

    Science.gov (United States)

    Nabovati, Ehsan; Vakili-Arki, Hasan; Eslami, Saeid; Khajouei, Reza

    2014-04-01

    This study was conducted to evaluate the usability of widely used laboratory and radiology information systems. Three usability experts independently evaluated the user interfaces of Laboratory and Radiology Information Systems using heuristic evaluation method. They applied Nielsen's heuristics to identify and classify usability problems and Nielsen's severity rating to judge their severity. Overall, 116 unique heuristic violations were identified as usability problems. In terms of severity, 67 % of problems were rated as major and catastrophic. Among 10 heuristics, "consistency and standards" was violated most frequently. Moreover, mean severity of problems concerning "error prevention" and "help and documentation" heuristics was higher than of the others. Despite widespread use of specific healthcare information systems, they suffer from usability problems. Improving the usability of systems by following existing design standards and principles from the early phased of system development life cycle is recommended. Especially, it is recommended that the designers design systems that inhibit the initiation of erroneous actions and provide sufficient guidance to users.

  6. Evaluation of radiological dispersion/consequence codes supporting DOE nuclear facility SARs

    Energy Technology Data Exchange (ETDEWEB)

    O`Kula, K.R.; Paik, I.K. [Westinghouse Savannah River Site, Aiken, SC (United States); Chung, D.Y. [Dept. of Energy, Germantown, MD (United States)

    1996-12-31

    Since the early 1990s, the authorization basis documentation of many U.S. Department of Energy (DOE) nuclear facilities has been upgraded to comply with DOE orders and standards. In this process, many safety analyses have been revised. Unfortunately, there has been nonuniform application of software, and the most appropriate computer and engineering methodologies often are not applied. A DOE Accident Phenomenology and Consequence (APAC) Methodology Evaluation Program was originated at the request of DOE Defense Programs to evaluate the safety analysis methodologies used in nuclear facility authorization basis documentation and to define future cost-effective support and development initiatives. Six areas, including source term development (fire, spills, and explosion analysis), in-facility transport, and dispersion/ consequence analysis (chemical and radiological) are contained in the APAC program. The evaluation process, codes considered, key results, and recommendations for future model and software development of the Radiological Dispersion/Consequence Working Group are summarized in this paper.

  7. Multidetector computed tomography (MDCT angiography of thoracic aortic coarctation in pediatric patients: Pre-operative evaluation

    Directory of Open Access Journals (Sweden)

    Mohamad Zakaryia Al-Azzazy

    2014-03-01

    Conclusion: We concluded that MDCT angiography with multiplanar and three dimensional techniques can be considered the modality of choice for pre-operative assessment of coarctation of the thoracic aorta in pediatric patients.

  8. Hanford Site Annual Report Radiological Dose Calculation Upgrade Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, Sandra F.

    2010-02-28

    Operations at the Hanford Site, Richland, Washington, result in the release of radioactive materials to offsite residents. Site authorities are required to estimate the dose to the maximally exposed offsite resident. Due to the very low levels of exposure at the residence, computer models, rather than environmental samples, are used to estimate exposure, intake, and dose. A DOS-based model has been used in the past (GENII version 1.485). GENII v1.485 has been updated to a Windows®-based software (GENII version 2.08). Use of the updated software will facilitate future dose evaluations, but must be demonstrated to provide results comparable to those of GENII v1.485. This report describes the GENII v1.485 and GENII v2.08 dose exposure, intake, and dose estimates for the maximally exposed offsite resident reported for calendar year 2008. The GENII v2.08 results reflect updates to implemented algorithms. No two environmental models produce the same results, as was again demonstrated in this report. The aggregated dose results from 2008 Hanford Site airborne and surface water exposure scenarios provide comparable dose results. Therefore, the GENII v2.08 software is recommended for future offsite resident dose evaluations.

  9. The role of routine magnetic resonance imaging in the preoperative evaluation of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ozturk, Cagatay; Karadereler, Selhan; Ornek, Ibrahim; Enercan, Meric; Ganiyusufoglu, Kursat; Hamzaoglu, Azmi

    2010-04-01

    The routine use of magnetic resonance imaging (MRI) in adolescent idiopathic scoliosis remains controversial, and current indications for MRI in idiopathic scoliosis vary from study to study. The purpose of this study was to demonstrate the prevalence of neural axis malformations and the clinical relevance of routine MRI studies in the evaluation of patients with adolescent idiopathic scoliosis undergoing surgical intervention without any neurological findings. A total of 249 patients with a diagnosis of idiopathic scoliosis were treated surgically between the years 2002 and 2007. A routine whole spine MRI analysis was performed in all patients. On the preoperative clinical examination, all patients were neurologically intact. There were 20 (8%) patients (3 males and 17 females) who had neural axis abnormalities on MRI. Three of those 20 patients needed additional neurosurgical procedures before corrective surgery; the remaining underwent corrective spinal surgery without any neurosurgical operations. Magnetic resonance imaging may be beneficial for patients with presumed idiopathic scoliosis even in the absence of neurological findings and it is ideally performed from the level of the brainstem to the sacrum.

  10. Evaluation of expert criteria for preoperative magnetic resonance imaging of newly diagnosed breast cancer.

    Science.gov (United States)

    Behrendt, Carolyn E; Tumyan, Lusine; Gonser, Laura; Shaw, Sara L; Vora, Lalit; Paz, I Benjamin; Ellenhorn, Joshua D I; Yim, John H

    2014-08-01

    Despite 2 randomized trials reporting no reduction in operations or local recurrence at 1 year, preoperative magnetic resonance imaging (MRI) is increasingly used in diagnostic workup of breast cancer. We evaluated 5 utilization criteria recently proposed by experts. Of women (n = 340) newly diagnosed with unilateral breast cancer who underwent bilateral MRI, most (69.4%) met at least 1 criterion before MRI: mammographic density (44.4%), under consideration for partial breast irradiation (PBI) (19.7%), genetic-familial risk (12.9%), invasive lobular carcinoma (11.8%), and multifocal/multicentric disease (10.6%). MRI detected occult malignant lesion or extension of index lesion in 21.2% of index, 3.3% of contralateral, breasts. No expert criterion was associated with MRI-detected malignant lesion, which associated instead with pre-MRI plan of lumpectomy without PBI (48.2% of subjects): Odds Ratio 3.05, 95% CI 1.57-5.91 (p adjusted for multiple hypothesis testing = 0.007, adjusted for index-vs-contralateral breast and covariates). The expert guidelines were not confirmed by clinical evidence.

  11. Current radiology. Volume 5

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, G.H.; Hanafee, W.N.

    1984-01-01

    This book contains 10 selections. They are: Nuclear Magnetic Resonance Imaging, Interventional Vascular Radiology, Genitourinary Radiology, Skeletal Radiology, Digital Subtraction Angiography, Neuroradiology, Computed Tomographic Evaluation of Degenerative Diseases of the Lumbar Spine, The Lung, Otolaringology and Opthalmology, and Pediatric Radiology: Cranial, Facial, Cervical, Vertebral, and Appendicular.

  12. Radiological Evaluation of Ambiguous Genitalia with Various Imaging Modalities

    Science.gov (United States)

    Ravi, N.; Bindushree, Kadakola

    2012-07-01

    Disorders of sex development (DSDs) are congenital conditions in which the development of chromosomal, gonadal, or anatomic sex is atypical. These can be classified broadly into four categories on the basis of gonadal histologic features: female pseudohermaphroditism (46,XX with two ovaries); male pseudohermaphroditism (46,XY with two testes); true hermaphroditism (ovotesticular DSD) (both ovarian and testicular tissues); and gonadal dysgenesis, either mixed (a testis and a streak gonad) or pure (bilateral streak gonads). Imaging plays an important role in demonstrating the anatomy and associated anomalies. Ultrasonography is the primary modality for demonstrating internal organs and magnetic resonance imaging is used as an adjunct modality to assess for internal gonads and genitalia. Early and appropriate gender assignment is necessary for healthy physical and psychologic development of children with ambiguous genitalia. Gender assignment can be facilitated with a team approach that involves a pediatric endocrinologist, geneticist, urologist, psychiatrist, social worker, neonatologist, nurse, and radiologist, allowing timely diagnosis and proper management. We describe case series on ambiguous genitalia presented to our department who were evaluated with multiple imaging modalities.

  13. Clinical evaluation of using semantic searching engine for radiological imaging services in RIS-integrated PACS

    Science.gov (United States)

    Ling, Tonghui; Zhang, Kai; Yang, Yuanyuan; Hua, Yanqing; Zhang, Jianguo

    2015-03-01

    We had designed a semantic searching engine (SSE) for radiological imaging to search both reports and images in RIS-integrated PACS environment. In this presentation, we present evaluation results of this SSE about how it impacting the radiologists' behaviors in reporting for different kinds of examinations, and how it improving the performance of retrieval and usage of historical images in RIS-integrated PACS.

  14. [Evaluating radiation dose load in medical personnel of radiologic diagnostic departments].

    Science.gov (United States)

    Trunov, B V; Koroleva, E P

    2014-01-01

    The article deals with materials on radiation hygienic evaluation of radiologic diagnostic departments in various medical institutions of Moscow. The studies covered work of medical staffers in X-ray examination and in contact with short-lived isotope generators. The authors outlined the examination types and stages with maximal radiation danger. Disimetric information obtained during the study helped to calculate values of equivalent, effective doses of radiation for medical personnel and maximal potential doses.

  15. Student Evaluations, Outcomes, and National Licensure Examinations in Radiology Education: A Narrative Review of the Literature

    OpenAIRE

    Linaker, Kathleen L.

    2015-01-01

    Objective The purpose of this study was to examine literature on radiological student evaluation and outcome assessments including national board examinations. Methods A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references. Results Of the 4716 unique abstracts reviewed by the author, 54 were found to be relevant to the purpose of thi...

  16. DEVELOPMENT AND EVALUATION OF EVIDENCE BASED PRE-OPERATIVE PATIENT EDUCATION BOOKLET IN LUMBAR DISCECTOMY

    Directory of Open Access Journals (Sweden)

    Manish Nagpal

    2014-02-01

    Full Text Available Objective: The objective of this study was to contribute towards further understanding of the preoperative educational requirement of patients by developing and evaluating suitable evidence based patient education booklet in lumbar discectomy. Summary of background data: The primary surgical intervention for lumbar radiculopathy is lumbar discectomy but its result remains variable. Patient education has been found beneficial in various surgeries and resulted in enhanced outcome of the surgery with respect to pain, disability and quality of life. Methodology: It consists of 5 Steps. 1 Literature review, informal interview and questionnaire filled by 3 surgeons, 5 physiotherapists and 5 patients were used to determine the domains of the education booklet. 2 Literature review to develop the content for the domains of the booklet and formulate a rough draft of the booklet. 3 Modification in the booklet as recommended by surgeons and therapists to develop the final booklet. 4 Evaluation of the booklet on readability ease by Flesch reading ease and by Suitability assessment of Material questionnaire filled by surgeons and therapists. 5 Pilot study on patients to take their views regarding the booklet developed. Results: The domains determined in step 1 were: Anatomy, understanding the mechanism of pain, about the surgery, complications associated with surgery and role of physiotherapy. The content was developed and modified in step 2 and 3. In step 4 Flesch reading score is 70.5 and suitability assessment of material questionnaire score- 77.3%. In step 5 patients rated the booklet easy to read and understand. Conclusion: The developed patient education booklet came out to be fairly easy to read according to flesch reading ease and of superior quality according to suitability assessment of material questionnaire and hence should be made a part of patient education.

  17. Preoperative evaluation of peripheral nerve injuries: What is the place for ultrasound?

    Science.gov (United States)

    Toia, Francesca; Gagliardo, Andrea; D'Arpa, Salvatore; Gagliardo, Cesare; Gagliardo, Giuseppe; Cordova, Adriana

    2016-09-01

    OBJECTIVE The purpose of this study was to evaluate the usefulness of ultrasound in the preoperative workup of peripheral nerve lesions and illustrate how nerve ultrasonography can be integrated in routine clinical and neurophysiological evaluation and in the management of focal peripheral nerve injuries. The diagnostic role and therapeutic implications of ultrasonography for different neuropathies are described. METHODS The authors analyzed the use of ultrasound in 119 entrapment, tumoral, posttraumatic, or postsurgical nerve injuries of limbs evaluated in 108 patients during 2013 and 2014. All patients were candidates for surgery, and in all cases the evaluation included clinical examination, electrodiagnostic studies (nerve conduction study and electromyography), and ultrasound nerve study. Ultrasound was used to explore the nerve fascicular echotexture, continuity, and surrounding tissues. The maximum cross-sectional area (CSA) and the presence of epineurial hyperechogenicity or intraneural hyper- or hypoechogenicity, of anatomical anomalies, dynamic nerve dislocations, or compressions were recorded. The concordance rate of neurophysiological and ultrasonographic data was analyzed, classifying ultrasound findings as confirming, contributive, or nonconfirming with respect to electrodiagnostic data. The correlation between maximum nerve CSA and neurophysiological severity degree in entrapment syndromes was statistically analyzed. RESULTS Ultrasonography confirmed electrodiagnostic findings in 36.1% of cases and showed a contributive role in the diagnosis and surgical planning in 53.8% of all cases; the findings were negative ("nonconfirming") in only 10.1% of the patients. In 16% of cases, ultrasound was not only contributive, but had a key diagnostic role in the presence of doubtful electrodiagnostic findings. The contributive role differed according to etiology, being higher for tumors (100%) and for posttraumatic or postsurgical neuropathies (72.2%) than for

  18. Preoperative evaluation of basal free triiodothyronine in patients undergoing coronary artery bypass grafting surgery. Does it help?

    Directory of Open Access Journals (Sweden)

    Kaushal Kishore Tiwari

    2015-11-01

    Full Text Available noBackground & Objectives: The postoperative Low T3 syndrome has been considered as a possible source of reduced myocardial contractility, resulting in increased mortality after CABG. Effect of preoperative Low T3 has not been well studied in patients undergoing CABG surgery. Aim of our study is to evaluate effect of preoperative Low T3 syndrome in patients undergoing CABG surgery.Materials & Methods: Six hundred and six patients undergoing CABG were included in this prospective study. The impact of the base-line FT3 concentration and of preoperative low T3 syndrome on the risk of postoperative low cardiac output and hospital death was analyzed.Results: Fifteen patients (2.3% postoperatively and 159 (26.2% developed major complications. At univariate analysis a reduced EF, the presence of peripheral vascular disease, the NYHA class, the surgical urgency, the aortic cross-clamp time, the CPB time and the FT3 concentration at admission were significantly associated with low CO and higher mortality. At multivariate analysis, the CPB time, an emergency procedure, a reduced LVEF, and the fT3 concentration were independently related to the development of low CO. However, in multivariate analysis low EF, and the fT3 concentration were the only predictors of hospital death.Conclusion: We conclude that preoperative low EF and low T3 syndrome independently causes low cardiac output and higher mortality in patients undergoing CABG. Therefore, all patients undergoing CABG should be evaluated for low T3 syndrome and patients with low T3 syndrome should be considered at increased risk. Appropriate preoperative T3 replacement therapy could decrease the postoperative complications in patients undergoing CABG.JCMS Nepal. 2015; 11(2:1-7

  19. Copper as ancillary diagnostic tool in preoperative evaluation of possible papillary thyroid carcinoma in patients with benign thyroid disease.

    Science.gov (United States)

    Dragutinović, Vesna V; Tatić, Svetislav B; Nikolić-Mandić, Snežana D; Tripković, Tatjana M; Dunđerović, Duško M; Paunović, Ivan R

    2014-09-01

    Preoperative diagnosis of papillary thyroid carcinoma (PTC) comprises numerous diagnostic procedures which are mostly applicable in tertiary institutions. Normal thyroid function depends on the presence of many trace elements and copper (Cu) and zinc (Zn) are some of those. The study is based on retrospective review of 118 patients with preoperatively diagnosed benign thyroid disease (BTD) and 12 with PTC, who underwent thyroid surgery at the Center for Endocrine Surgery Clinical Center of Serbia, Belgrade, between 2010 and 2012. The objective was to evaluate concentrations of Cu and Zn in serum as possible prediction markers for PTC in patients who underwent surgery for preoperatively diagnosed BTD. Concentrations of Cu and Zn ions in serum were measured using atomic absorption spectrophotometer. Data were analyzed using methods of descriptive statistics, Anova and t-test (p papillary microcarcinoma-mPTC in 13 (11.0%) of BTD patients. The concentrations of Cu ions in serum of PTC patients as well as in serum of patients with mPTC were significantly higher than in serum of BTD patients (p thyroid surgery can be useful, easy available, and a low-cost tool in prediction of preoperatively undiagnosed PTC in patients with BTD.

  20. Case-oriented computer-based-training in radiology: concept, implementation and evaluation

    Directory of Open Access Journals (Sweden)

    Helmberger Thomas

    2001-10-01

    Full Text Available Abstract Background Providing high-quality clinical cases is important for teaching radiology. We developed, implemented and evaluated a program for a university hospital to support this task. Methods The system was built with Intranet technology and connected to the Picture Archiving and Communications System (PACS. It contains cases for every user group from students to attendants and is structured according to the ACR-code (American College of Radiology 2. Each department member was given an individual account, could gather his teaching cases and put the completed cases into the common database. Results During 18 months 583 cases containing 4136 images involving all radiological techniques were compiled and 350 cases put into the common case repository. Workflow integration as well as individual interest influenced the personal efforts to participate but an increasing number of cases and minor modifications of the program improved user acceptance continuously. 101 students went through an evaluation which showed a high level of acceptance and a special interest in elaborate documentation. Conclusion Electronic access to reference cases for all department members anytime anywhere is feasible. Critical success factors are workflow integration, reliability, efficient retrieval strategies and incentives for case authoring.

  1. Usefulness of the evaluation of preoperative sternal shape for reconstruction of pectus excavatum using three-dimensional computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Masahiko; Kondoh, Shohji; Kondoh, Yoshiaki; Akabane, Genichiroh [Nagano Children`s Hospital (Japan); Matsuo, Kiyoshi

    1997-04-01

    In the reconstruction of the pectus excavatum deformity, when sternal growth must be considered, it is desirable that osteotomy of the sternum be performed if necessary. From this standpoint, we evaluate the preoperative sternal shape using three-dimensional computed tomography. The sternum is outlined on the mid-sagittal plane, and the curved portions are examined. Preoperatively, the sternums are classified into 3 groups based on the number of curved portions. On the basis of these observations, we determine the position and degree of the sternal osteotomy and, if necessary, combined sternal osteotomy and augmentation using resected cartilage. We think that this method is useful not only for reconstruction of pectus excavatum but also in evaluating the postoperative shape of the thorax. (author)

  2. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A.R.; Hansen, B.A.; Hogenhaven, H;

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the 'Engel score', was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation...

  3. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A R; Hansen, B A; Høgenhaven, H;

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the "Engel score", was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation....

  4. [Multiple gastro-intestinal stromal tumors (GIST) in a patient with type I neurofibromatosis revealed by chronic bleeding: pre-operative radiological diagnosis].

    Science.gov (United States)

    Guillaud, Olivier; Dumortier, Jérôme; Bringuier, Pierre-Paul; Saurin, Jean-Christophe; Poncet, Gilles; Boulez, Jean; Henry, Luc; Chayvialle, Jean-Alain; Scoazec, Jean-Yves

    2006-02-01

    Recent studies have pointed out a high incidence of GIST, usually multiple and of small intestinal location, in patients with type I neurofibromatosis. We here report an additional case, revealed by chronic gastro-intestinal bleeding and diagnosed at pre-operative imaging studies. A 56-year-old patient, with known type I neurofibromatosis, was referred to our department for the exploration of chronic gastro-intestinal bleeding during anti-aggregant therapy. Endoscopical examination was negative. Enteroscanner showed the presence of four tumor lesions, 3 in the jejunum and 1 in the ileum. Segmental surgical resections were performed. At histological examination, 2 of among the 3 jejunal lesions were diagnosed as typical GIST, of low risk of malignancy, CD117+, CD34+, whereas the last jejunal and ileal lesions were identified as fibroid tumors. Mutations of c-kit gene and of the gene coding for PDGF-Ralpha were not detected. Post-operative recovery was uneventful; no recurrent bleeding was observed. Our case report underlines the potential role of enteroscanner in the management of patients with type I neurofibromatosis with possible digestive complications. It also emphasizes the importance of an accurate diagnosis of the digestive tumors associated with type I neurofibromatosis: GISTs are frequent in this setting and must not be misdiagnosed as neurofibromas.

  5. Long-term results of a randomized controlled trial evaluating preoperative chemotherapy in resectable non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Chen ZW

    2013-06-01

    Full Text Available Zhiwei Chen,* Qingquan Luo,* Hong Jian, Zhen Zhou, Baijun Cheng, Shun Lu, Meilin LiaoShanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equallyObjective: We aimed to evaluate whether preoperative chemotherapy provides benefits in the survival and prognosis of patients with non-small cell lung cancer (NSCLC in resectable stages I to IIIA, except T1N0. Methods: In this randomized, controlled trial, 356 patients with stage I (except for T1N0, II and IIIA NSCLC were assigned to either the preoperative chemotherapy plus surgery arm (179 patients or the primary surgery arm (177 patients. Both treatments were followed by adjuvant chemotherapy. The end point of this study included overall survival (OS, progression-free survival (PFS, and survival rate associated with clinical remission. Results: Statistical survival difference was found between the preoperative chemotherapy plus surgery arm and the surgery-alone arm. However, the median survival time (MST in the preoperative chemotherapy arm was lower than that of surgery-alone arm (MST, 45.42 months vs 57.59 months (P = 0.016. When comparing the effect of preoperative chemotherapy at each stage of NSCLC, a statistical survival difference was found in stage II NSCLC but not in stage I and IIIA (MST 40.86 months vs 80.81 months (P = 0.044. However, no statistically significant difference in PFS was noticed between the two arms, except for stage I NSCLC (hazard radio [HR] = 0.87; 95% CI, 0.561−1.629; P = 0.027. The survival rate was higher for patients who had clinical remission after preoperative chemotherapy, but the differences did not reach statistical significance (MST 42.10 months vs 35.33 months (P = 0.630. Conclusion: Preoperative chemotherapy did not show benefits in OS and PFS for stage I-IIIA NSCLC patients. Keywords: NSCLC, neoadjuvent, mitomycin, cisplatin, vindesine

  6. MR evaluation of chronic achilles tendinosis. A longitudinal study of 15 patients preoperatively and two years postoperatively

    Energy Technology Data Exchange (ETDEWEB)

    Shalabi, A.; Kristoffersen-Wiberg, M.; Aspelin, P. [Huddinge Univ. Hospital (Sweden). Dept. of Radiology; Movin, T. [Huddinge Univ. Hospital (Sweden). Dept. of Orthopedic Surgery

    2001-05-01

    Purpose: To evaluate surgically treated patients with chronic Achilles tendinosis by MR. Material and Methods: Gd-contrast-enhanced (CME) T1-, precontrast T1-, PD- and T2-weighted images were obtained preoperatively and 2 years following surgical treatment on 15 middle-aged patients with severe symptoms of chronic Achilles tendinosis. MR evaluation included the depiction of intratendinous signal alterations and their volume, and also measurement of tendon diameter. A questionnaire and clinical examination evaluated the clinical outcome. Results: The most sensitive sequence to depict an intratendinous lesion was the CME T1-WI. There was marked regress of the estimated volume of the intratendinous signal alteration from a median of 1.2 cm{sup 3} preoperatively to 0.0 cm{sup 3} postoperatively on CME T1-WI. CME T1-WI showed a regress in intratendinous signal abnormality from 13 out of 15 patients preoperatively to 4 of 15 patients 2 years postoperatively. The a.p. dimension was 9 mm at both MR occasions. The clinical outcome was excellent in 8, good in 5, fair in 1 and poor in 1 patient. Conclusion: Surgical treatment of chronic Achilles tendinosis and its healing resulted in a decrease or elimination of the intratendinous signal alteration correlating to an improved clinical outcome 2 years postoperatively.

  7. Sensitivity of 3-Dimensional Sonography in Preoperative Evaluation of Parathyroid Glands in Patients With Primary Hyperparathyroidism.

    Science.gov (United States)

    Frank, Susan J; Goldman-Yassen, Adam E; Koenigsberg, Tova; Libutti, Steven K; Koenigsberg, Mordecai

    2017-09-01

    Preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism facilitates targeted surgery. We assessed the sensitivity of 3-dimensional (3D) sonography for preoperative localization of abnormal parathyroid glands. We conducted a retrospective review of patients who underwent parathyroidectomy for primary hyperparathyroidism at a single site at our institution. We compared preoperative 2-dimensional (2D) sonography, 3D sonography, and sestamibi scans with final gland localization at surgery. Two readers reviewed the sonograms to assess inter-reader variability. From January 2010 through April 2015, 52 patients underwent parathyroidectomy after preoperative 2D sonography, 3D sonography, and sestamibi scans. Three-dimensional sonography had sensitivity of 88-92% compared with 69-71% for 2D sonography for gland localization. In patients in whom sonography and sestamibi scans localized abnormalities to the same side, the sensitivities were 100% (43 of 43) for 3D sonography and 96% (48 of 50) for 2D sonography. Three-dimensional sonography had significantly higher sensitivity for localization of glands smaller than 500 mg compared with 2D sonography (88% versus 58%; P = .012). There was better inter-reader agreement between the radiologists when using 3D sonography (κ = 0.65) compared with 2D sonography (κ = 0.41). We found a significantly higher sensitivity and better inter-reader agreement for 3D sonography compared with 2D sonography for preoperative identification of abnormal parathyroid glands, especially among smaller glands. © 2017 by the American Institute of Ultrasound in Medicine.

  8. Factors Influencing Patients' Perspectives of Radiology Imaging Centers: Evaluation Using an Online Social Media Ratings Website.

    Science.gov (United States)

    Doshi, Ankur M; Somberg, Molly; Rosenkrantz, Andrew B

    2016-02-01

    The goal of this study was to use patient reviews posted on Yelp.com, an online ratings website, to identify factors most commonly associated with positive versus negative patient perceptions of radiology imaging centers across the United States. A total of 126 outpatient radiology centers from the 46 largest US cities were identified using Yelp.com; 1,009 patient reviews comprising 2,582 individual comments were evaluated. Comments were coded as pertaining to either the radiologist or other service items, and as expressing either a positive or negative opinion. Distribution of comments was compared with center ratings using Fisher's exact test. Overall, 14% of comments were radiologist related; 86% pertained to other aspects of service quality. Radiologist-related negative comments more frequent in low-performing centers (mean rating ≤2 on 1-5 scale) than high-performing centers (rating ≥4) pertained to imaging equipment (25% versus 7%), report content (25% versus 2%), and radiologist professionalism (25% versus 2%) (P culture throughout their practice. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  9. Evaluation of radiological teaching programs in the Internet; Evaluation radiologischer Lernprogramme im Internet

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, J.; Schubert, S.; Voelk, M.; Scheibl, K.; Paetzel, C.; Schreyer, A.; Djavidani, B.; Feuerbach, S. [Institut fuer Roentgendiagnostik, Klinikum der Universitaet Regensburg (Germany); Strotzer, M. [Institut fuer Radiologie, Krankenhause Hohe Warte,Hohe Warte 8, 95445 Bayreuth (Germany)

    2003-01-01

    Evaluation of web based training programs,which can be contacted from the homepages of radiological departments of German universities.Material and method From june 2000 to january 2002 the 75 web based training programs of 57 providers,which can be contacted from the web pages of the radiological departments of german universities were evaluated in a prospective study.A medical student experienced in using the world wide web examined each training program three times in an interval of six months using the following criteria: availability of the web sites,target group,kind of training program,contents and structure and the technical solution. 51 of the 57 the homepages were fully available at each visit. 64 of the 75 web based training programs which could be connected from these sites were available at all three visitis.One program was only partially available at one spot check. 8 of the 75 programs were designed for physicians and medically trained personal, 23 were made for medical students and 44 addressed both target groups (partially more than once mentioned).The number of the presented cases ranged between one single and 3700. In 31 of 75 training programs links to other teaching files were found.A complete presentation of cases was presented by 48 of the 75 web sites.5 of the 75 web sites offered physiological images for comparison. In 20 training programs the pathological changes were optically marked in the x-ray images.A logical and didactical structure was found in 24 teaching files, 14 gave the possibility to check the learning results.No provider made use of the possibility to pass credits to the students or physicians acount with regard to official training programs. Multimedia techniques were used in 15 training programs.43 sites used data reduced preview images (thumbnails).The latest update of the site is mentioned in 55 of the 75 web sites. 19 of 57 providers had either no possibility of contact or did not answer to an e-mail. From the homepages

  10. Bypass of an anesthesiologist-directed preoperative evaluation clinic results in greater first-case tardiness and turnover times.

    Science.gov (United States)

    Epstein, Richard H; Dexter, Franklin; Schwenk, Eric S; Witkowski, Thomas A

    2017-09-01

    We evaluated 4 hypotheses related to bypass of an anesthesiologist-directed preoperative evaluation clinics (APEC): 1) first-case tardiness and turnover times increased; 2) turnover times increased more than first-case tardiness; and higher American Society of Anesthesiologists Physical Status (ASA PS) resulted in both an ordered increase among ASA PS and within ASA PS in 3) first-case tardiness; and 4) turnover times. Retrospective observational study using electronic health records. One large, teaching hospital. An average of 14,310 patients per year undergoing elective surgery in the hospital's main opera rating rooms who were not inpatients preoperatively between 2006 and 2016. None. Average increases in first-case tardiness and turnover times between patients seen or not seen preoperatively in the APEC. APEC bypass increased first-case tardiness 2.58 min per case (CI 1.55-3.61; Ptardiness (difference=4.91 min; CI 3.76-6.06; Ptardiness (difference=5.71, CI 3.17-4.72; Ptardiness and turnover times with increasing ASA PS (Ptardiness (all P-valuestardiness and turnover times. A strategy of selective bypass of ASA PS 1-2 patients would not be effective economically because of substantial delays from ASA PS 2 patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. A pilot study to evaluate the use of virtual lectures for undergraduate radiology teaching

    Energy Technology Data Exchange (ETDEWEB)

    Sendra-Portero, Francisco, E-mail: sendra@uma.es [Departamento de Radiología y Medicina Física, Facultad de Medicina, Universidad de Málaga, Boulevar Louis Pasteur, 32, 29071 Málaga (Spain); Torales-Chaparro, Oscar E., E-mail: oetjft@terra.es [Departamento de Radiología y Medicina Física, Facultad de Medicina, Universidad de Málaga, Boulevar Louis Pasteur, 32, 29071 Málaga (Spain); Ruiz-Gómez, Miguel J., E-mail: mjrg@uma.es [Departamento de Radiología y Medicina Física, Facultad de Medicina, Universidad de Málaga, Boulevar Louis Pasteur, 32, 29071 Málaga (Spain); Martínez-Morillo, Manuel, E-mail: mmorillo@uma.es [Departamento de Radiología y Medicina Física, Facultad de Medicina, Universidad de Málaga, Boulevar Louis Pasteur, 32, 29071 Málaga (Spain)

    2013-05-15

    Purpose: To demonstrate that virtual lectures can substitute conventional lectures in radiology education for medical students. Methods and materials: During the course 2005–2006, 89 out from 191 (46.6%) third year students of a subject entitled “General Radiology”, participated voluntarily in a pilot study including 22 virtual lectures (Flash presentations translated from the same PowerPoint presentations of conventional lectures, adding recorded narration and navigation tools). Participants (P) studied by means of virtual lectures, while non-participants (NP) assisted to conventional lectures. The results of the final oral exam classified from 0 to 3, and a 60-questions evaluation on image interpretation were used to compare both groups after training. Finally, 34 students from the group P (38.2%) fulfilled a 10-points scale quality survey about the project. Results: Final exam qualifications were significantly higher for P than for NP (2.11 ± 0.85 versus 1.73 ± 1.04) as well as the number of correct answers of the evaluation on image interpretation (24.2 ± 6.2 versus 21.2 ± 5.4), but differences could obey to different attitudes between both groups. The usefulness of virtual lectures to learn General Radiology obtained the highest global scoring (8.82 ± 1.00). Contents were generally better evaluated than the design of the presentations. Conclusion: Virtual lectures can substitute conventional lectures in radiology education for medical students with no detriment to students’ learning. Their potential advantage is that magisterial lectures can be used to discuss contents with students in a more participative way if virtual lectures are provided before.

  12. Clinical results of tumor shrinkage and evaluation of quality of life in low rectal carcinoma after preoperative combined treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Osamu; Suganuma, Yasushi; Tamura, Takao; Ohnishi, Kazuyoshi; Nishiue, Takashi; Itoh, Masahiko; Horie, Hiroshi; Sawai, Seiji; Takahashi, Toshio (Kyoto Prefectural Univ. of Medicine (Japan))

    1992-10-01

    To improve the surgical rate and the quality of life (QOL) for patients with advanced low rectal carcinoma, we investigated whether preoperative treatments (irradiation and hyperthermia and 5-fluorouracil (5-FU) suppository, irradiation and hyperthermia, irradiation and 5-FU suppository, irradiation alone and 5-FU suppository alone) were useful. The tumor shrinkage rate after preoperative treatments was highest in the irradiation, hyperthermia and 5-FU suppository group. Pathologically complete regression was observed in the 2 of 18 cases (12%). According to our criteria of histological changes, the irradiation, hyperthermia and 5-FU suppository group showed the greatest effectiveness. The 4 year postoperative survival rate and the 4 year local recurrence rate were 100% and 8% in the irradiation, hyperthermia and 5-FU suppository group and the data suggest that these results were the best of the 5 treatments. After the carcinoma was shrunk after irradiation, hyperthermia and 5-FU suppository, the patients could receive curatively a sphincter-saving operation (super-low anterior resection and transanal rectal resection). The fecal continence of 7 patients after sphincter-saving operations was increased as good by manometric study, defecography and clinical evaluation. In conclusion, our data suggest that the preoperative combined treatment of irradiation, hyperthermia and 5-FU suppository prevents local recurrence and increases the possibility of a sphincter-saving operation for advanced rectal carcinoma. (author).

  13. Description and critical environmental evaluation of the REE refining plant LAMP near Kuantan/Malaysia. Radiological and non-radiological environmental consequences of the plant's operation and its wastes

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Gerhard

    2013-01-25

    The description of the critical environmental evaluation of the REE refining plant LAMP near Kuantan/Malaysia covers the radiological and non-radiological consequences of the plant operation and its waste. The Australian company Lynas plans to import ore concentrate from Australia to Malaysia and to process the concentrate in the plant LAMP in Kuantan, Malaysia. The authors have analyzed the emissions of radon over the stack, the emissions of sulfuric acid and dust over the stack, the hazards and their control in the production processes and the wastes from the production process with respect to the radiological and non-radiological toxicity.

  14. Financial impact of radiological reports on medical-legal evaluation of compensation for meniscal lesions.

    Science.gov (United States)

    Lelario, M; Ciuffreda, P; Lupo, P; Bristogiannis, C; Vinci, R; Stoppino, L P; De Filippo, M; Macarini, L

    2013-08-01

    To evaluate any discrepancy between radiological reports for clinical purposes and for medicolegal purposes and to quantify its economic impact on repayments made by private insurance companies for meniscal injuries of the knee. The medical records obtained pertaining to 108 knee injury patients (mean age 43.3 years) assessed over a period of 12 months were analysed. Clinical medical reports, aimed at assessing the lesion, and medicolegal reports, drawn up with a view to quantifying compensation, were compared. Unlike reports for clinical purposes in reports for medicolegal purposes, in the evaluation of meniscal lesions, in addition to morphological features of lesions, chronological, topographical, severity and exclusion criteria were applied. To estimate the economic impact resulting from the biological damage, we consulted an actuarial table based on the 9-point minor incapacity classification system. Meniscal lesions not compatible with a traumatic event and therefore not eligible for an insurance payout were found in 56 patients. Of these, 37 failed exclusion criteria, while 19 failed to meet chronological criteria. This difference resulted in a reduction in compensation made by private insurance companies with savings estimated with a saving between euro 203,715.41 and euro 622,315.39. The use of a clinical report for medicolegal purposes can be a source of valuation error, as chronological and/or dynamic information regarding the trauma mechanism may be lacking. Therefore, the use of a full radiological appraisal allows a better damage's assessment and an adequate compensation for injuries.

  15. Evaluation of Residual Cellularity and Proliferation on Preoperatively Treated Breast Cancer: A Comparison between Image Analysis and Light Microscopy Analysis

    Directory of Open Access Journals (Sweden)

    Valentina Corletto

    1998-01-01

    Full Text Available Histopathology has been suggested as a reliable method for tumour reduction evaluation of preoperatively treated breast cancer. Immunocytochemistry can be used to enhance the visibility of residual tumour cellularity and in the evaluation of its proliferative activity. We compared Image Analysis (IA with Light Microscopy Analysis (LMA on sections of breast carcinomas treated with preoperative chemo‐ or chemo/radiotherapy in the evaluation of the Neoplastic Cell Density (NCD (69 cases and the Proliferation Index (PI (35 cases. NCD was expressed as the immunoreactive area to cytokeratin over the total original neoplastic area and PI was expressed as the number of immunostained tumoural nuclei with MIB1 MoAb over the total of tumoural nuclei. The intraobserver agreement and that between IA and LMA for both indices were estimated by the common (Kw and the jackknife weighted kappa statistic (K˜w. The extent of agreement of each considered category was also assessed by means of the category‐specific kappa statistics (Kcs. The intraobserver agreement within LMA for NCD and PI and that between IA and LMA for PI were both satisfactory. Upon evaluation of the NCD, the agreement between IA and LMA showed unsatisfactory results, especially when the ratio between the residual tumour cells and the background was critical.

  16. Evaluation of residual cellularity and proliferation on preoperatively treated breast cancer: a comparison between image analysis and light microscopy analysis.

    Science.gov (United States)

    Corletto, V; Verderio, P; Giardini, R; Cipriani, S; Di Palma, S; Rilke, F

    1998-01-01

    Histopathology has been suggested as a reliable method for tumour reduction evaluation of preoperatively treated breast cancer. Immunocytochemistry can be used to enhance the visibility of residual tumour cellularity and in the evaluation of its proliferative activity. We compared Image Analysis (IA) with Light Microscopy Analysis (LMA) on sections of breast carcinomas treated with preoperative chemo- or chemo/radiotherapy in the evaluation of the Neoplastic Cell Density (NCD) (69 cases) and the Proliferation Index (PI) (35 cases). NCD was expressed as the immunoreactive area to cytokeratin over the total original neoplastic area and PI was expressed as the number of immunostained tumoural nuclei with MIB 1 MoAb over the total of tumoural nuclei. The intraobserver agreement and that between IA and LMA for both indices were estimated by the common (kappa(w)) and the jackknife weighted kappa statistic (kappa(w)). The extent of agreement of each considered category was also assessed by means of the category-specific kappa statistics (kappa(cs)). The intraobserver agreement within LMA for NCD and PI and that between IA and LMA for PI were both satisfactory. Upon evaluation of the NCD, the agreement between IA and LMA showed unsatisfactory results, especially when the ratio between the residual tumour cells and the background was critical.

  17. Preoperative Evaluation of Thyroid Epithelial Lesions by DNA Ploidy and Galectin-3 Expression in FNAC

    Directory of Open Access Journals (Sweden)

    Sonia L. Elsharkawy

    2014-12-01

    CONCLUSIONS: From the results of this study we can consider that DNA ploidy and Galectin-3 could refine the FNA results and  increase its sensitivity as a screening test from sensitivity(60% to reach sensitivity (93.3%, thus decreasing the false negative cases. From this study, it is concluded that the application of ancillary techniques as galectin-3 immunocytochemical markers may become a reliable indicator for surgical intervention, DNA ploidy measurements on the other hand may be of value in galectin-3 negative cases to determine the behavior of the lesion in such cases & refine the preoperative assessment by out ruling false negative cases.

  18. Paraganglioma of the heart. The value of magnetic resonance imaging in the preoperative evaluation.

    Science.gov (United States)

    Conti, V R; Saydjari, R; Amparo, E G

    1986-10-01

    Although the 131I-metaiodobenzylguanidine scan has proven reliable in identifying mediastinal paragangliomas, further localization has usually required dynamic computerized tomographic scanning which requires rapid bolus injection of contrast material. In the case presented herein, magnetic resonance imaging provided accurate preoperative localization and added important anatomic detail that was not appreciated with dynamic computerized tomograms or with other studies. Magnetic resonance imaging can accurately localize cardiac paragangliomas without injection of contrast material and may provide more detailed information for better guidance for surgical excision.

  19. Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery.

    Science.gov (United States)

    Costa, Jean Allan; Almeida, Maria Lucia Pereira; Estrada, Tereza Cristina Duque; Werneck, Guilherme Lobosco; Rocha, Alexandre Marins; Rosa, Maria Luiza Garcia; Ribeiro, Mario Luiz; Mesquita, Claudio Tinoco

    2016-11-01

    The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries. To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk. A total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study. Assessment of patients was conducted by conventional echocardiogram using the ultraportable V Scan (GE) device right after the pre-anesthetic clinical evaluation. We assessed the clinical impact of echocardiography results by using a questionnaire addressed to the anesthetist. Mean age of patients was 68.9 ± 7.0 years, 154 were women. The most frequent surgeries were: a) facectomy - cataract - 18; b) inguinal hernia surgery - 18; c) Cholecystectomy - 16. We found 58 normal tests (27.5%), 70 (33.2%) with mild valve reflux, and 83 (39.3%) with relevant abnormality, such as increase in heart chamber size, global and/or segmental contractile dysfunction, significant valve dysfunction or other unspecified. Test results caused delay of surgical procedure for a more detailed cardiac evaluation in 20 (9.5%) patients, and change in anesthetic management in 7 (3.3%). There was a considerable clinical impact with the use of the ultraportable echocardiography, since one out of every ten patients evaluated had their clinical management changed due to the detection of previously unsuspected, significant heart diseases, with the potential for severe complications. O ecocardiógrafo ultraportátil, com importante mobilidade e facilidade diagnóstica em mãos experientes pode contribuir para a segurança na avaliação pré-operatória em cirurgias não cardíacas. Avaliar os parâmetros de função cardíaca nos pacientes com mais de 60 anos de idade, candidatos

  20. Evaluation of patient radiation doses using DAP meter in interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Sam [Dept. of Radiological Technology. Shingu University, Sungnam (Korea, Republic of); Yoon, Yong Su [Dept. of Health Sciences, Graduate School of Medical Sciences, Kyushu Univeristy, Kyushu (Japan)

    2017-03-15

    The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipment in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effective of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were 237.7 Gy·cm{sup 2} in TACE, 17.3 Gy·cm{sup 2} in AVF, 114.1 Gy·cm{sup 2} in LE PTA and STENT, 188.5 Gy·cm{sup 2} in TFCA, 383.5 Gy·cm{sup 2} in Aneurysm Coil, 64.6 Gy·cm{sup 2} in PTBD, 64.6 Gy·cm{sup 2} in Biliary Stent, 22.4 Gy·cm{sup 2} in PCN, 4.3 Gy·cm{sup 2} in Hickman, 2.8 Gy·cm{sup 2} in Chemo-port, 4.4 Gy·cm{sup 2} in Perm-Cather, 17.1 Gy·cm{sup 2} in PCD, and 357.9 Gy·cm{sup 2} in Vis, EMB. Dose reference level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipment and procedures in the interventional radiology procedures, further studies and monitoring are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

  1. The S.T.O.N.E. Score: A new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features

    Directory of Open Access Journals (Sweden)

    Wilson R. Molina

    2014-01-01

    Full Text Available Objective: To develop a user friendly system (S.T.O.N.E. Score to quantify and describe stone characteristics provided by computed axial tomography scan to predict ureteroscopy outcomes and to evaluate the characteristics that are thought to affect stone free rates. Materials and Methods: The S.T.O.N.E. score consists of 5 stone characteristics: (Size, (Topography (location of stone, (Obstruction, (Number of stones present, and (Evaluation of Hounsfield Units. Each component is scored on a 1-3 point scale. The S.T.O.N.E. Score was applied to 200 rigid and flexible ureteroscopies performed at our institution. A logistic model was applied to evaluate our data for stone free rates (SFR. Results: SFR were found to be correlated to S.T.O.N.E. Score. As S.T.O.N.E. Score increased, the SFR decreased with a logical regression trend (p 90% and typically falls off by 10% per point thereafter. Conclusions: The S.T.O.N.E. Score is a novel assessment tool to predict SFR in patients who require URS for the surgical therapy of ureteral and renal stone disease. The features of S.T.O.N.E. are relevant in predicting SFR with URS. Size, location, and degree of hydronephrosis were statistically significant factors in multivariate analysis. The S.T.O.N.E. Score establishes the framework for future analysis of the treatment of urolithiasis.

  2. Evaluation of a blended learning course for teaching oral radiology to undergraduate dental students.

    Science.gov (United States)

    Kavadella, A; Tsiklakis, K; Vougiouklakis, G; Lionarakis, A

    2012-02-01

    The purpose of this study was to develop and implement a blended course (a combined face-to-face and online instruction) on undergraduate oral radiology and evaluate it by comparing its educational effectiveness (derived from students' performance and answers to questionnaires) to a conventional course's. Students' attitudes concerning the blended methodology were also registered. An original course was developed and implemented, and its electronic version was uploaded to an e-learning educational platform. The course was attended by two groups of final-year students, who were taught by either the conventional face-to-face methodology or the blended learning methodology. Students answered a series of questionnaires, before and after following the course, regarding their perceptions, attitudes and evaluation of the course. Additionally, they completed knowledge assessment tests and their grades (before and after the course) were compared. Educational effectiveness of the course was determined by analysing the results of the questionnaires and the tests. Students in the blended group performed significantly better than their colleagues of the conventional group in the post-course knowledge test, and female students of the blended group performed better than male students. Students evaluated high the course content, organisation, educational material, and the blended group students additionally appreciated the course design and clarity of instructions. Students' attitudes towards elements of blended learning (effectiveness, motivation and active engagement) were very positive. Most of the blended group students, who attended the face-to-face meeting (approx. 91%), evaluated it as helpful for summarising the subject and clarifying difficult issues. Blended learning is effective and well evaluated by dental students and can be implemented in undergraduate curriculum for teaching oral radiology. © 2011 John Wiley & Sons A/S.

  3. Preoperative and postoperative evaluation of somatosensorial evoked potentials of upper extremities in cervical intervertebral disc herniation.

    Science.gov (United States)

    Umur, Ahmet Sukru; Selcuki, Mehmet; Selcuki, Deniz; Temiz, Cuneyt; Akbasak, Aytac

    2013-01-01

    This study aims to determine the dysfunction caused by existing pathological condition in structures involved in the transfer of sensory functions of the neural system in cervical disc herniation, and to establish whether or not the level and degree of this anatomical damage can be anticipated by SEP (Somatosensorial Evoked Potentials). We compared the obtained SEP values for statistical significance using the Friedman Variation Analysis. In parameters with statistical significance, the Wilcoxon Signed Rank test was used to identify when significant improvements occurred. The study found that the statistical data of the latency of the N14 wave originating from the dorsal column nuclei of the medulla spinalis and dorsal column gray matter improved (p < 0.05) in the postoperative period compared with the preoperative values. Using the Wilcoxon Signed Rank test, we studied postoperative months separately in regard to the difference in the latency of the N14 wave, and found the statistically significant improvement to be marked particularly in months 3 and 6 postoperatively (p < 0.05). In conclusion, we suggest that SEP is a useful tool to check the functional condition of the dorsal spinal column. The benefit of the SEP utilization is the ability to determine the severity of the pathological condition preoperatively and follow the patient's functional postoperative improvement.

  4. [Predisposition to latex allergy undetected on preoperative evaluation: a case report].

    Science.gov (United States)

    Kimura, Yuriko; Okamura, Makoto; Harioka, Tokuya; Hara, Tadashi; Kamiya, Kiyoshi; Matsukawa, Takashi

    2013-12-01

    A 70-year-old man was scheduled to undergo laparoscopic total gastrectomy for stomach cancer. He had no history of atopy, fruit allergies, or frequent exposure to natural rubber. Preoperative latex-specific IgE antibodies were negative. Anesthesia was induced, and the surgery was started uneventfully. Soon after the surgeon had begun to manipulate the intestine, the blood pressure suddenly dropped to 27/21 mmHg. Facial flushing was also observed. Anaphylactic shock caused by latex was strongly suspected, and surgery was immediately halted. The surgical gloves were changed to latex-free ones, and adrenaline was administered. The blood pressure was gradually normalized within 30 min, and the facial flushing mostly disappeared. Postoperative laboratory examination revealed that serum tryptase had increased to 34.4 microg l-1, 40 minutes after the onset of anaphylaxis, and decreased to 19.4 microg l-1, 24 hours than later. Latex-specific IgE antibodies and a prick test with latex were both positive. Consequently, the diagnosis of latex-induced anaphylactic reaction was confirmed. Because even detailed questioning and examination does not always identify such a predisposition, avoiding contactwith latex products is more rational exhaustively checking every preoperative patient for latex allergy

  5. B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Giuseppina Napolitano

    2013-01-01

    Full Text Available Papillary thyroid cancer (PTC is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs. The ultrasonography (US is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging (BFI, recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs (BFI-TS, within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high values ​​of specificity (99.7% and sensitivity (80.9%. The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.

  6. ETIOLOGY, EPIDEMIOLOGICAL PROFILE AND RADIOLOGICAL EVALUATION OF OBSTRUCTIVE JAUNDICE AT A TERTIARY CARE CENTER

    Directory of Open Access Journals (Sweden)

    Lokesh

    2015-09-01

    Full Text Available BACKGROUND AND AIM: Obstructive jaundice is nowadays usually referred to gastroenterology department and therefore, it is important to identify the common causes and relevant investigations to find out the cause. With this objective we conducted a study at Mahatma Gandhi Hospital, Jaipur to find out the etiology and epidemiological profile of patients presenting with obstructive jaundice to our department. PATIENTS AND METHODS: 50 patients of obstructive jaundice were evaluated thoroughly for etiology, epid emiological profile and radiological evaluation. RESULTS: Malignancy was more common in males while benign causes predominated in females. Carcinoma head of pancreas was most common cause of obstructive jaundice followed by choledocholithiasis. CONCLUSION : Malignant obstructive jaundice is more common as compared to benign obstructive jaundice and malignant causes are more frequent in males as compared to females Where benign causes predominate. Ultrasound should be the first diagnostic test to be performed and in selected cases CT and MRCP should be performed.

  7. Role of blood AFP mRNA and tumor grade in the preoperative prognostic evaluation of patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Umberto Cillo; Giacomo Zanus; Vito De Pascale; Mario Plebani; Davide Francesco D'Amico; Alessandro Vitale; Filippo Navaglia; Daniela Basso; Umberto Montin; Marco Bassanello; Francesco D'Amico; Francesco Antonio Ciarleglio; Alberto Brolese

    2005-01-01

    AIM: To explore the potential prognostic role of preoperative tumor grade and blood AFP mRNA in a cohort of patients with hepatocellular carcinoma (HCC)eligible for radical therapies according to a well-defined treatment algorithm not including nodule size and number as absolute selection criteria.METHODS: Fifty patients with a diagnosis of HCC were prospectively enrolled in the study. Inclusion criteria were: (1) histological assessment of tumor grade by means of percutaneous biopsies; (2) determination of AFP mRNA status in the blood; (3) patient's eligibility for radical therapies.RESULTS: At preoperative evaluation, 54% of the study group had a well-differentiated HCC, 42% had AFP mRNA in the blood, 40% had a tumor larger than 5 cm and 56% had more than one nodule. Surgery (resection or liver transplantation) was performed in 29 patients,while 21 had percutaneous ablation procedures. After a median follow-up of 28 mo, 12-, 24-, and 36-mo survival rates were 78%, 58%, and 51%, respectively. Surgical therapy, performance status and three tumor-related variables (AFP mRNA, HCC grade and gross vascular invasion) resulted as significant survival predictors at univariate analysis. Nodule size and number did not perform as significant prognosticators. Multivariate study selected only surgical therapy and a biologically early HCC profile (AFP mRNA negative and well-differentiated tumor without gross vascular invasion) as independent survival variables.CONCLUSION: The preoperative determination of tumor grade and blood AFP mRNA status may potentially refine the prognostic evaluation of HCC patients and improve the selection process for radical therapies.

  8. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Oh, Joo Hyeong; Yoon, Yub; Lee, Tae Won; Ihm, Chun Gyoo [Kyunghee University Hospital, seoul (Korea, Republic of)

    2001-01-01

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416{+-}45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency.

  9. Clinical and radiological evaluation of furcal perforation repaired by mineral trioxide aggregate and intermediate restorative material

    Directory of Open Access Journals (Sweden)

    Kamrun Naher Shomi

    2017-05-01

    Full Text Available The purpose of the present study was to assess the clinical and radiological outcome following repair of furcal perforation by mineral trioxide aggregate (MTA and intermediate restorative material (IRM in mandibular molar teeth. Forty teeth having furcal perforation were enrolled in this study, out of which 20 teeth were treated with MTA and the remaining 20 teeth were subjected to IRM treatment. Following perforation repair, all teeth were subjected to root canal treatment followed by final restoration. Clinical and radiological outcome was evaluated at 3, 6 and 12 months interval. The results showed that in both MTA and IRM groups, pain, tenderness on percussion as well as swelling and sinus was gradually decreased with the increase of the observation period. Furthermore, the widening of the periodontal ligament space and communi-cation with the oral cavity were gradually decreased. Although there was no significant differences between MTA and IRM at 3 and 6 months observation period but at 12 months, the clinical outcome between MTA and IRM was statistically significant (p<0.05. It can be concluded that repair of furcal perforation by MTA showed more effective than that of IRM.

  10. A four-alternative forced choice (4AFC) software for observer performance evaluation in radiology

    Science.gov (United States)

    Zhang, Guozhi; Cockmartin, Lesley; Bosmans, Hilde

    2016-03-01

    Four-alternative forced choice (4AFC) test is a psychophysical method that can be adopted for observer performance evaluation in radiological studies. While the concept of this method is well established, difficulties to handle large image data, perform unbiased sampling, and keep track of the choice made by the observer have restricted its application in practice. In this work, we propose an easy-to-use software that can help perform 4AFC tests with DICOM images. The software suits for any experimental design that follows the 4AFC approach. It has a powerful image viewing system that favorably simulates the clinical reading environment. The graphical interface allows the observer to adjust various viewing parameters and perform the selection with very simple operations. The sampling process involved in 4AFC as well as the speed and accuracy of the choice made by the observer is precisely monitored in the background and can be easily exported for test analysis. The software has also a defensive mechanism for data management and operation control that minimizes the possibility of mistakes from user during the test. This software can largely facilitate the use of 4AFC approach in radiological observer studies and is expected to have widespread applicability.

  11. Background Radiation Survey of the Radiological/Nuclear Countermeasures Test and Evaluation Center

    Energy Technology Data Exchange (ETDEWEB)

    Colin Okada

    2010-09-16

    In preparation for operations at the Radiological/Nuclear Countermeasures Test and Evaluation Complex (Rad/NucCTEC), the Department of Homeland Security Domestic Nuclear Detection Office (DHS/DNDO) requested that personnel from the Remote Sensing Laboratory (RSL) conduct a survey of the present radiological conditions at the facility. The measurements consist of the exposure rate from a high-pressure ion chamber (HPIC), high-resolution spectra from a high-purity germanium (HPGe) system in an in situ configuration, and low-resolution spectra from a sodium iodide (NaI) detector in a radiation detection backpack. Measurements with these systems were collected at discrete locations within the facility. Measurements were also collected by carrying the VECTOR backpack throughout the complex to generate a map of the entire area. The area was also to be surveyed with the Kiwi (an array of eight-2-inch x 4-inch x 16-inch NaI detectors) from the Aerial Measuring Systems; however, conflicts with test preparation activities at the site prevented this from being accomplished.

  12. Morphological evaluation of damage to esophageal tumors caused by preoperative irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kanaev, S.V.; Stolyarov, V.I.; Serov, S.F.; Savel' eva, O.P.; Frolova, Z.V.; Volkov, O.N.; Nejshtadt, Eh.L. (Nauchno-Issledovatel' skij Inst. Onkologii, Leningrad (USSR))

    1982-01-01

    Post-radiation changes were studied in 21 patients suffering from esophageal cancer who had undergone preoperative irradiation. The results of quantitative morphological analysis were compared with the data obtained from examination of 15 patients operated for tumors but unexposed to radiation. Tumor damage index proved to be 35.0%+-4. Mitotic index remained unchanged, while pathological mitoses in tumors increased four times after irradiation (62.0%+-5.8 as compared with 15.4%+-4.4). They are mostly observed in the dispersion of chromosomes in metaphase. It is concluded that in order to adequately visualise radiation-induced damage to tumor, different morphological criteria should be used in its evaluaton, depending on the length of post-irradiation period.

  13. Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Masaaki Karino

    Full Text Available BACKGROUND: We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma. METHODS: A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio, and nuclear area coefficient of variation (NACV. Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis. RESULTS: Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site. CONCLUSION: Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.

  14. Radiological evaluation of treatment with SpineCor brace in children with idiopathic spinal scoliosis.

    Science.gov (United States)

    Plewka, Barbara; Sibiński, Marcin; Synder, Marek; Witoński, Dariusz; Kołodziejczyk-Klimek, Katarzyna; Plewka, Michał

    2013-06-28

    INTRODUCTION. This paper reports on a radiological evaluation of the outcomes of treatment with the SpineCor brace in children with idiopathic spinal scoliosis vs. a control group who had only received 24 months of rehabilitation. The compliance of the SpineCor-treated patients with medical instructions was also assessed. MATERIAL AND METHODS. A prospective evaluation encompassed a group of forty (40) children, treated with a SpineCor brace for idiopathic scoliosis. A control group included forty (40) children who were followed up. The mean age of the children was 12.0 years and sixty-six (66) of the patients were girls. The study group and the control group were comparable in terms of demographic data and radiological parameters of scoliosis. The mean scoliosis angle was 25.3˚ and 26.1˚ in the thoracic and lumbar spine, respectively. RESULTS. In the (SpineCor-treated) study group, stabilisation or improvement of the scoliosis was obtained in 31 (78%) patients, while progression was noted in 9 (22%). In the control group, stabilisation was found in 21 (53%) patients and progression in 19 (47%), while none of the children met improvement criteria. In the brace-treated group, a smaller change in the thoracic curvature angle was observed (R=0.34, p=0.0001) than in the control group, while no such difference was identified at the lumbar spine level (R=0.15, p=0.18). Out of the 40 treated children, 38 used the brace regularly. Four of the children were active in sports above recreation level. CONCLUSIONS. The treatment of idiopathic spinal scoliosis in children by means of the SpineCor dynamic brace solution significantly more frequently led to stabilisation or correction of scoliosis as measured by Cobb's angle. A high compliance of the children and their parents was also observed.

  15. A randomised trial to evaluate preoperative oral carbohydrate administration on insulin resistance in off-pump coronary artery bypass patients.

    Science.gov (United States)

    Lee, Bora; Soh, Sarah; Shim, Jae-Kwang; Kim, Ha Y; Lee, Hyelin; Kwak, Young-Lan

    2017-04-21

    In fasting cardiac surgery patients, preoperative carbohydrate (CHO) drink intake attenuated insulin resistance and improved cardiac metabolism, although its beneficial effects were not evident after cardiac surgery possibly due to cardiopulmonary bypass-related extreme systemic inflammation. We aimed to evaluate whether preoperative CHO intake affected insulin resistance and free-fatty acid (FFA) concentrations in off-pump coronary revascularisation. A randomised controlled trial. Primary care in a university hospital in Korea from January 2015 to July 2016. Sixty patients who underwent elective multi-vessel off-pump coronary revascularisation were randomised into two groups. Three patients were excluded from analysis and 57 patients completed study. The CHO group received oral CHO (400 ml) the prior evening and 2 to 3 h before surgery, and the control group was fasted from food and water according to standard protocol. Insulin resistance was assessed twice, after anaesthetic induction and after surgery via short insulin tolerance test. FFA, C-reactive protein and creatine kinase-myocardial band concentrations were determined serially for 48 h after surgery. Insulin sensitivity was greater (P = 0.002) and plasma FFA concentrations were lower (P = 0.001) after anaesthetic induction in the CHO group compared with the Control group, although there were no intergroup differences after surgery. The postoperative peak creatine kinase-myocardial band concentration was significantly lower in the CHO group compared with the Control group [8.8 (5.4 to 18.2) vs. 6.4 (3.5 to 9.7) ng ml, P = 0.031]. A preoperative CHO supplement significantly reduced insulin resistance and FFA concentrations compared with fasting at the beginning of the surgery, but these benefits were lost after off-pump coronary revascularisation. Despite their transient nature, these beneficial effects resulted in less myocardial injury, mandating further studies focused on the impact

  16. Evaluation of Stress Intensity and Anxiety Level in Preoperative Period of Cardiac Patients.

    Science.gov (United States)

    Rosiek, Anna; Kornatowski, Tomasz; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz; Leksowski, Krzysztof

    2016-01-01

    The stress related to patient's stay in a hospital increases when it is necessary to perform a surgery. Therefore, the study of the phenomenon of stress intensity in hospitalized patients has become an important issue for public health. The study was conducted in University Hospital No. 1 in the cardiosurgery clinic. The study involved 58 patients who were admitted as planned to the hospital. The study used a standardized questionnaire measuring intensity of the stress and also deepened interviews with patients about stress and anxiety felt before the surgery. The greater the patient's anxiety resulting from his state of health, the greater the intensity of stress in the preoperative period. This relationship is linear. The results of the study also made it possible to see intrapersonal factors (pain, illness, and suffering) and extrapersonal factors (anesthesia, surgery, and complications after surgery), which are causes of anxiety before surgery. The research showed high (negative) results of anxiety and stress associated with the disease, surgery, and complications after cardiac surgery. Active involvement in hospitalization elements, such as patient education before surgery, psychological support, and medical care organization taking into account patient's preferences, reduces the impact of stressors.

  17. An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement.

    Science.gov (United States)

    Steen Law, S L; Southard, K A; Law, A S; Logan, H L; Jakobsen, J R

    2000-12-01

    Patients undergoing orthodontic treatment can experience significant levels of pain. This study assessed the effectiveness of preoperative ibuprofen in reducing the incidence and the severity of pain after orthodontic separator placement. Sixty-three adolescent patients (mean age, 13 years) were included in this randomized, double-blind, placebo-controlled, prospective study. Patients were randomly assigned to 1 of 3 experimental conditions: (1) 400 mg of ibuprofen taken orally 1 hour before separator placement and a lactose placebo taken orally immediately after the appointment, (2) a lactose placebo taken orally 1 hour before separator placement and 400 mg of ibuprofen taken orally immediately after the appointment, or (3) a lactose placebo taken orally 1 hour before separator placement and again immediately after the appointment. The patient's level of discomfort was assessed with a visual analog scale at 2, 6, and 24 hours, as well as at 2, 3, and 7 days after placement of the orthodontic separators. An analysis of variance and Duncan's multiple range test revealed that 2 hours after their orthodontic appointment the patients who had taken ibuprofen 1 hour before separator placement had significantly less pain with chewing than did the patients who received either ibuprofen postoperatively or a placebo. Additional measures suggest a trend for less pain for this group of patients. These results support the use of pretreatment ibuprofen for patients requiring analgesics for orthodontic discomfort. Future study of the use of preemptive analgesics in orthodontics is warranted.

  18. Radiologic evaluation of coronary artery disease in adults with congenital heart disease.

    Science.gov (United States)

    Valenzuela, David M; Ordovas, Karen G

    2016-01-01

    Improved surgical and medical therapy have prolonged survival in patients with congenital heart disease (CHD) such that general medical conditions like coronary artery disease (CAD) are now the main determinants of mortality. A summary of the association of CAD with CHD, as well as a discussion of the radiologic evaluation of the coronary arteries in adults with CHD is described herein. Cross sectional imaging to evaluate CAD in adults with CHD should follow the same appropriateness criteria as gender and aged matched patients without CHD. Coronary CT imaging may be particularly valuable in evaluating the coronary arteries in this patient population as invasive coronary angiography may prove challenging secondary to complicated or unconventional anatomy of the coronary arteries. Further, typical methods for evaluating CAD such as stress or echocardiography may be impractical in adults with CHD. Finally, delineating the anatomic relationship of the coronary arteries and their relationship with the sternum, chest wall, conduits, grafts, and valves is highly recommended in patients with CHD prior to reintervention to avoid iatrogenic complications.

  19. Utility of electrodiagnostic testing and computed tomography myelography in the preoperative evaluation of neonatal brachial plexus palsy.

    Science.gov (United States)

    Vanderhave, Kelly L; Bovid, Karen; Alpert, Hilary; Chang, Kate Wan-Chu; Quint, Douglas J; Leonard, James A; Yang, Lynda J S

    2012-03-01

    The rate of neonatal brachial plexus palsy (NBPP) remains 0.4%-4% despite improvements in perinatal care. Among affected children, the extent of brachial plexus palsy differs greatly, as does the prognosis. Controversial elements in management include indications and timing of nerve repair as well as type of reconstruction in patients in whom function will ultimately not be recovered without surgical intervention. Differentiating preganglionic (avulsion) from postganglionic (rupture) lesions is critical because preganglionic lesions cannot spontaneously recover motor function. Distinguishing between these lesions at initial presentation based on clinical examination alone can be difficult in infants. The purpose of the present study was to determine the sensitivity of preoperative electrodiagnostic studies (EDSs) and CT myelography (CTM) in determining the presence of nerve root rupture and avulsions in infants with NBPP. After receiving institutional review board approval, the authors conducted a retrospective review of patients referred to the Neonatal Brachial Plexus Program between 2007 and 2010. Inclusion criteria included children who underwent brachial plexus exploration following preoperative EDSs and CTM. The CTM scans were interpreted by a staff neuroradiologist, EDSs were conducted by a single physiatrist, and intraoperative findings were recorded by the operating neurosurgeon. The findings from the preoperative EDSs and CTM were then compared with intraoperative findings. The sensitivities and 95% confidence intervals were determined to evaluate performance accuracy of each preoperative measure. Twenty-one patients (8 male amd 13 female) met inclusion criteria for this study. The sensitivity of EDSs and CTM for detecting a postganglionic rupture was 92.8% (CI 0.841-0.969) and 58.3% (CI 0.420-0.729), respectively. The sensitivity for EDSs and CTM for preganglionic nerve root avulsion was 27.8% (CI 0.125-0.509) and 72.2% (CI 0.491-0.875), respectively. In

  20. Comparison of low-dose sequences of dual-source CT and echocardiography for preoperative evaluation of aortic valve disease

    Institute of Scientific and Technical Information of China (English)

    FENG Juan; WANG Xi-ming; JI Xiao-peng; LI Hai-ou; LI Qiao; GUO Wen-bin; WANG Zheng-jun

    2013-01-01

    Background Accurate evaluation of coronary artery,aortic valve annulus diameter (AVAD),and cardiac function in patients with aortic valve disease is of great significance for surgical strategy.In this study,we explored the preoperative evaluation of low-dose sequence (MinDose sequence) scan of dual-source CT (DSCT) for those patients.Methods Forty patients suspected for aortic valve disease (the experimental group) underwent MinDose sequence of DSCT to observe coronary artery,AVAD,and left ventricular ejection fraction (LVEF).Another 33 subjects suspected for coronary artery disease (the control group) underwent conventional retrospective electrocardiographically-gated sequence of DSCT.Two-dimensional transthoracic echocardiography (2D-TTE) and four-dimensional transthoracic echocardiography (4D-TTE) were applied in the experimental group to measure AVAD and LVEF and compared with MinDose-DSCT.Results There was a strong correlation between LVEFs measured by 2D-TTE and MinDose-DSCT (r=0.87,P <0.01),as well as between 4D-TTE and MinDose-DSCT (r=0.90,P <0.01).AVAD measured by MinDose-DSCT was in good agreement with corresponding measurements by 2D-TTE (r=0.90,P <0.01).The effective dose in the experimental group was 63.54% lower than that in the control group.Conclusions MinDose sequence of DSCT with a low radiation dose serving as a one-stop preoperative evaluation makes effective assessment of the coronary artery,AVAD,and LVEF for patients with aortic valve disease.

  1. Pattern mining of user interaction logs for a post-deployment usability evaluation of a radiology PACS client

    NARCIS (Netherlands)

    Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A.; Oudkerk, Matthijs; van Ooijen, Peter M. A.

    2016-01-01

    Objectives: To perform a post-deployment usability evaluation of a radiology Picture Archiving and Communication System (PACS) client based on pattern mining of user interaction log data, and to assess the usefulness of this approach compared to a field study. Methods: All user actions performed on

  2. 76 FR 72431 - Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness...

    Science.gov (United States)

    2011-11-23

    ... Plans and Preparedness in Support of Nuclear Power Plants, NUREG-0654/FEMA-REP-1, Supplement 4 and FEMA... Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants,'' NUREG-0654/FEMA-REP- 1, Revision 1 (NUREG-0654), and the Radiological Emergency Preparedness Program Manual (the...

  3. Fine Needle Aspiration and Medullary Thyroid Carcinoma: The Risk of Inadequate Preoperative Evaluation and Initial Surgery When Relying Upon FNAB Cytology Alone

    NARCIS (Netherlands)

    Essig, G.F.; Porter, K.; Schneider, D.; Debora, A.; Lindsey, S.C.; Busonero, G.; Fineberg, D.; Fruci, B.; Boelaert, K.; Smit, J.W.A.; Meijer, J.A.M.; Duntas, L.; Sharma, N.; Costante, G.; Filetti, S.; Sippel, R.S.; Biondi, B.; Topliss, D.J.; Pacini, F.; Maciel, R.M.; Walz, P.C.; Kloos, R.T.

    2013-01-01

    Objectives: To evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) to preoperatively diagnose medullary thyroid cancer (MTC) among multiple international centers and evaluate how the cytological diagnosis alone could impact patient management.Methods: We performed a retrospectiv

  4. Evaluating the impact of a Canadian national anatomy and radiology contouring boot camp for radiation oncology residents.

    Science.gov (United States)

    Jaswal, Jasbir; D'Souza, Leah; Johnson, Marjorie; Tay, KengYeow; Fung, Kevin; Nichols, Anthony; Landis, Mark; Leung, Eric; Kassam, Zahra; Willmore, Katherine; D'Souza, David; Sexton, Tracy; Palma, David A

    2015-03-15

    Radiation therapy treatment planning has advanced over the past 2 decades, with increased emphasis on 3-dimensional imaging for target and organ-at-risk (OAR) delineation. Recent studies suggest a need for improved resident instruction in this area. We developed and evaluated an intensive national educational course ("boot camp") designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary (MDT) approach. The anatomy and radiology contouring (ARC) boot camp was modeled after prior single-institution pilot studies and a needs-assessment survey. The boot camp incorporated joint lectures from radiation oncologists, anatomists, radiologists, and surgeons, with hands-on contouring instruction and small group interactive seminars using cadaveric prosections and correlative axial radiographs. Outcomes were evaluated using pretesting and posttesting, including anatomy/radiology multiple-choice questions (MCQ), timed contouring sessions (evaluated relative to a gold standard using Dice similarity metrics), and qualitative questions on satisfaction and perceived effectiveness. Analyses of pretest versus posttest scores were performed using nonparametric paired testing. Twenty-nine radiation oncology residents from 10 Canadian universities participated. As part of their current training, 29%, 75%, and 21% receive anatomy, radiology, and contouring instruction, respectively. On posttest scores, the MCQ knowledge scores improved significantly (pretest mean 60% vs posttest mean 80%, Pradiology in addition to enhancing their confidence and accuracy in contouring. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The superiority of 256-slice spiral computed tomography angiography for preoperative evaluation of surrounding arteries in patients with gastric cancer

    Science.gov (United States)

    Wu, Deqing; Zhao, Linyong; Liu, Ying; Wang, Junjiang; Hu, Weixian; Feng, Xingyu; Lv, Zejian; Li, Yong; Yao, Xueqing

    2017-01-01

    Objective To evaluate the utilization of 256-slice spiral computed tomography (CT) angiography in preoperative assessment of perigastric vascular anatomy in patients with gastric cancer. Methods In this study, 80 gastric cancer patients were included. The medical procedure of 256-slice spiral CT angiography was performed on each of these patients consecutively. Thereafter, these patients were subjected to surgical treatment in our hospital. The techniques of volume rendering (VR) and maximum intensity projection (MIP) were used to image reconstruction of arteries around the stomach. Results Both VR and MIP were applied to reconstruct the images of perigastric arteries. The results indicated that VR imaging was inferior to MIP in determining the variant small artery anatomy around the greater curvature and fundus. The respective rates of imaging produced by VR and MIP for left gastroepiploic artery, short gastric artery, and posterior gastric artery, were 32.50% versus 100%, 16.25% versus 87.50%, and 3.75% versus 25.00%, respectively. According to Hiatt’s classification, 75 out of 240 cases were abnormal types, among which we found Type II in 30 cases, Type III in 33 cases, Type IV in three cases, Type V in six cases, and Type VI in only three cases. There was no significant difference for total and every single variation type, between our group and Hiatt’s group (P>0.05). Conclusion The 256-slice spiral CT angiography can be regarded as an effective and accurate diagnostic modality for preoperative assessing anatomical arterial variations in gastric cancer; MIP was superior to VR at identifying variations of some small artery, whereas VR was better than MIP at showing anatomical arterial variations due to its three-dimensional effect.

  6. Evaluation of preoperative computed tomography angiography in association with conventional angiography versus computed tomography angiography only, in the endovascular treatment of aortic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Metzger, Patrick Bastos; Novero, Eduardo Rafael; Rossi, Fabio Henrique; Moreira, Samuel Martins; Linhares, Frederico Augusto; Almeida, Bruno Lorencao de; Barbato, Heraldo Antonio; Izukawa, Nilo Mitsuru; Kambara, Antonio Massamitsu, E-mail: patrickvascular@gmail.com [Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP (Brazil)

    2013-09-15

    Objective: to evaluate the association of conventional angiography (AG) with computed tomography angiography (CTA) as compared with CTA only, preoperatively, in the treatment of aortic diseases. Materials and methods: retrospective study involving patients submitted to endovascular treatment of aortic diseases, in the period from January 2009 to July 2010, with use of preoperative CTA + conventional AG or CTA only. The patients were divided into two groups, namely: G1 - thoracic aortic diseases; and G2 - abdominal aortic diseases. G1 was subdivided into 1A (preoperative AG + CTA) and 1B (preoperative CTA). G2 was subdivided into 2C (CTA + AG) and 2D (CTA only). Results: the authors evaluated 156 patients. In subgroups 1A and 1B, the rate of technical success was, respectively, 100% and 94.7% (p = 1.0); and the rate of therapeutic success was, respectively, 81% and 58% (p = 0.13). A higher number of complications were observed in subgroup 1B (p = 0.057). The accuracy in the calculation of the prosthesis was higher in subgroup 1A (p = 0.065). In their turn, the rate of technical success in subgroups 2C and 2D was, respectively, 92.3% and 98.6% (p = 0.17). The rate of therapeutic success was 73% and 98.6% (p = 0.79). Conclusion: preoperative conventional AG should be reserved for cases where CTA cannot provide all the information in the planning of a therapeutic intervention. (author)

  7. Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study.

    Science.gov (United States)

    Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

    2016-01-01

    Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. "Management and empowerment of human resources'' (weight = 0.465) and "requirements and facilities" (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country's hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards

  8. Evaluation of the Association Between Preoperative Clinical Factors and Long-term Weight Loss After Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Wood, G Craig; Benotti, Peter N; Lee, Clare J; Mirshahi, Tooraj; Still, Christopher D; Gerhard, Glenn S; Lent, Michelle R

    2016-11-01

    Weight loss after bariatric surgery varies, yet preoperative clinical factors associated with long-term suboptimal outcomes are not well understood. To evaluate the association between preoperative clinical factors and long-term weight loss after Roux-en-Y gastric bypass (RYGB). From June 2001 to September 2007, this retrospective cohort study followed up RYGB patients before surgery to 7 to 12 years after surgery. The setting was a large rural integrated health system. Of 1033 eligible RYGB patients who consented to participate in longitudinal research and completed surgery before October 2007, a total of 726 (70.3%) had a weight entered in the electronic medical record 7 or more years after surgery and were included in the analyses after exclusions for pregnancy and mortality. Date of the long-term weight measurement was recorded between August 2010 and January 2016. The primary outcome was percentage weight loss (%WL) at 7 to 12 years after surgery. Preoperative clinical factors (>200) extracted from the electronic medical record included medications, comorbidities, laboratory test results, and demographics, among others. Among the 726 study participants, 83.1% (n = 603) were female and 97.4% (n = 707) were of white race, with a mean (SD) preoperative body mass index (calculated as weight in kilograms divided by height in meters squared) of 47.5 (7.4). From the time of surgery to long-term follow-up (median, 9.3 postoperative years), the mean (SD) %WL was 22.5% (13.1%). Preoperative insulin use, history of smoking, and use of 12 or more medications before surgery were associated with greater long-term postoperative %WL (6.8%, 2.8%, and 3.1%, respectively). Preoperative hyperlipidemia, older age, and higher body mass index were associated with poorer long-term postoperative %WL (-2.8%, -8.8%, and -4.1%, respectively). Few preoperative clinical factors associated with long-term weight loss after RYGB were identified. Preoperative insulin use was strongly

  9. Comparison of intravenous urography and magnetic resonance urography in preoperative evaluation of pelvi-ureteric junction obstruction in children.

    Science.gov (United States)

    Sharma, Alok; Sodhi, Kushaljit Singh; Saxena, Akshay Kumar; Bhatia, Anmol; Menon, Prema; Rao, Katragadda L N; Khandelwal, Niranjan

    2016-01-01

    To compare intravenous urography (IVU) and magnetic resonance urography (MRU) in the preoperative evaluation of pelvi-ureteric junction obstruction (PUJO) in children. A total of 35 children up to 10 years of age in whom unilateral or bilateral PUJO were suspected on ultrasonography were enrolled in this prospective study. All children underwent IVU and MRU, and the findings were compared. Of the 70 kidneys evaluated, 14 (20%) were not visualized on IVU because of nonexcretion of contrast, whereas all the 70 (100%) kidneys were visualized on MRU. On IVU, nephrogram was not visualized in 66 (94.2%) of the 70 kidneys, whereas MRU showed prompt and homogeneous nephrogram in 68 (97.1%) of the 70 kidneys. No evidence of PUJO was seen in 31 (44.2%) kidneys on both IVU and MRU. IVU showed PUJO in 26 (37.1%) kidneys, whereas MRU showed it in 38 (54.2%) kidneys. MRU detected two duplex systems that were missed on IVU. A focal renal lesion and two incidental extra renal abnormalities were detected on MRU, which were not visualized on IVU. MRU is better than IVU, especially in case of poorly functioning kidneys which are not visualized on IVU. MRU also provides anatomic details of the ureter and vessels with better evaluation of renal parenchyma. It also has an additional advantage of detecting incidental extra renal abnormalities, if present.

  10. Preoperative evaluation of the artery of adamkiewicz by MR angiography and CT angiography in patients with a thoracic aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Niinuma, Hiroyuki; Ohira, Atsushi; Makita, Shinji; Moriai, Yoshiteru; Hiramori, Katsuhiko [Iwate Medical Univ., Morioka (Japan). School of Medicine; Yoshioka, Kunihiro; Nakajima, Takayuki; Kawazoe, Kohei [Iwate Medical Univ., Morioka (Japan). Memorial Heart Center

    2002-08-01

    Paraplegia is known as an extremely serious and important complication of surgical repair in patients with a thoraco-abdominal aortic aneurysm. It is important to evaluate the artery of Adamkiewicz (AdA) before surgical repair to prevent paraplegia. But the AdA is difficult to visualize by the invasive and hazardous, conventional selective angiography. The aim of this study was to visualize AdA by MR angiography (MRA) and CT angiography (CTA). Twenty-one consecutive patients with a thoracic aortic aneurysm underwent both gadolinium-enhanced, three-dimensional MRA and CTA using multislice helical CT. The AdA was successfully visualized in 15 of the 21 patients (71.4%) by MRA, and in 17 of those 21 patients (80.9%) by CTA. Its continuity was depicted in 12 of 15 patients (80%) by MRA, and in 9 of 17 patients (47%) by CTA. AdA was visualized at 85.7% by MRA or CTA, respectively. This study shows that CTA is a much more sensitive method to detect AdA than MRA. On the other hand, MRA is better to evaluate the continuity of AdA from the descending aorta to the anterior spinal artery, than CTA. Therefore, MRA and CTA are both useful for a preoperative evaluation of AdA and its detailed vascular anatomy from the aorta to the anterior spinal artery. (author)

  11. Radiological and Clinical Evaluation of the Transosseous Cortical Button Technique in Distal Biceps Tendon Repair.

    Science.gov (United States)

    Caekebeke, Pieter; Vermeersch, Nicolas; Duerinckx, Joris; van Riet, Roger

    2016-12-01

    One of the options to repair a ruptured distal biceps tendon to the radial tuberosity is by means of a transosseous cortical button. Although excellent functional outcomes have been reported, no studies have been performed to quantify the effect of the transosseous fixation technique on the radius. Our study evaluated the clinical outcome and radiological outcome of this technique. The main goal of this study was to evaluate the radiographic evolution of the bone tunnel in the radius. Patients with an acute distal biceps tendon rupture treated with a transosseous cortical button were invited to take part in the study. Fourteen patients were included in the final analysis. All patients were evaluated both clinically and by computed tomography scanning of the proximal radius after a minimum follow-up of 2 years. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. Bone tunnel volume was measured with semiautomated computed tomography segmentation using image-processing software. There were no failures of fixation in the patient group examined. Elbow mobility, arm, and forearm circumference were symmetric for all patients. Average visual analog scale for pain was less than 2. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score were 2.3 and 97.6, respectively. Computed tomography images showed an average closure of the radial bony tunnel of 64% of the initial volume. Biceps tendon repair with cortical button fixation only shows partial tunnel closure. This could reduce the risk of potential complications due to osteolysis, such as radius fracture or hardware failure. Functional results were excellent and comparable to other fixation methods. The role of interference screws in transosseous cortical button techniques to strengthen the repair and to avoid osteolysis may therefore be questioned. Therapeutic IV. Copyright © 2016

  12. 'Top of the basilar' syndrome. Clinico-radiological evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Masaharu; Kuroda, Ryotaro; Nakatani, Jiro; Watanabe, Masaru; Akai, Fumiharu; Ioku, Masahiko

    1988-06-01

    Seventeen patients (age 23 - 81) having the ''top of the basilar'' syndrome were the subjects of this study. They were evaluated clinico-radiologically. The diagnosis of this syndrome was made by computerized tomography. The infarcted lesions of each patient were widely distributed in many areas among the thalamus, midbrain, pons, cerebellum, and occipital lobe. Both the thalami were involved in 8 patients. When the thalamus was involved bilaterally, the low density areas of both the thalami were demonstrated to be almost the same in size and symmetric in localization by computerized tomography, showing a characteristic pattern. Further, magnetic resonance imaging could reveal small lesions in the brain stem minutely. Angiography revealed that stenosis or occlusion was within the circle of 2 cm in diameter surrounding the five-forked road of the top of the basilar artery in 84.6 %. Recanalization of the occluded artery occurred in 61.5 %, which suggests that the embolism plays an important role in appearance of this syndrome. In spite of frequent recanalization hemorrhagic infarction never occurred. The prognosis was very poor.

  13. Osseous and dental outcomes of primary gingivoperiosteoplasty with iliac bone graft: A radiological evaluation.

    Science.gov (United States)

    Touzet-Roumazeille, Sandrine; Vi-Fane, Brigitte; Kadlub, Natacha; Genin, Michaël; Dissaux, Caroline; Raoul, Gwenaël; Ferri, Joël; Vazquez, Marie-Paule; Picard, Arnaud

    2015-07-01

    Primary alveolar cleft repair has two main purposes: to restore normal morphology and normal function. Gingivoperiosteoplasty with bone grafting in mixed dentition has been a well-established procedure. We hypothesized that 1) performance of this surgery in deciduous dentition would provide favorable bone graft osseointegration, and 2) would improve the support of incisor teeth eruption, thereby avoiding maxillary growth disturbances. We conducted a retrospective study of clinical and tridimensional radiological data for 73 patients with alveolar clefts (with or without lip and palate clefts) who underwent gingivoperiosteoplasty with iliac bone graft in deciduous dentition. Pre- and post-operative Cone Beam Computed Tomography (CBCT) comparison allowed evaluation of the ratio between bone graft volume and initial cleft volume (BGV/ICV ratio), and measurement of central incisor teeth movements. This series of 73 patients included 44 males and 29 females, with a mean age of 5.5 years. Few complications were observed. Post-operative CBCT was performed at 7.4 months. The mean BGV/ICV ratio was 0.62. Axial rotation was significantly improved post-operatively (p = 0.004). Gingivoperiosteoplasty with iliac bone graft is safe when performed in deciduous dentition and results in a sufficient bone graft volume to support lateral incisor eruption and upper central incisor tooth position improvement.

  14. Radiologic Evaluation of Compressive Osseointegration for the Fixation of Reconstruction Prostheses after Tumor Resection

    Directory of Open Access Journals (Sweden)

    Manol Lazarov

    2015-01-01

    Full Text Available Objective. In pursuance of thoroughly understanding and facilitating the evaluation of the radiological changes in the preloaded bone by Compliant Pre-Stress osseointegration (Compress Biomet, Warsaw, Indiana a new staging method was created depicting four stages. Methods. Two cohorts (10 and 17 patients resp., not-receiving and receiving chemotherapy were compared in terms of progression of osseointegration. Based on the changes at the bone-metal interface seen on röntgenorgrams four stages were defined: stage 0: immediate postoperative status, no ingrowth, or noncalcified callus; stage 1: early mineralization, calcified callus; stage 2: mature mineralization; and stage 3: hypertrophy at the level of the pins. Results. There were no significant differences between the two cohorts. Group 2, which was significantly younger than group 1 (p<0.001, presented a delayed initial rate of bone formation and reached stage 1 at 6 months instead of 3 months like group 1. The children from the group 2 demonstrated a visible rebound ingrowth. Conclusion. Despite the fact that the staging fails to demonstrate a statistical difference, it is rather simple and can be used for future studies.

  15. A radiological evaluation of allografts (ethylene oxide sterilized cadaver bone and autografts in anterior cervical fusion.

    Directory of Open Access Journals (Sweden)

    Parthiban J

    2002-01-01

    Full Text Available Serial roentgenograms of 40 patients who had 70 cervical intervertebral spaces grafted with ethylene oxide sterilized cadaver bone and 28 patients who received 44 iliac crest auto grafts for anterior cervical spine fusion, were studied. The radiological evaluation was made on the basis of settlement of intervertebral spaces, fusion rate, delayed union, non-union, graft collapse and extrusion of the graft. Indigenous methodologies were designed for the assessment of settlement of grafted intervertebral spaces in percentage. Disc space settlement was more common in autografts (93% cases than in allografts (80% cases. The average percentage of settlement of intervertebral disc space (S% was 22 in autografts and 28 in allografts during the first four months. By the end of eight months, allograft disc spaces settle more. No significant difference was noted in fusion rate at the end of one year viz. allografts (90% cases and autografts (93% cases. Autograft and allograft (ethylene oxide sterilized cadaver bone are equally useful in anterior cervical spine fusions.

  16. A study of the evaluation methodology for radiological emergency planning zone of nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, In Young

    2004-02-15

    For the protection of the public health against nuclear accidents with major release of radioactive material, the Emergency Planning Zone(EPZ) has been designated for an area with a radius of 8{approx}10 km around nuclear power plants(NPPs) in Korea. However, since the current size of EPZ set in 1980's is based on simple assumptions about accident source terms, meteorological conditions, and conservative protective action guides(PAGs), 10 mSv to the whole body and 100 mSv to the thyroids, it is questionable that the current EPZ provides adequate protection against spectrum of accidents encompassing probable severe reactor accidents. The aim of this study is to establish a new methodology to determine the EPZ for NPPs in Korea by reflecting advances in the reactor risk assessment. An illustrative evaluation of EPZ sizes was carried out for the Uljin NPP units 3 and 4. Since the previous PAGs did not seem to warrant initiation of burdensome protective actions, the new PAGs were set to the level of preventing serious deterministic effects-early fatality was considered in this study-as recommended by the International Commission on Radiological Protection(ICRP). In addition, after the guidelines developed by the International Atomic Energy Agency(IAEA), EPZs were sub-divided into two categories: the Precautionary Action Zone(PAZ) and the Urgent Protective Action Planning Zone(UPZ). Six severe accident source term categories(STCs) resulted from the individual plant examination study for Uljin 3 and 4, for which the core damage frequency exceeded approximately 10{sup -6} per reactor year, were selected and corresponding environmental release source terms were adopted as accident source terms for EPZ determination. The MACCS2(MELCOR Accident Consequence Code System2) was used in calculation of radiological consequences. The radiological emergency plans and procedures for Uljin NPPs were referred for accident notification system and the planned protective actions. The

  17. Relevance of computerized tomography in the preoperative evaluation of patients with vulvar cancer

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Zobbe, Vibeke; Thranov, Ingrid Regitze;

    2015-01-01

    BACKGROUND: The purpose of the study was to determine whether inclusion of computerized tomography (CT) in the prospective evaluation of vulvar cancer changed the surgical treatment strategy in terms of detection of lymph node metastases, tumor spread and comorbidity, and additionally to examine...

  18. Analysis of 64-row multidetector CT images for preoperative angiographic evaluation of potential living kidney donors; Analyse der mehrphasigen 64-Zeilen-Multidetektor-Computertomographie zur praeoperativen angiographischen Evaluation potenzieller Lebendnierenspender

    Energy Technology Data Exchange (ETDEWEB)

    Blondin, D.; Andersen, K.; Kroepil, P.; Cohnen, M.; Moedder, U.; Jung, G. [Universitaetsklinikum Duesseldorf, Institut fuer Diagnostische Radiologie, Duesseldorf (Germany); Sandmann, W. [Universitaetsklinikum Duesseldorf, Klinik fuer Gefaesschirurgie und Nierentransplantation, Duesseldorf (Germany); Ivens, K. [Universitaetsklinikum Duesseldorf, Klinik fuer Nephrologie, Duesseldorf (Germany)

    2008-07-15

    Anatomical imaging and the ascertainment of any anomalies in the renal vessels and the ureters are essential in the planning of a kidney donation. The aim of the present study was to assess the value of 64-row multidetector CT in noninvasive examination of the renal vessels and ureters of potential living kidney donors. The evaluation embraced 63 living renal donors (LNS) who underwent preoperative CT examination from December 2004 to January 2007. The examinations were all carried out using a Somatom Sensation -Cardiac 64 (Siemens Medical Solutions, Germany). As well as CT angiography (CTA), a venous phase of the abdomen and a late phase after 15 min using low-dose technique were performed for CT urography (CTU). The radiological findings were compared with the surgical results, or with the angiograms in 2 cases. Sensitivity, specificity and both negative and positive predictive value were calculated. In the 63 (31 female, 32 male) donors CTA had a sensitivity of 100% in examination of the main and accessory renal arteries and of 98.3% when the venous and ureteric anatomy were assessed. The sensitivity of low-dose CTU was also 100%. The findings recorded in this study indicate that noninvasive preoperative planning with 64-row multidetector CTA and CTU is a reliable 'one-stop shopping' method of examination for potential living kidney donors. (orig.) [German] Die anatomische Darstellung und Erfassung moeglicher Anomalien der Nierengefaesse und Ureteren ist fuer die Planung einer Lebendnierenspende von essenzieller Bedeutung. Die vorliegende Untersuchung soll die Wertigkeit der nichtinvasiven Evaluation mit der 64-Zeilen-Multidetektor-CT untersuchen. In die Auswertung wurden 63 Lebendnierenspender (LNS) eingeschlossen, die im Zeitraum 12.2004 bis 01.2007 mit der CT praeoperativ untersucht wurden. Die Untersuchungen erfolgten mit einem Somatom-Sensation-Cardiac-64 (Siemens Medical Solutions, Deutschland). Neben einer CT-Angiographie (CTA) wurden eine

  19. Essentials of skeletal radiology

    Energy Technology Data Exchange (ETDEWEB)

    Yochum, T.R.; Rowe, L.J.

    1987-01-01

    This book discusses the following topics of skeletal radiology: Positioning of patients for diagnostic radiology and normal anatomy; congenital malformations of skeleton; measurements in radiology; spondylolisthesis; metabolic and endocrine diseases of bone and their diagnostic aspects; image processing of vertebrae, skeleton, bone fractures evaluations and epidemiological and social aspects of some bone diseases. Various modalities as CT scanning, NMR imaging, ultrasonography and biomedical radiography are briefly discussed in relation to bone pathology.

  20. Pulmonary function tests in the preoperative evaluation of lung cancer surgery candidates. A review of guidelines

    OpenAIRE

    Trzaska-Sobczak, Marzena; Skoczyński, Szymon; Pierzchała, Władysław

    2014-01-01

    Before planned surgical treatment of lung cancer, the patient's respiratory system function should be evaluated. According to the current guidelines, the assessment should start with measurements of FEV1 (forced expiratory volume in 1 second) and DLco (carbon monoxide lung diffusion capacity). Pneumonectomy is possible when FEV1 and DLco are > 80% of the predicted value (p.v.). If either of these parameters is < 80%, an exercise test with VO2 max (oxygen consumption during maximal exercise) m...

  1. Preoperative evaluation and comprehensive risk assessment for children with Down syndrome.

    Science.gov (United States)

    Lewanda, Amy Feldman; Matisoff, Andrew; Revenis, Mary; Harahsheh, Ashraf; Futterman, Craig; Nino, Gustavo; Greenberg, Jay; Myseros, John S; Rosenbaum, Kenneth N; Summar, Marshall

    2016-04-01

    Down syndrome is a common chromosome disorder affecting all body systems. This creates unique physiologic concerns that can affect safety during anesthesia and surgery. Little consensus exists, however, on the best way to evaluate children with Down syndrome in preparation for surgery. We review a number of salient topics affecting these children in the perioperative period, including cervical spine instability, cardiovascular abnormalities, pulmonary hypertension, upper airway obstruction, hematologic disturbances, prematurity, low birth weight, and the use of supplements and alternative therapies. Recommendations include obtaining a complete blood count to detect an increased risk for bleeding or stroke, and cardiology evaluation to identify patients with pulmonary hypertension, as well as undiagnosed or residual heart disease. Pediatric cardiac anesthesiologists and intensivists should be involved as needed. The potential for cervical spine instability should be considered, and the anesthesiologist may wish to have several options available both for the medications and equipment used. The child's family should always be asked if he or she is on any nutritional supplements, as some products marketed to families may have secondary effects such as inhibition of platelet function. Using this evaluation in presurgical planning will allow physicians to better consider the individual circumstances for their patients with Down syndrome. Our goal was to optimize patient safety by choosing the most appropriate setting and perioperative personnel, and to mitigate those risk factors amenable to intervention.

  2. CBCT fine preoperative evaluation of inflammatory radicular cysts and postoperative local integration appreciation of alloplastic grafts materials.

    Science.gov (United States)

    Nica, Diana; Ianes, Emilia; Brad, S

    2014-01-01

    The purpose of this paper is to point out the value of CBCT exam in pre and postoperative diagnosis assessment of inflammatory radicular cysts together with full appreciation of local integration of alloplastic graft materials used to repair the osseous defects. There were statistically retrospective evaluated the pre and postoperative results of CBCT and x-ray examinations of 34 patients with inflammatory radicular cysts clinically, biologically and histopathologically assessed at Oral and Maxilo-Facial Surgery Clinic from Timisoara. In all cases we proceeded to surgical radicular cysts removement, extraction of the associated non-vital tooth together with alloplastic graft materials repairement of the osseous defects. The CBCT preoperative scans clearly showed the extent, the morphological characteristics and the topoanatomic reports, in all 34 cases of inflammatory radicular cysts together with regional endodontic status. The CBCT postoperative scans revealed the very local integration of alloplastic graft materials used to repair the osseous defects and, in some cases, the dental rehabilitation by metallic implants. CBCT scan is the imaging method of choice in pre and postoperative diagnosis assessment of inflammatory radicular cysts together with alloplastic graft materials repairement of the osseous defects and dental rehabilitation by metallic implants, due to high specific abilities in bone tissue 3D evaluation.

  3. A CLINICAL STUDY ON SURGICAL MANAGEMENT OF TIBIAL PLATEAU FRACTURES - FUNCTIONAL AND RADIOLOGICAL EVALUATION

    Directory of Open Access Journals (Sweden)

    Bhavani

    2015-10-01

    Full Text Available BACKGROUND: Tremendous advance in mechanization and fastness of travel have been accompanied by steep increase in number and severity of fractures and those of tibial plateau are no exception. Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. AIM OF STUDY: This study is to analyze the functional outcome of CRIF or ORIF with or without bone grafting in tibial plateau fractures in adults. MATERIALS AND METHODS: 30 cases of tibial plateau fractures treated by various modalities were studied from 1 - 8 - 2012 to 31 - 1 - 2014 at our institution and followed for a minimum of 6 months. Fractures were evaluated using Modified Rasmussen’s Clinical, Radiological grading system. RESULTS : The selected patients were evaluated thoroughly and after the relevant investigations, were taken for surgery. The fractures were classified as per the SCHATZKER’S types and operated accordingly with CRIF with Percutaneous cannulated cancellous screws, ORIF with buttress plate/LCP with or without bone grafting. Immobilization of fractures continued for 3 weeks by POP slab. Early range of motion was then started. Weight bearing up to 6 - 8 weeks was not allowed. The full weight bearing deferred until 12 weeks or complete fracture union . The knee range of motion was excellent to very good, gait and weight bearing after complete union was satisfactory, knee stiffness in 3 cases , wound dehiscence and infection in 1 case and non - union in none of our cases was noted. CONCLUSION: Functional outcome is better in operatively treated tibial plateau fractures in adults, because it gives excellent anatomical reduction and rigid fixation to restore articular congruity and early motion thereby preventing knee stiffness.

  4. Surface electromyography in preoperative evaluation and postoperative monitoring of Zenker's diverticulum.

    Science.gov (United States)

    Vaiman, Michael

    2006-01-01

    Patients with Zenker's diverticulum (ZD) underwent surface electromyography (sEMG) evaluation to determine sEMG patterns specific for ZD. Group 1 comprised patients with proven long-standing ZD that refused surgical treatment (n = 11, age mean = 55.7 years). Group 2 comprised surgically operated on patients with ZD (n = 6, age mean = 61 years). The timing, amplitude, and graphic patterns of activity of the masseter, submental, and laryngeal strap muscles were examined during voluntary single water swallows ("normal"), single swallows of excessive amounts of water (20 ml, "stress test"), and continuous drinking of 100 cc of water. The muscle activity in pharyngeal and initial esophageal stages of swallowing was measured, and graphic records were evaluated in relation to timing and voltage. The data were compared with the previously established normative database. The main sEMG patterns of ZD are (1) duration of swallowing and drinking is longer than normal (p swallowing activity is higher than normal (p swallow followed by secondary swallow of the regurgitated portion of a bolus as seen at the sEMG records are specific graphic patterns for the ZD. Zenker's diverticulum has its own specific sEMG patterns. Surface EMG, being an important screening method for patients with dysphagia, is a valuable additional diagnostic tool for ZD. Because it is noninvasive and nonradiographic, it can be used for monitoring of long-standing cases of the disease as well as monitoring of postsurgical recovery.

  5. Usefulness of an accelerated transoesophageal stress echocardiography in the preoperative evaluation of high risk severely obese subjects awaiting bariatric surgery

    Directory of Open Access Journals (Sweden)

    Tessier Michel

    2010-07-01

    Full Text Available Abstract Background Severe obesity is associated with an increased risk of coronary artery disease (CAD. Bariatric surgery is an effective procedure for long term weight management as well as reduction of comorbidities. Preoperative evaluation of cardiac operative risk may often be necessary but unfortunately standard imaging techniques are often suboptimal in these subjects. The purpose of this study was to demonstrate the feasibility, safety and utility of transesophageal dobutamine stress echocardiography (TE-DSE using an adapted accelerated dobutamine infusion protocol in severely obese subjects with comorbidities being evaluated for bariatric surgery for assessing the presence of myocardial ischemia. Methods Subjects with severe obesity [body mass index (BMI >40 kg/m2] with known or suspected CAD and being evaluated for bariatric surgery were recruited. Results Twenty subjects (9M/11F, aged 50 ± 8 years (mean ± SD, weighing 141 ± 21 kg and with a BMI of 50 ± 5 kg/m2 were enrolled in the study and underwent a TE-DSE. The accelerated dobutamine infusion protocol used was well tolerated. Eighteen (90% subjects reached their target heart rate with a mean intubation time of 13 ± 4 minutes. Mean dobutamine dose was 31.5 ± 9.9 ug/kg/min while mean atropine dose was 0.5 ± 0.3 mg. TE-DSE was well tolerated by all subjects without complications including no significant arrhythmia, hypotension or reduction in blood arterial saturation. Two subjects had abnormal TE-DSE suggestive of myocardial ischemia. All patients underwent bariatric surgery with no documented cardiovascular complications. Conclusions TE-DSE using an accelerated infusion protocol is a safe and well tolerated imaging technique for the evaluation of suspected myocardial ischemia and cardiac operative risk in severely obese patients awaiting bariatric surgery. Moreover, the absence of myocardial ischemia on TE-DSE correlates well with a low operative risk of cardiac event.

  6. Evaluation of preoperative radiation therapy in combination with low dose carboplatin and 5FU

    Energy Technology Data Exchange (ETDEWEB)

    Yokomizo, Michinori; Tada, Hiroyuki; Ishikawa, Kazuo; Togawa, Kiyoshi [Akita Univ. (Japan). School of Medicine; Okamoto, Yoshitaka; Matsuzaki, Zensei

    1997-10-01

    A comparative study was performed to evaluate difference in the histological effects and side effects between a group of tongue cancer and hypopharyngeal cancer patients treated with 5FU (250 mg x 3 days/week) and 60 Gy radiation, and those treated with CBDCA (50-80 mg x 1 day/week) followed by 5FU (250 mg x 2 days/week) and 40 Gy radiation. In the tongue cancer patients, there was no significant change in histological effects according to Shimosato`s classification system. A decrease in leukocytes was found in the CBDCA group, which was not statistically significant. In cases with hypopharyngeal cancer, the number of leukocytes was significantly decreased in the CBDCA group. However the number of platelets and degree of stomatitis was not significantly altered. (author)

  7. Evaluation and management of ischiofemoral impingement: a pathophysiologic, radiologic, and therapeutic approach to a complex diagnosis.

    Science.gov (United States)

    Hernando, Moisés Fernández; Cerezal, Luis; Pérez-Carro, Luis; Canga, Ana; González, Raquel Prada

    2016-06-01

    Ischiofemoral impingement syndrome (IFI) is an underrecognized form of atypical, extra-articular hip impingement defined by hip pain related to narrowing of the space between the ischial tuberosity and the femur. The etiology of IFI is multifactorial and potential sources of ischiofemoral engagement include anatomic variants of the proximal femur or pelvis, functional disorders as hip instability, pelvic/spinal instability, or abductor/adductor imbalance, ischial tuberosity enthesopathies, trauma/overuse or extreme hip motion, iatrogenic conditions, tumors and other pathologies. Magnetic resonance imaging (MRI) is the diagnostic procedure of choice for assessing IFI and may substantially influence patient management. The injection test of the ischiofemoral space (IFS) has both a diagnostic and therapeutic function. Endoscopic decompression of the IFS appears useful in improving function and diminishing hip pain in patients with IFI but conservative treatment is always the first step in the treatment algorithm. Because of the ever-increasing use of advanced MRI techniques, the frequent response to conservative treatment, and the excellent outcomes of new endoscopic treatment, radiologists must be aware of factors that predispose or cause IFI. In addition, focused treatment in these conditions is often more important than in secondary impingement. In this article, we briefly describe the anatomy of the IFS, review the clinical examination and symptoms, assess the diagnostic imaging criteria and pathophysiological mechanisms, and develop an understandable classification of IFI, with particular focus on its etiology, predisposing factors, and associated musculoskeletal abnormalities. We also assess the role of the radiologist in the diagnosis, treatment, and preoperative evaluation of both primary and secondary IFI.

  8. Radiologic Technology Program Standards.

    Science.gov (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This publication contains statewide standards for the radiologic technology program in Georgia. The standards are divided into 12 categories; Foundations (philosophy, purpose, goals, program objectives, availability, evaluation); Admissions (admission requirements, provisional admission requirements, recruitment, evaluation and planning); Program…

  9. Pulmonary function tests in the preoperative evaluation of lung cancer surgery candidates. A review of guidelines.

    Science.gov (United States)

    Trzaska-Sobczak, Marzena; Skoczyński, Szymon; Pierzchała, Władysław

    2014-09-01

    Before planned surgical treatment of lung cancer, the patient's respiratory system function should be evaluated. According to the current guidelines, the assessment should start with measurements of FEV1 (forced expiratory volume in 1 second) and DLco (carbon monoxide lung diffusion capacity). Pneumonectomy is possible when FEV1 and DLco are > 80% of the predicted value (p.v.). If either of these parameters is VO2 max (oxygen consumption during maximal exercise) measurement should be performed. When VO2 max is VO2 max is in the range of 35-75% p.v. or 10-20 ml/kg/min, the postoperative values of FEV1 and DLco (ppoFEV1, ppoDLco) should be determined. The exercise test with VO2 max measurement may be replaced with other tests such as the shuttle walk test and the stair climbing test. The distance covered during the shuttle walk test should be > 400 m. Patients considered for lobectomy should be able to climb 3 flights of stairs (12 m) and for pneumonectomy 5 flights of stairs (22 m).

  10. Evaluation of Pain Preoperatively and Postoperatively in Patients with Chronic Pancreatitis Undergoing Longitudinal Pancreaticojejunostomy.

    Science.gov (United States)

    Bhat, K R Seetharam; Khajanchi, Monty; Prajapati, Ram; Satoskar, R R

    2015-12-01

    Chronic pancreatitis is a fairly common condition with pain being the major symptom, and longitudinal pancreaticojejunostomy (LPJ) is performed for symptomatic relief. The aim of the study is to assess relief of pain post-LPJ for chronic pancreatitis and to evaluate the factors influencing relief of symptoms. A prospective observational non-interventional study enrolling 28 patients. This study involved a questionnaire studying various risk factors and pain related to chronic pancreatitis, pancreaticojejunostomy, and postoperative assessment of pain relief at 1 and 6 months from surgery. Pain was assessed using Visual analogue scale (VAS). In chronic pancreatitis, there is a significant relief in symptoms of pain post-LPJ; the degree of relief was less in the alcoholics vs non-alcoholics (p = 0.09) and smokers. There was also reduction in analgesic requirement and frequency of acute attacks of pain. Fifty-seven percent of patients had a complete remission of their pain after LPJ for CP. In chronic pancreatitis, there is a significant relief in symptoms of pain post-LPJ, although the degree of relief is less in the alcoholics and smokers.

  11. Clinical, radiological, and functional evaluation of surgical treatment in degenerative lumbar canal stenosis

    Directory of Open Access Journals (Sweden)

    B. C. M. Prasad

    2016-01-01

    Conclusions: The post-operative VAS, ODI, JOA, SF-36 scores showed a significant improvement from the preoperative ones. Postoperative thecal sac measurements showed a significant neural decompression substantiating the results of improvement in the functional assessment scores after surgery. The treadmill test is a quantifiable means of dynamic function. It may be considered as a useful tool for the assessment of functional impairment and for the correlation of thecal sac CSA with lumbar canal stenosis. A combination of functional scores, treadmill test, and thecal sac CSA may be included in the preoperative assessment of outcome in patients with LCS.

  12. Pulmonary complications of liver transplantation: radiological appearance and statistical evaluation of risk factors in 300 cases

    Energy Technology Data Exchange (ETDEWEB)

    Golfieri, R.; Giampalma, E.; d' Arienzo, P.; Maffei, M.; Muzzi, C.; Tancioni, S.; Gavelli, G. [Dipartimento Clinico di Scienze Radiologiche ed Istocitopatologiche, Policlinico S.Orsola, Universita di Bologna, Via Massarenti 9, I-40138 Bologna (Italy); Morselli Labate, A.M.; Sama, C. [Dipartimento di Medicina Interna e Gastroenterologia, Policlinico S.Orsola, Universita di Bologna, Via Massarenti 9, I-40138 Bologna (Italy); Jovine, E.; Grazi, G.L.; Mazziotti, A.; Cavallari, A. [Dipartimento di Discipline Chirurgiche, Rianimatorie e dei Trapianti, Policlinico S.Orsola, Universita di Bologna, Via Massarenti 9, I-40138 Bologna (Italy)

    2000-07-01

    The aim of this study was to evaluate the incidence, radiographic appearance, time of onset, outcome and risk factors of non-infectious and infectious pulmonary complications following liver transplantation. Chest X-ray features of 300 consecutive patients who had undergone 333 liver transplants over an 11-year period were analysed: the type of pulmonary complication, the infecting pathogens and the mean time of their occurrence are described. The main risk factors for lung infections were quantified through univariate and multivariate statistical analysis. Non-infectious pulmonary abnormalities (atelectasis and/or pleural effusion: 86.7%) and pulmonary oedema (44.7%) appeared during the first postoperative week. Infectious pneumonia was observed in 13.7%, with a mortality of 36.6%. Bacterial and viral pneumonia made up the bulk of infections (63.4 and 29.3%, respectively) followed by fungal infiltrates (24.4%). A fairly good correlation between radiological chest X-ray pattern, time of onset and the cultured microorganisms has been observed in all cases. In multivariate analysis, persistent non-infectious abnormalities and pulmonary oedema were identified as the major independent predictors of posttransplant pneumonia, followed by prolonged assisted mechanical ventilation and traditional caval anastomosis. A ''pneumonia-risk score'' was calculated: low-risk score (<2.25) predicts 2.7% of probability of the onset of infections compared with 28.7% of high-risk (>3.30) population. The ''pneumonia-risk score'' identifies a specific group of patients in whom closer radiographic monitoring is recommended. In addition, a highly significant correlation (p<0.001) was observed between pneumonia-risk score and the expected survival, thus confirming pulmonary infections as a major cause of death in OLT recipients. (orig.)

  13. Radiological evaluation of pulmonary atresia: An analysis of cineangiography in 32 cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Ho; Yeon, Kyung Mo; Park, Jae Hyung; Han, Man Chung; Yoon, Yong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1983-06-15

    Total 32 cases of pulmonary atresia were diagnosed radiographically at Seoul National University Hospital from March, 1979 to August 1982. Some characteristic radiological findings were analyzed in chest PA and cineangiographies. The results were as follows: 1. In the evaluation of chest PA, cardiomegaly was noticed in 16 cases, dextrocardia in 8 cases, elevated cardiac apex in 7 cases and right-sided aortic arch in 6 cases. The pulmonary vascularties were mildly decreased in 20 cases, markedly decreased in 9 cases and decreased with reticular pattern in 3 cases. 2. As final diagnoses after cineangiography, pulmonary atresia was associated with Tetralogy of Fallot variant in 17 cases, transposition of great vessels in 7 cases, single ventricle in 5 cases, tricuspid atresia in 2 cases and intact ventricular septum in 1 case. 3. The classification according to the pattern of pulmonary artery is main pulmonary trunk with PDA(Type Ia) in 10 cases, pulmonary arterial confluence with PDA (Type Ib) in 10 cases, no pulmonary arterial confluence with PDA (Type Ic) in 5 cases, main pulmonary trunk without PDA (Type IIa) in 0 case, pulmonary arterial confluence without PDA (Type IIb) in 5 cases, and no pulmonary arterial confluence without PDA ( Type IIc) in 2 cases. 4. Pulmonary wedge venography was done and successful in 8 cases. Among them, confluence between right and left pulmonary arteries was noticed in 5 cases. 5. Biventricular cineangiograpy and/or pulmonary wedge venography, if necessary, is essential for the accurate diagnosis of pulmonary atresia to demonstrate detailed anatomy of pulmonary artery.

  14. Errors in the radiological evaluation of the alimentary tract: part I.

    Science.gov (United States)

    Mandato, Ylenia; Reginelli, Alfonso; Galasso, Rosario; Iacobellis, Francesca; Berritto, Daniela; Cappabianca, Salvatore

    2012-08-01

    Physicians are subjected to an increasing number of medical malpractice claims, and radiology is one of the specialties most liable to claims of medical negligence The etiology of radiological error is multifactorial, deriving by poor technique, failures of perception, lack of knowledge, and misjudgments. Reducing errors will improve patient care, may reduce costs, and will improve the image of the hospital. The main reason for studying medical errors is to try to prevent them. This article focuses on the spectrum of diagnostic errors in radiology, including a classification of the errors, and highlights the malpractice issues in methods for functional alimentary tract examination: swallowing act study, 3-dimensional endoanal ultrasound, defecography, and defecography in magnetic resonance.

  15. The superiority of 256-slice spiral computed tomography angiography for preoperative evaluation of surrounding arteries in patients with gastric cancer

    Directory of Open Access Journals (Sweden)

    Wu D

    2017-02-01

    Full Text Available Deqing Wu, Linyong Zhao, Ying Liu, Junjiang Wang, Weixian Hu, Xingyu Feng, Zejian Lv, Yong Li, Xueqing Yao Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China Objective: To evaluate the utilization of 256-slice spiral computed tomography (CT angiography in preoperative assessment of perigastric vascular anatomy in patients with gastric cancer. Methods: In this study, 80 gastric cancer patients were included. The medical procedure of 256-slice spiral CT angiography was performed on each of these patients consecutively. Thereafter, these patients were subjected to surgical treatment in our hospital. The techniques of volume rendering (VR and maximum intensity projection (MIP were used to image reconstruction of arteries around the stomach. Results: Both VR and MIP were applied to reconstruct the images of perigastric arteries. The results indicated that VR imaging was inferior to MIP in determining the variant small artery anatomy around the greater curvature and fundus. The respective rates of imaging produced by VR and MIP for left gastroepiploic artery, short gastric artery, and posterior gastric artery, were 32.50% versus 100%, 16.25% versus 87.50%, and 3.75% versus 25.00%, respectively. According to Hiatt’s classification, 75 out of 240 cases were abnormal types, among which we found Type II in 30 cases, Type III in 33 cases, Type IV in three cases, Type V in six cases, and Type VI in only three cases. There was no significant difference for total and every single variation type, between our group and Hiatt’s group (P>0.05. Conclusion: The 256-slice spiral CT angiography can be regarded as an effective and accurate diagnostic modality for preoperative assessing anatomical arterial variations in gastric cancer; MIP was superior to VR at identifying variations of some small artery, whereas VR was better than MIP at showing anatomical arterial variations

  16. Preoperative evaluation of penetrating esophageal trauma in the current era: An analysis of the National Trauma Data Bank

    Directory of Open Access Journals (Sweden)

    Daniel Dante Yeh

    2015-01-01

    Full Text Available Background: Preoperative diagnostic evaluation (PDE of penetrating esophageal injury (PeEsIn can delay treatment and increase morbidity. We sought to study the relationship among PDE, delay in definitive treatment, and patient mortality in PeEsIn. Materials and Methods: The 2008-2010 National Trauma Data Banks were queried for PeEsIn. Exclusion criteria were death within 1 day of injury, and missing data about survival to discharge or operative intervention. Data extracted included demographics, vital signs, injury severity, diagnostic procedures (endoscopy, computed tomography, and fluoroscopy, time to procedures and/or operation, hospital-free days, and mortality. Results: Of 280 patients, 75 underwent PDE and 205 did not. There were no significant differences in baseline demographics, vital signs or injury severity between the two groups. The median time to the first operation was shorter in the nonPDE cohort compared to the PDE cohort (2 vs. 3 h; P = 0.018. Median hospital-free days at day 60 were significantly less in nonPDE (42 days, interquartile range ([IQR] = [28, 50] versus PDE patients (47 days, IQR = [38, 51] (P = 0.007. Mortality was not statistically different. Conclusions: PDE in PeEsIn slightly delays the time to operation without worsening mortality, and is a predictor of more hospital-free days

  17. An in vivo evaluation of the change in the pulpal oxygen saturation after administration of preoperative anxiolytics and local anesthesia

    Science.gov (United States)

    P. Shetty, Krishna; V. Satish, Sarvepalli; Kilaru, Krishnarao; Chakravarthi Ponangi, Kalyana; M. Luke, Alexander; Neshangi, Srisha

    2016-01-01

    Background. Given the influence of systemic blood pressure on pulpal blood flow, anxiolytics prescribed may alter the pulpal blood flow along with the local anesthetic solution containing a vasoconstrictor. This study evaluated the impact of preoperative anxiolytics and vasoconstrictors in local anesthetic agents on pulpal oxygen saturation. Methods. Thirty anxious young healthy individuals with a mean age of 24 years were randomly selected using the Corah’s Dental Anxiety Scale (DAS). After checking the vital signs the initial pulpal oxygen saturation (initial SpO2) was measured using a pulse oximeter. Oral midzolam was administered at a dose of 7.5 mg. After 30 min, the vital signs were monitored and the pulpal oxygen saturation (anxiolytic SpO2) was measured. A total of 1.5 mL of 2% lidocaine with 1:200000 epinephrine was administered as buccal infiltration anesthesia and 10 min the final pulpal oxygen saturation (L.A SpO2) was measured. Results. The mean initial (SpO2) was 96.37% which significantly decreased to 90.76% (SpO2) after the administration of the anxiolytic agent. This drop was later accentuated to 85.17% (SpO2) after administration of local anesthetic solution. Statistical significance was set at Pcavity preparation. Therefore, maintaining optimal blood flow during restorative procedures may prevent pulpal injury. PMID:27092212

  18. The complex evaluation of tumor oxygen state and vasculature during preoperative chemotherapy in patients with breast cancer

    Science.gov (United States)

    Pavlov, M. V.; Subochev, P. V.; Kalganova, T. I.; Golubyatnikov, G. Yu.; Plekhanov, V. I.; Ilyinskaya, O. E.; Orlova, A. G.; Shakhova, N. M.; Maslennikova, A. V.

    2017-02-01

    Effective breast cancer treatment requires the assessment of metabolic changes of tumor tissue during chemo- and hormonotherapy for prediction tumor response. Evaluation of the dynamics of tumor oxygen state (by diffuse optical spectroscopy imaging) and tumor vasculature (by ultrasound investigation in power Doppler mode) was performed before treatment beginning and before the second cycle of chemotherapy in 16 patients who received preoperative chemotherapy. Changes of these indicators were compared then with tumor pathologic response. Breast tumors demonstrated different dynamics of tumor oxygenation depending on the changes of tumor tissue. The increase of the tumor oxygenation after the first cycle of chemotherapy was observed in five of six patients with grade 4 and 5 of pathologic tumor response. Decrease of the oxygenation level was revealed in one patient with the 4th degree of tumor response. Variable changes of the oxygenation level were mentioned in the patients with moderate (the 3d degree) tumor response. Tumor oxygenation decreased or was unchanged in case of 1 or 2 degree of tumor response in five of six cases. The study of the tumor blood vessels didn't reveal any correlation between vasculature changes and tumor response under the performed treatment. The trend of tumor oxygenation in early time after treatment beginning might be a predictive criterion of tumor sensitivity to chemotherapy.

  19. The Evaluation of Renal Osteodystrophy in Patients on Hemodialysis by Biochemical and Radiological Methods

    Directory of Open Access Journals (Sweden)

    Sibel Mandıroğlu

    2013-04-01

    Full Text Available Aim: We planned this study in order to evaluate the radiological and biochemical parameters that may be useful in the early diagnosis of renal osteodystrophy in the patients with chronic renal failure, prospectively. Meterial and Methods: In this study, 50 cases on hemodialysis due to chronic renal failure were included and 50 cases without renal and bone pathology were included as control group. Serum levels of calcium, phosphate, alkalen phosphatase, βm, osteocalcin (BGP and intact parathormon (iPTH were measured. Right hand graphies of both case and control groups were taken by magnifying techniques. Bone mineral densities (BMD of lumbar vertebra and femur neck were calculated by DEXA method. Results: The average disease duration and the average of duration of hemodialysis of cases were 8.38±5.61years and 6.9±4.01years, respectively. There were signi cant differences between case and control groups in all biochemical parameters, except calcium levels (p<0.05. There were a negative correlation between iPTH and BMD (r=-0.4, p<0.05, and pozitif correlations between iPTH and BGP (r=0.6, p<0.05, and between PTH and β-m (r=0.5, p<0.05. A low level negative but statistically signi cant correlation between dialysis duration and femur neck bone mineral density was determined (r=0.2, p<0.05. There were positive correlations between dialysis duration and PTH levels (r:0.3, p<0.05, and between dialysis duration and β2 m (r=0.4, p<0.05. In the hand graphies, osteopenia, subperiostal resorption, radial artery calci cation and endoosteal resorption were seen. Ostepenia was determined in 80% of our cases, however, subperiostal resorption was found in 58% of patients. The cases that had iPTH levels over than 200 pg/ml and cases that have osteopenia have sensitivity of 93% and spesi ty of 92% for RO diagnosis. Sensitivity and spesi ty for high iPTH-BGP levels were 90.3% and 87%, respectively. Sensitivity and spesi ty in the evaluation of

  20. 类风湿关节炎患者全膝置换术术前评估%Preoperative evaluation of total knee arthroplasty in rheumatoid arthritis patients

    Institute of Scientific and Technical Information of China (English)

    刘大猛; 周新社

    2016-01-01

    Total knee arthroplasty ( TKA ) is developing. Rheumatoid arthritis ( RA ) patients, whose knee function is severely affected, have obtained good effects. RA can not only affect the joints, but a systemic and multi-systematic disease. When involving the cervical spine, RA can cause upper cervical instability. It is essential to pay more attention to asymptomatic patients, so as to select appropriate treatment measures. Preoperative heart function rating can assess the risk of surgery and the tolerance of patients. The pulmonary injury often slacks up lung functions too. RA patients also have higher prevalence of oral or periodontal diseases, which is related with artificial joint infection after the surgery. Anemia can lead to increased risk of infection and delayed wound healing. So for each body the comprehensive and systematic preoperative evaluation is necessary. In addition, degree of preoperative rheumatoid arthritis and inflammatory indexes such as blood sedimentation, c-reactive protein level are of controversy. The use of clinical drugs to relieve symptoms before surgery or not is worth the attention of orthopedic surgeons. Patients with long-term drug therapy, such as traditional DMARDs and biological agents, cortisol, have the risk of infection after the knee replacement. Researches on biological agents in the treatment of rheumatoid arthritis are being conducted in recent years. Foreigners also put forward the guide on the perioperative use of biological agents. Detailed preoperative evaluation and multidisciplinary cooperation are necessary to reduce the risk of surgery.

  1. Endobronchial valves in severe emphysematous patients: CT evaluation of lung fissures completeness, treatment radiological response and quantitative emphysema analysis

    Directory of Open Access Journals (Sweden)

    Marcel Koenigkam-Santos

    2013-02-01

    Full Text Available OBJECTIVE: To evaluate lung fissures completeness, post-treatment radiological response and quantitative CT analysis (QCTA in a population of severe emphysematous patients submitted to endobronchial valves (EBV implantation. MATERIALS AND METHODS: Multi-detectors CT exams of 29 patients were studied, using thin-section low dose protocol without contrast. Two radiologists retrospectively reviewed all images in consensus; fissures completeness was estimated in 5% increments and post-EBV radiological response (target lobe atelectasis/volume loss was evaluated. QCTA was performed in pre and post-treatment scans using a fully automated software. RESULTS: CT response was present in 16/29 patients. In the negative CT response group, all 13 patients presented incomplete fissures, and mean oblique fissures completeness was 72.8%, against 88.3% in the other group. QCTA most significant results showed a reduced post-treatment total lung volume (LV (mean 542 ml, reduced EBV-submitted LV (700 ml and reduced emphysema volume (331.4 ml in the positive response group, which also showed improved functional tests. CONCLUSION: EBV benefit is most likely in patients who have complete interlobar fissures and develop lobar atelectasis. In patients with no radiological response we observed a higher prevalence of incomplete fissures and a greater degree of incompleteness. The fully automated QCTA detected the post-treatment alterations, especially in the treated lung analysis.

  2. Radiation dose assessments to support evaluations of radiological control levels for recycling or reuse of materials and equipment

    Energy Technology Data Exchange (ETDEWEB)

    Hill, R.L.; Aaberg, R.L.; Baker, D.A.; Kennedy, W.E. Jr.

    1995-07-01

    Pacific Northwest Laboratory is providing Environmental Protection Support and Assistance to the USDOE, Office of Environmental Guidance. Air, Water, and Radiation Division. As part of this effort, PNL is collecting data and conducting technical evaluations to support DOE analyses of the feasibility of developing radiological control levels for recycling or reuse of metals, concrete, or equipment containing residual radioactive contamination from DOE operations. The radiological control levels will be risk-based, as developed through a radiation exposure scenario and pathway analysis. The analysis will include evaluation of relevant radionuclides, potential mechanisms of exposure, and both health and non-health-related impacts. The main objective of this report is to develop a methodology for establishing radiological control levels for recycle or reuse. This report provides the results of the radiation exposure scenario and pathway analyses for 42 key radionuclides generated during DOE operations that may be contained in metals or equipment considered for either recycling or reuse. The scenarios and information developed by the IAEA. Application of Exemption Principles to the Recycle and Reuse of Materials from Nuclear Facilities, are used as the initial basis for this study. The analyses were performed for both selected worker populations at metal smelters and for the public downwind of a smelter facility. Doses to the public downwind were estimated using the US (EPA) CAP88-PC computer code with generic data on atmospheric dispersion and population density. Potential non-health-related effects of residual activity on electronics and on film were also analyzed.

  3. Endobronchial valves in severe emphysematous patients: CT evaluation of lung fissures completeness, treatment radiological response and quantitative emphysema analysis

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br, E-mail: marcelk46@usp.b [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas da Faculdade de Medicina; Paula, Wagner Diniz de [University of Brasilia (UnB), DF (Brazil). Brasilia University Hospital; Gompelmann, Daniela [University of Heidelberg (Germany). Department of Pneumology and Respiratory Medicine of the Chest Clinic (Thoraxklinik); Kauczor, Hans-Ulrich [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology; Heussel, Claus Peter; Puderbach, Michael [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology with Nuclear Medicine of the Chest Clinic (Thoraxklinik)

    2013-01-15

    Objective: To evaluate lung fissures completeness, post-treatment radiological response and quantitative CT analysis (QCTA) in a population of severe emphysematous patients submitted to endobronchial valves (EBV) implantation. Materials and Methods: Multi-detectors CT exams of 29 patients were studied, using thin-section low dose protocol without contrast. Two radiologists retrospectively reviewed all images in consensus; fissures completeness was estimated in 5% increments and post-EBV radiological response (target lobe atelectasis/volume loss) was evaluated. QCTA was performed in pre and post-treatment scans using a fully automated software. Results: CT response was present in 16/29 patients. In the negative CT response group, all 13 patients presented incomplete fissures, and mean oblique fissures completeness was 72.8%, against 88.3% in the other group. QCTA most significant results showed a reduced post-treatment total lung volume (LV) (mean 542 ml), reduced EBV-submitted LV (700 ml) and reduced emphysema volume (331.4 ml) in the positive response group, which also showed improved functional tests. Conclusion: EBV benefit is most likely in patients who have complete interlobar fissures and develop lobar atelectasis. In patients with no radiological response we observed a higher prevalence of incomplete fissures and a greater degree of incompleteness. The fully automated QCTA detected the post-treatment alterations, especially in the treated lung analysis. (author)

  4. Evaluation of management of communication in the actions of preparedness and response to nuclear and radiological emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Mello Filho, Mauro Otto de Cavalcanti; Beserra, Marcela Tatiana Fernandes, E-mail: maurootto@cefet-rj.br, E-mail: maurootto@gmail.com, E-mail: mbeserra@cefet-rj.br [Centro Federal de Educacao Celso Sucknow da Fonseca (CEFET-RJ), Rio de Janeiro, RJ (Brazil); Wasserman, Maria Angelica Vergara, E-mail: mwasserman@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Wasserman, Julio Cesar de Faria Alvim, E-mail: geowass@vm.uff.br [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2013-07-01

    The use of practices involving the use of ionizing radiation in diverse areas of knowledge increases every day. This growth warning about the increased probability of accidents, radiological and nuclear emergencies, with possible consequences for the public, workers and the environment. Within this scenario, it is clear that studies and reassessments of the emergency response actions, receive proposals for continuous improvement. The achievement of the objectives of the response must be sustained by tactical, operation and logistics optimized processes. The articulation through communication between the teams involved in the response must be adaptable to each accident or emergency, respecting its size. The objectives of this study is to perform an assessment on the management of communication in the actions of Preparedness and Response to Nuclear and Radiological Emergencies. This assessment is supported by best practices of the Incident Command System (ICS) and the Institute of Project Management (Project Management Institute-PMI). For this purpose, based on models referred were established performance indicators supported by the BSC (Balanced Scorecard). These indicators allowed to evaluate more objectively the performance of the communication processes associated with each phase of the response. The study resulted in the proposed model documents aiming to assist planning of communications exercises in preparation and response actions, supported and adapted the best practices of PMI. These methodologies were evaluated by real cases selected from radiological and nuclear emergencies published by the International Atomic Energy Agency (IAEA). (author)

  5. Preoperative Quantitative MR Tractography Compared with Visual Tract Evaluation in Patients with Neuropathologically Confirmed Gliomas Grades II and III: A Prospective Cohort Study

    Science.gov (United States)

    Delgado, Anna F.; Nilsson, Markus; Latini, Francesco; Mårtensson, Johanna; Zetterling, Maria; Berntsson, Shala G.; Alafuzoff, Irina; Lätt, Jimmy; Larsson, Elna-Marie

    2016-01-01

    Background and Purpose. Low-grade gliomas show infiltrative growth in white matter tracts. Diffusion tensor tractography can noninvasively assess white matter tracts. The aim was to preoperatively assess tumor growth in white matter tracts using quantitative MR tractography (3T). The hypothesis was that suspected infiltrated tracts would have altered diffusional properties in infiltrated tract segments compared to noninfiltrated tracts. Materials and Methods. Forty-eight patients with suspected low-grade glioma were included after written informed consent and underwent preoperative diffusion tensor imaging in this prospective review-board approved study. Major white matter tracts in both hemispheres were tracked, segmented, and visually assessed for tumor involvement in thirty-four patients with gliomas grade II or III (astrocytomas or oligodendrogliomas) on postoperative neuropathological evaluation. Relative fractional anisotropy (rFA) and mean diffusivity (rMD) in tract segments were calculated and compared with visual evaluation and neuropathological diagnosis. Results. Tract segment infiltration on visual evaluation was associated with a lower rFA and high rMD in a majority of evaluated tract segments (89% and 78%, resp.). Grade II and grade III gliomas had similar infiltrating behavior. Conclusion. Quantitative MR tractography corresponds to visual evaluation of suspected tract infiltration. It may be useful for an objective preoperative evaluation of tract segment involvement. PMID:27190647

  6. Preoperative Quantitative MR Tractography Compared with Visual Tract Evaluation in Patients with Neuropathologically Confirmed Gliomas Grades II and III: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Anna F. Delgado

    2016-01-01

    Full Text Available Background and Purpose. Low-grade gliomas show infiltrative growth in white matter tracts. Diffusion tensor tractography can noninvasively assess white matter tracts. The aim was to preoperatively assess tumor growth in white matter tracts using quantitative MR tractography (3T. The hypothesis was that suspected infiltrated tracts would have altered diffusional properties in infiltrated tract segments compared to noninfiltrated tracts. Materials and Methods. Forty-eight patients with suspected low-grade glioma were included after written informed consent and underwent preoperative diffusion tensor imaging in this prospective review-board approved study. Major white matter tracts in both hemispheres were tracked, segmented, and visually assessed for tumor involvement in thirty-four patients with gliomas grade II or III (astrocytomas or oligodendrogliomas on postoperative neuropathological evaluation. Relative fractional anisotropy (rFA and mean diffusivity (rMD in tract segments were calculated and compared with visual evaluation and neuropathological diagnosis. Results. Tract segment infiltration on visual evaluation was associated with a lower rFA and high rMD in a majority of evaluated tract segments (89% and 78%, resp.. Grade II and grade III gliomas had similar infiltrating behavior. Conclusion. Quantitative MR tractography corresponds to visual evaluation of suspected tract infiltration. It may be useful for an objective preoperative evaluation of tract segment involvement.

  7. Radiological English

    Energy Technology Data Exchange (ETDEWEB)

    Ribes, R. [Hospital Reina Sofia, Cordoba (Spain). Servicio de Radiologia; Ros, P.R. [Harvard Medical School, Boston, MA (United States). Div. of Radiology

    2007-07-01

    The book is an introductory book to radiological English on the basis that there are a lot of radiologists, radiology residents, radiology nurses, radiology students, and radiographers worldwide whose English level is indeterminate because their reading skills are much higher than their fluency. It is intended to help those health care professionals who need English for their work but do not speak English on a day-to-day basis. (orig.)

  8. The effects of expanding outpatient and inpatient evaluation and management services in a pediatric interventional radiology practice.

    Science.gov (United States)

    Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew

    2017-03-01

    Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.

  9. Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation.

    Science.gov (United States)

    Gunduz, Yasemin; Altintoprak, Fatih; Tatli Ayhan, Lacin; Kivilcim, Taner; Celebi, Fehmi

    2014-01-01

    Idiopathic granulomatous mastitis (IGM) is a rare inflammatory, noncaseating, chronic granulomatous benign disease. The etiology of IGM is still unknown. It is postulated to be an autoimmune localized response. The use of a course of oral steroids provides an important regression of breast mass and skin lesions. Topical corticosteroids are used to treat many skin diseases, but no study is available on the sole use of topical steroids for treating IGM. Eleven women with IGM were treated with topical steroid and evaluated using mammography, ultrasonography, and dynamic MRI. At the end of the 12th week, patients were clinically and radiologically evaluated for the regression of breast and skin lesions. Pre- and post-treatment time-intensity curve patterns (TICs) were also compared. During the topical steroid treatment, the inflammation signs in the affected breast had markedly disappeared, the fistulas had become inactive, and the fistula orifices and/or skin erosions had closed in nine patients. The median follow-up period was 17 months (range: 12-48 months). Recurrence was observed in two patients (2/11) at 5 and 8 months, which were treated again topically. The inflammatory findings of the breast skin completely resolved after 8 weeks of treatment, and no side effects or steroid-related complications occurred. In the pretreatment period, TICs from enhancing areas showed a Type 1 pattern in three cases, a Type 2 pattern in five cases, and a Type 3 pattern in three cases. After topical steroid treatment, TIC was not changed only in one patient (Type 2). Type 1 patterns were determined in seven cases and Type 2 patterns in two cases. In addition, in two patients, TICs were not determined due to complete healing. Our MRI findings showed that topical steroid therapy may be useful because it affects mammary parenchyma as well as mammary skin. Further studies with a greater number of patients are needed to determine the topical steroid therapy dosing and duration, and

  10. The Effect of Reduction Mammaplasty on the Vertebral Column: A Radiologic Study

    Directory of Open Access Journals (Sweden)

    Onder Karaaslan

    2013-01-01

    Full Text Available Some studies emphasized that anatomic mechanisms of vertebral aberrations could be associated with large breasts. The effect of mammaplasty operation on the vertebral column and body posture seems to be beneficial; in this trial, it was planned to investigate the objective radiologic effect of reduction mammaplasty on the posture of the vertebral column in a group of patients operated due to the large breasts. Thirty-four white women with large breasts were enrolled in this study. The patients were divided into three groups according to their breast cup sizes. Anteroposterior and lateral radiographs of the lumbosacral and thoracic spine were taken at baseline preoperatively, and the same radiographic images were taken in an average of 12 months later than the reduction mammaplasty operation. All were evaluated and compared for thoracic kyphosis angle and lumbar lordosis angle both preoperatively and postoperatively. The mean thoracic kyphosis angle was 40,53 preoperatively and 39,38 postoperatively. However, there was no statistically significant difference between the preoperative and postoperative measurements in all groups (P>0,05. The mean lumbar lordosis angle was 54,71 preoperatively and 53,18 postoperatively. Regarding the preoperative and postoperative measurements of lumbar lordosis angles, no statistically significant difference was found between the groups (P>0,05. Although breast size may be an important factor that affects body posture, reduction mammaplasty operations have little or no radiologic effect on the vertebral column.

  11. The effect of reduction mammaplasty on the vertebral column: a radiologic study.

    Science.gov (United States)

    Karaaslan, Onder; Demirkiran, H Gokhan; Silistreli, Ozlem; Sonmez, Erhan; Bedir, Yagmur Kaan; Can, Melih; Caliskan, Gorkem; Aslan, Cem; Oral, Meltem Ayhan; Kankaya, Yuksel

    2013-01-01

    Some studies emphasized that anatomic mechanisms of vertebral aberrations could be associated with large breasts. The effect of mammaplasty operation on the vertebral column and body posture seems to be beneficial; in this trial, it was planned to investigate the objective radiologic effect of reduction mammaplasty on the posture of the vertebral column in a group of patients operated due to the large breasts. Thirty-four white women with large breasts were enrolled in this study. The patients were divided into three groups according to their breast cup sizes. Anteroposterior and lateral radiographs of the lumbosacral and thoracic spine were taken at baseline preoperatively, and the same radiographic images were taken in an average of 12 months later than the reduction mammaplasty operation. All were evaluated and compared for thoracic kyphosis angle and lumbar lordosis angle both preoperatively and postoperatively. The mean thoracic kyphosis angle was 40,53 preoperatively and 39,38 postoperatively. However, there was no statistically significant difference between the preoperative and postoperative measurements in all groups (P > 0,05). The mean lumbar lordosis angle was 54,71 preoperatively and 53,18 postoperatively. Regarding the preoperative and postoperative measurements of lumbar lordosis angles, no statistically significant difference was found between the groups (P > 0,05). Although breast size may be an important factor that affects body posture, reduction mammaplasty operations have little or no radiologic effect on the vertebral column.

  12. Preoperative evaluation of micro-organisms in non-operated cleft in soft palate: impact on use of antibiotics.

    Science.gov (United States)

    Roode, G J; Bütow, K-W; Naidoo, S

    2017-02-01

    To identify the pathogenic micro-organisms that had colonised preoperatively in clefts in the soft palate and oro-nasopharynx, we retrospectively studied the preoperative microbiological profiles of 200 infants who had had primary repair of all types of cleft in the soft palate. Data from a private practice that specialises in the repair of facial clefts were extracted randomly from patients' files. We analysed the results of the culture of preoperative swabs taken from clefts in the soft palate and oro-nasopharynx, and the resistance profile of organisms towards various antibiotics. A total of 23 different pathogenic micro-organisms were isolated from 115 (57%) of the sample. Klebsiella pneumoniae most commonly colonised clefts in the lip, alveolus, and palate. This was considerably higher than in other groups. The second most common micro-organism was Staphylococcus aureus, which was found most often in patients with isolated clefts in the hard palate. Those with complete cleft lip and palate presented with more pathogenic micro-organisms in preoperative cultures than those with other types of cleft. We need to find a way to control pathogenic micro-organisms in the oral and oro-nasopharyngeal region preoperatively to limit postoperative complications.

  13. An evaluation of factors influencing the assessment time in a nurse practitioner-led anaesthetic pre-operative assessment clinic.

    Science.gov (United States)

    Hawes, R H; Andrzejowski, J C; Goodhart, I M; Berthoud, M C; Wiles, M D

    2016-03-01

    Elective patients undergoing anaesthetic pre-operative assessment are usually allocated the same period of time with a nurse practitioner, leading to potential inefficiencies in patient flow through the clinic. We prospectively collected data on 8519 patients attending a pre-operative assessment clinic. The data set were split into derivation and validation cohorts. Standard multiple regressions were used to construct a model in the derivation cohort, which was then tested in the validation cohort. Due to missing data, 2457 patients were not studied, leaving 5892 for analysis (3870 in the derivation cohort and 2022 in the validation cohort). The mean (SD) pre-operative assessment time was 46 (12) min. Age, ASA physical status, nurse practitioner and surgical specialty all influenced the time spent in pre-operative assessment. The predictive equations calculated using the derivation cohort, based on age and ASA physical status, correctly estimated duration of consultation to within 20% of the maximum predicted time in 74.2% of the validation cohort. We conclude that if age and ASA physical status are known before the pre-operative assessment consultation, it could allow appointment times to be allocated more accurately.

  14. Evaluating the Impact of a Canadian National Anatomy and Radiology Contouring Boot Camp for Radiation Oncology Residents

    Energy Technology Data Exchange (ETDEWEB)

    Jaswal, Jasbir [Department of Radiation Oncology, London Health Sciences Centre, London, Ontario (Canada); D' Souza, Leah; Johnson, Marjorie [Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario (Canada); Tay, KengYeow [Department of Diagnostic Radiology, London Health Sciences, London, Ontario (Canada); Fung, Kevin; Nichols, Anthony [Department of Otolaryngology, Head & Neck Surgery, Victoria Hospital, London, Ontario (Canada); Landis, Mark [Department of Diagnostic Radiology, London Health Sciences, London, Ontario (Canada); Leung, Eric [Department of Radiation Oncology, London Health Sciences Centre, London, Ontario (Canada); Kassam, Zahra [Department of Diagnostic Radiology, St. Joseph' s Health Care London, London, Ontario (Canada); Willmore, Katherine [Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario (Canada); D' Souza, David; Sexton, Tracy [Department of Radiation Oncology, London Health Sciences Centre, London, Ontario (Canada); Palma, David A., E-mail: david.palma@lhsc.on.ca [Department of Radiation Oncology, London Health Sciences Centre, London, Ontario (Canada)

    2015-03-15

    Background: Radiation therapy treatment planning has advanced over the past 2 decades, with increased emphasis on 3-dimensional imaging for target and organ-at-risk (OAR) delineation. Recent studies suggest a need for improved resident instruction in this area. We developed and evaluated an intensive national educational course (“boot camp”) designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary (MDT) approach. Methods: The anatomy and radiology contouring (ARC) boot camp was modeled after prior single-institution pilot studies and a needs-assessment survey. The boot camp incorporated joint lectures from radiation oncologists, anatomists, radiologists, and surgeons, with hands-on contouring instruction and small group interactive seminars using cadaveric prosections and correlative axial radiographs. Outcomes were evaluated using pretesting and posttesting, including anatomy/radiology multiple-choice questions (MCQ), timed contouring sessions (evaluated relative to a gold standard using Dice similarity metrics), and qualitative questions on satisfaction and perceived effectiveness. Analyses of pretest versus posttest scores were performed using nonparametric paired testing. Results: Twenty-nine radiation oncology residents from 10 Canadian universities participated. As part of their current training, 29%, 75%, and 21% receive anatomy, radiology, and contouring instruction, respectively. On posttest scores, the MCQ knowledge scores improved significantly (pretest mean 60% vs posttest mean 80%, P<.001). Across all contoured structures, there was a 0.20 median improvement in students' average Dice score (P<.001). For individual structures, significant Dice improvements occurred in 10 structures. Residents self-reported an improved ability to contour OARs and interpret radiographs in all anatomic sites, 92% of students found the MDT format effective for their learning, and 93% found the boot camp

  15. Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Alimohammadzadeh

    2015-12-01

    Full Text Available Background Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. Objectives The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP and quality evaluation of their service in 2015. Materials and Methods This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. Results “Management and empowerment of human resources’’ (weight = 0.465 and “requirements and facilities” (weight = 0.139 were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316, MD (weight = 0.259, AT (weight = 0.14, TS (weight = 0.108, MO (weight = 0.095, and LH (0.082 achieved the first to sixth rankings respectively. Conclusion The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of

  16. La evaluación en Radiología como aporte pedagógico Evaluation in Radiology as a pedagogic contribution

    Directory of Open Access Journals (Sweden)

    Luis Humberto Ros Mendoza

    2012-09-01

    discriminación; su fiabilidad, esto es, su precisión y consistencia en relación con el grado de objetividad; y finalmente, su eficiencia en tanto optimización del costo-eficacia. En general, en nuestro caso se plantea un examen eminentemente práctico, basado en la resolución de problemas, y una evaluación continua sobre la participación del alumno durante el curso de las clases y seminarios interactivos.After defining evaluation (a systematic process of data collection and analysis in order to take decisions in a specific field; in our case, radiology training at medical school, we should specify the characteristics of such evaluation, which include the aim (what for?, subject-matter (which content?, benchmarks (i.e., the standards against which we are comparing, when to evaluate, and how strictly or at what cost. Once these questions have been answered, we are able to select the most appropriate procedures for evaluation, bearing in mind that evaluation is a process, while grading implies an already made decision. There are different types of evaluation: the initial evaluation, which is not necessarily nominal, is performed to define the student's level at the beginning of the course; the normative or norm-referenced evaluation has a relative nature, as it compares student achievement to that of others; and the absolute or criterion-referenced evaluation, which is based on established criteria, where the goals which should be achieved become the key element for designing teaching and evaluation. Evaluation may be used to generate motivation. This requires the establishment of clear and relevant objectives as well as knowledge on how to correct mistakes. Oral questions in the classroom may also be motivating. Within the triple domain to be taken into account (cognitive, affective and psychomotor, the objectives to be measured should be considered in a hierarchical order from simple to complex: necessary knowledge, comprehension of such concepts, practical application

  17. Radiology fundamentals

    CERN Document Server

    Singh, Harjit

    2011-01-01

    ""Radiology Fundamentals"" is a concise introduction to the dynamic field of radiology for medical students, non-radiology house staff, physician assistants, nurse practitioners, radiology assistants, and other allied health professionals. The goal of the book is to provide readers with general examples and brief discussions of basic radiographic principles and to serve as a curriculum guide, supplementing a radiology education and providing a solid foundation for further learning. Introductory chapters provide readers with the fundamental scientific concepts underlying the medical use of imag

  18. An observational, prospective study to evaluate the preoperative planning tool "CI-Wizard" for cochlear implant surgery.

    Science.gov (United States)

    Pirlich, Markus; Tittmann, Mary; Franz, Daniela; Dietz, Andreas; Hofer, Mathias

    2017-02-01

    "CI-Wizard" is a new, three-dimensional software planning tool for cochlear implant surgery with manual and semi-automatic algorithms to visualize anatomical risk structures of the lateral skull base preoperatively. Primary endpoints of the study represented the evaluation of the CI-Wizards usability, accuracy, subjectively perceived and objectively measured time in clinical practice. In a period from January 2014 to March 2015, n = 36 participants were included in this study. These members were divided into three groups of equal number (n = 12), but different level of experience. Senior doctors and consultants (group 1), residents (group 2) and medical students (group 3) segmented 12 different CT-scan data sets of the CI-Wizard (four per participant). In total, n = 144 data sets were collected. The usability of the CI-Wizard was measured by the given questionnaire with an interval rating scale. The Jaccard coefficient (JT) was used to evaluate the accuracy of the anatomical structures segmented. The subjectively perceived time was measured with an interval rating scale in the questionnaire and was compared with the objectively mean measured time (time interact). Across all three groups, the usability of the CI-Wizard has been assessed between 1 ("very good") and 2 ("with small defects"). Subjectively, the time was stated as "appropriate" by questionnaire. Objective measurements of the required duration revealed averages of t = 9.8 min for creating a target view. Concerning the accuracy, semi-automatic anatomical structures such as the external acoustic canal (JT = 0.90), the tympanic cavity (JT = 0.87), the ossicles (JT = 0.63), the cochlea (JT = 0.66), and the semicircular canals (JT = 0.61) reached high Jaccard values, which describes a great match of the segmented structures between the partcipants and the gold standard. Facial nerve (JT = 0.39) and round window (JT = 0.37) reached lower Jaccard values. Very little overlap tendency was

  19. Clinico-audio-radiological and operative evaluation of otitis media with effusion

    Directory of Open Access Journals (Sweden)

    Karan Sharma

    2015-01-01

    Full Text Available Aims: Otitis media with effusion (OME is a common cause of hearing and speech impairment in children. The correlation of the clinical, audiological, radiological, and intraoperative findings was carried out so as to make a protocol for early diagnosis and management of OME. It will help prevent the more serious sequelae of OME such as tympanosclerosis, chronic adhesive otitis media, and even chronic suppurative otitis media. Methods: 300 clinically diagnosed patients of OME were studied prospectively. Thereafter, patients underwent impedance audiometry, pure tone audiometry, and X-ray soft tissue nasopharynx for adenoids. The patients were given adequate medical treatment for 3 to 6 months, and the patients who did not respond to the treatment were subjected to adenoidectomy with ear examination under magnification and myringotomy with or without grommet insertion. Results: The mean age at presentation was 5.96 years. Only 32% patients gave a history of hearing loss. About 90% patients had mouth breathing, followed by snoring (84%. About 79% ears had abnormal tympanic membrane appearance and mobility; 65.5% had an abnormality on impedance audiometry; and 69.75% had an air condition threshold level of >20 dB. About 78% patients had either Grade III or Grade IV Adenoid hypertrophy. Adenoidectomy was done in all 300 patients with myringotomy in 472 ears. Grommets were inserted in 365 ears. There was a significant reduction in mean air conduction threshold with an improvement of 8.0 dB and 7.5 dB in right and left ears, respectively at 2 months postoperatively. At 6 th month postoperative, the average improvement from baseline dropped to 6.0 dB in right ear and 5.5 dB in the left ear. Conclusion: OME is the most frequent causes of silent hearing impairment in young children which needs a close vigil. All suspected children (on clinical and otoscopic findings must be subjected to impedance audiometry and X-ray soft tissue nasopharynx for adenoids

  20. Noncontrast-Enhanced Magnetic Resonance Versus Computed Tomography Angiography in Preoperative Evaluation of Potential Living Renal Donors.

    Science.gov (United States)

    Blankholm, Anne Dorte; Pedersen, Bodil G; Østrat, Ernst Ø; Andersen, Gratien; Stausbøl-Grøn, Brian; Laustsen, Susse; Ringgaard, Steffen

    2015-11-01

    Living renal donors undergo an extensive examination program. These examinations should be as safe, gentle, and patient friendly as possible. To compare computed tomography angiography (CTA) and an extensive magnetic resonance imaging (MRI) protocol without contrast agents to observations from nephrectomy in living renal donors and to evaluate whether noncontrast-enhanced MRI can replace CTA for vessel assessment in living renal donors. CTA and MRI results were compared to observations from nephrectomy, which served as the reference standard. Fifty-one potential kidney donors underwent imaging, and 31 donated a kidney. Comparisons in sensitivity, specificity, and accuracy were made with respect to the number of arteries, early branching, and the number of veins. Agreement was assessed using Cohen's kappa. The exact McNemar's test was used to test for statistically significant differences. In the assessment of more than one renal artery, the sensitivity and specificity of MRI and CTA were high and in perfect agreement compared to observations from surgery. The results for both MRI and CTA were as follows: (sensitivity 100%/specificity100%/accuracy 100%/Kappa = 1/P = 1). When comparing the ability to test for early branching we found, MRI: (sensitivity 33%/specificity 100%/accuracy 87%/Kappa = 0.45/P = 1) and CTA: (sensitivity 50%/specificity 100%/accuracy 90%/Kappa = 0.62/P = 1). When used to depict supernumerary veins, we found MRI: (sensitivity60%/specifivity100%/accuracy 93%/Kappa = 0.72/P = 1), whereas CTA showed: (sensitivity 40%/specificity 96%/accuracy 87% Kappa = 0.43/P = 1). In conclusion, an optimized MRI protocol that includes noncontrast-enhanced magnetic resonance angiography can be substituted for CTA for preoperative assessment of the renal vessels before living donor nephrectomy. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  1. Evaluation of long-term surgical site occurrences in ventral hernia repair: implications of preoperative site independent MRSA infection.

    Science.gov (United States)

    Baucom, R B; Ousley, J; Oyefule, O O; Stewart, M K; Phillips, S E; Browman, K K; Sharp, K W; Holzman, M D; Poulose, B K

    2016-10-01

    Previous work demonstrated that prior MRSA infection [MRSA(+)] is associated with 30-day surgical site infection (SSI) following ventral hernia repair (VHR). We aimed to determine the impact of MRSA(+) on long-term wound outcomes after VHR. A retrospective cohort study was performed at a tertiary center between July 11, 2005, and May 18, 2012, of patients undergoing elective VHR with class I wounds. Patients with documented preoperative MRSA infection at any site (urinary, bloodstream, SSI, etc.) were considered MRSA(+). Primary outcome was 2-year surgical site occurrence (SSO), defined as SSI, cellulitis, necrosis, nonhealing wound, seroma, hematoma, dehiscence, or fistula. SSOs were subdivided into those that required procedural intervention (SSOPI) and those that did not. Among 632 patients, 46 % were female with average age 53 ± 13 years. There were 368 SSOs in 193 patients (31 %); an SSOPI occurred in 9.8 % (n = 62). The most common SSOs were cellulitis (91/632), seroma (91/632), and serous drainage (58/632). The rate of 2-year SSO was higher with MRSA(+) compared to those without (46 vs. 29 %, p = 0.023), attributed to increased soft tissue necrosis, purulent drainage, serous drainage, cellulitis, and fistula. In multivariable analysis, MRSA(+) was not associated with 2-year SSO (HR 1.5, 95 % CI 0.91-2.55, p = 0.113); factors associated with SSO included obesity, immunosuppression, mesh repair, and operative times. This study is the first to evaluate long-term SSOs and SSOPIs after VHR, highlighting the importance of long-term follow-up. Though not independently associated with SSOs, MRSA(+) may be a marker of hernia complexity.

  2. Evaluation of an intervention to improve skills in diagnostic radiology of rural physicians over one year in four rural hospitals.

    Directory of Open Access Journals (Sweden)

    Tienan Feng

    Full Text Available BACKGROUND: Primary health care and patient triage are two basic functions of rural hospitals. As a routine test, the diagnostic radiology is still unavailable in some rural hospitals in China. Therefore, high-level hospitals are often the first choice of rural residents when they feel unwell. It brings serious social problems. This study was designed to propose an on-the-job drilling schema with integration of practical medical recordings and experienced radiological doctors as tutors to improve skills in diagnostic radiology of rural physicians. METHODS: The information technology was used to help the contact between rural doctors and tutors. In a longitudinal pre/post-test control study design, a cohort of 20 young physicians, each of whom was working in a rural hospital and had a work experience less than two years, were established as the trial group over one year. Another 20 similar counterparts were established as the control group. Participants' performances were evaluated in four categories at five-time point (TP. RESULTS: The trial group significantly outscored the control group on the style of writing at the second TP (d = 2.28; on the accuracy of the image description at final TP (d = 1.11; on the accuracy of the diagnosis at the fourth TP (d = 3.62; and on the correct treatment selection at the third TP (d = 6.45. The aspects with the most improvement were the accuracies of the diagnosis and the treatment selection. CONCLUSION: This study provided the detailed evidences that applying the on-the-job drilling schema has a significant effect on the skills improvement in diagnostic radiology of rural physicians. It was also concluded that the educational intervention based on practical cases was better than that only based on didactic slides presentation.

  3. Pattern mining of user interaction logs for a post-deployment usability evaluation of a radiology PACS client.

    Science.gov (United States)

    Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A; Oudkerk, Matthijs; van Ooijen, Peter M A

    2016-01-01

    To perform a post-deployment usability evaluation of a radiology Picture Archiving and Communication System (PACS) client based on pattern mining of user interaction log data, and to assess the usefulness of this approach compared to a field study. All user actions performed on the PACS client were logged for four months. A data mining technique called closed sequential pattern mining was used to automatically extract frequently occurring interaction patterns from the log data. These patterns were used to identify usability issues with the PACS. The results of this evaluation were compared to the results of a field study based usability evaluation of the same PACS client. The interaction patterns revealed four usability issues: (1) the display protocols do not function properly, (2) the line measurement tool stays active until another tool is selected, rather than being deactivated after one use, (3) the PACS's built-in 3D functionality does not allow users to effectively perform certain 3D-related tasks, (4) users underuse the PACS's customization possibilities. All usability issues identified based on the log data were also found in the field study, which identified 48 issues in total. Post-deployment usability evaluation based on pattern mining of user interaction log data provides useful insights into the way users interact with the radiology PACS client. However, it reveals few usability issues compared to a field study and should therefore not be used as the sole method of usability evaluation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Radiology illustrated. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology

    2014-11-01

    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  5. Lessons from surgery and anaesthesia: evaluation of non-technical skills in interventional radiology

    Science.gov (United States)

    Patel, Salil B; Pilkington, Nicola

    2015-01-01

    In the medical profession, surgery and anaesthesia are leading the way in identifying human errors that negatively affect patient safety. Evidence suggests that the implementation of non-technical skills assessments reduces such errors. Interventional Radiology is a procedural based speciality and therefore may also benefit from formal assessment of non-technical skills. This literature review supports the use of standardised assessment tools used in surgery and anaesthesia. Using the Downing framework of internal validity, the tools demonstrated good internal consistency but a spectrum of inter-rater variability, which can be partially improved with training. At present, a formal Interventional Radiology non-technical skills assessment tool is probably not suitable to be a stand-alone ‘high stakes’ assessment, but may be a useful adjunct to the existing array of workplace-based assessments. PMID:26664733

  6. Radiologic evaluation of the continent (S-pouch) ileal reservoir with anal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Hennild, V.; Kjaergaard, H.; Kuld Hansen, L.

    A radiologic investigation was performed in 26 patients subjected to colectomy, mucosal proctectomy and endorectal ileo-anal anastomosis after the creation of an ileal reservoir. The patients had suffered from ulcerative colitis or familial polyposis. The reservoir and its efferent leg was best demonstrated by contrast enema. The size and position of the reservoir and the efferent leg was demonstrated, and stenoses, abscesses and fistulae could be identified. Examination of the small bowel with a contrast medium showed slight dilatation of the ileum orally to the reservoir in all instances and one patient had a stenosis at the junction of the afferent leg of the reservoir. Erect and supine projections of the abdomen showed gas in the intestine and fluid levels in the reservoir. These radiographic findings should not be confused with ileus or pelvic abscess. Radiology was of great value in disclosing postoperative complications.

  7. Evaluation of embryological sequences of ear anomalies and its radiological relevance

    OpenAIRE

    C Amarnath; G Sathyan; R Soniya; A L Periakaruppan; K Shiva Shankar

    2016-01-01

    Aim: To correlate the sequence of embryological development of ear with radiological imaging. Materials and Methods: The study enrolled 23 patients of age group 11 months to 27 years with malformed external ear/microtia and hearing loss. The children with postoperative changes, acute hearing loss (such as infection, trauma) were excluded from the study. We used high-resolution computed tomography, with axial and coronal sections to examine the temporal bones of patients. Results: Of the 23 ca...

  8. Comparative evaluation of oral gabapentin versus clonidine as premedication on preoperative sedation and laryngoscopic stress response attenuation for the patients undergoing general anesthesia

    OpenAIRE

    Saikat Majumdar; Anjan Das; Haripada Das; Sambhunath Bandyopadhyay; Bimal Kumar Hajra; Dipankar Mukherjee

    2015-01-01

    Background: Laryngoscopy and endotracheal intubation (L and I) is associated with rise in blood pressure (BP), heart rate (HR), leading to adverse cardiological outcome especially in susceptible individuals. To compare the BP, HR during L and I as well as to evaluate the preoperative sedation status between oral clonidine (Group C) and oral gabapentine (Group G) as premedication for the patients undergoing major surgery under general anesthesia (GA). Materials and Methods: From April 2008...

  9. Comparative evaluation of oral clonidine and midazolam as premedication on preoperative sedation and laryngoscopic stress response attenuation for the patients undergoing general anaesthesia

    OpenAIRE

    Anjan Das; Tushar Kanti Saha; Saikat Majumdar; Rahul Deb Mandal; Anindya Mukherjee; Subrata Kumar Mandal

    2013-01-01

    Context: Laryngoscopy and endotracheal intubation is associated detrimental hemodynamic changes like rise in blood pressure (BP), heart rate (HR) leading to adverse cardiological outcome specially in susceptible individuals. Aims: To compare the blood pressure (BP) and heart rate (HR) changes during laryngoscopy and endotracheal intubation as well as to evaluate the preoperative sedation status between oral clonidine and oral midazolam as premedication for the patients undergoing general anes...

  10. Preoperative surgical planning and simulation of complex cranial base tumors in virtual reality

    Institute of Scientific and Technical Information of China (English)

    YI Zhi-qiang; LI Liang; MO Da-peng; ZHANG Jia-yong; ZHANG Yang; BAO Sheng-de

    2008-01-01

    @@ The extremely complex anatomic relationships among bone,tumor,blood vessels and cranial nerves remains a big challenge for cranial base tumor surgery.Therefore.a good understanding of the patient specific anatomy and a preoperative planning are helpful and crocial for the neurosurgeons.Three dimensional (3-D) visualization of various imaging techniques have been widely explored to enhance the comprehension of volumetric data for surgical planning.1 We used the Destroscope Virtual Reality (VR) System (Singapore,Volume Interaction Pte Ltd,software:RadioDexterTM 1.0) to optimize preoperative plan in the complex cranial base tumors.This system uses patient-specific,coregistered,fused radiology data sets that may be viewed stereoscopically and can be manipulated in a virtual reality environment.This article describes our experience with the Destroscope VR system in preoperative surgical planning and simulation for 5 patients with complex cranial base tumors and evaluates the clinical usefulness of this system.

  11. Quality assurance in preoperative radiotherapy of rectal cancer : evaluation of a pre-trial dummy-run

    NARCIS (Netherlands)

    Widder, J; Sedlmayer, F; Stanek, C; Potter, R

    2000-01-01

    Purpose: To assess inter-institution variability of treated volumes in preoperative radiotherapy for rectal cancer among Austrian radiotherapy institutions in the framework of a multi-centre phase-In clinical trial. Materials and,methods: All eleven Austrian radiotherapy departments were invited to

  12. Radiological evaluation of the therapeutic response of malignant diseases. Status quo, innovative developments and requirements for radiology; Radiologische Beurteilung des Therapieansprechens maligner Erkrankungen. Status quo, innovative Entwicklungen und Anforderungen an die Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Hoeink, A.J.; Heindel, W.; Buerke, B. [University Hospital Muenster (Germany). Dept. of Clinical Radiology

    2014-10-15

    In consequence of the rapid development of newer targeted and personalized tumor therapies, radiology as an essential component of the treatment concept of numerous malignant diseases needs to improve in order to adequately capture and evaluate the effects, but also the side effects of these novel therapeutic agents. The early recognition of therapy response or failure is crucial for the optimal planning of the further treatment and can therefore have direct impact on the chances of recovery and the survival time of oncological patients. In previous years, the goal of medical imaging was to just qualitatively assess the increase or reduction in the size of tumors and their metastases, which was often achieved by a simple subjective estimation of the tumor findings by the diagnosing radiologist. Nowadays, radiology is faced with the challenge of evaluating changes during therapy quantitatively and of visualizing therapeutic effects that are more discrete (e.g. necrosis, altered tumor perfusion). The importance of an adequate assessment of therapy response is further underlined by the fact that in these days, a good portion of oncological patients are enrolled in clinical trials, in which the quantitative radiological evaluation of malignant disorders is an important surrogate parameter. On the basis of this development, the demands for radiology to provide more sophisticated assessments of therapy response and documentation of imaging findings have been constantly growing. The following article provides an overview of the established and still widely spread but in particular also the latest imaging modalities and evaluation criteria with regard to oncological diseases as well as of the increasing demands on radiology that result from these developments. Beyond that, future advancements in tumor imaging are taken into account and the new challenges these developments will bring are discussed.

  13. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2016-08-15

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone.

  14. Errors in the radiological evaluation of the alimentary tract: part II.

    Science.gov (United States)

    Reginelli, Alfonso; Mandato, Ylenia; Solazzo, Antonio; Berritto, Daniela; Iacobellis, Francesca; Grassi, Roberto

    2012-08-01

    Plain abdominal radiography and computed tomographic (CT) enteroclysis are 2 essential radiological investigations in the study of gastrointestinal tract. Errors in patient preparation, execution, and interpretation may lead to severe consequences in the diagnosis and thus in patient outcome. Abdominal radiography is one of the most frequently requested radiographic examinations, and has an established role in the assessment of the acute abdomen. CT enteroclysis has revolutionized the assessment of small-bowel pathology, especially in patients with inflammatory bowel. The purpose of this article is to describe the pitfalls in the execution and interpretation of plain abdominal film and CT enteroclysis.

  15. Imaging and radiology

    Science.gov (United States)

    Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the interpretation ...

  16. Comprehensive preoperative evaluation and repair of inguinal hernias at the time of open radical retropubic prostatectomy decreases risk of developing post-prostatectomy hernia.

    Science.gov (United States)

    Marien, Tracy; Taouli, Bachir; Telegrafi, Shpetim; Babb, James S; Lepor, Herbert

    2012-12-01

    What's known on the subject? and What does the study add? Some studies have evaluated preoperative and intraoperative examination for inguinal hernias and their repair, noting a decrease in the rate of post-prostatectomy hernias. However, this did not eradicate post-prostatectomy hernias, indicating that this method probably missed subclinical hernias. Other studies looked at prophylactic procedures to prevent the formation of inguinal hernias at the time of prostatectomy and showed a decrease in the rate of postoperative hernias. To our knowledge this is the only series evaluating a multi-modal approach with magnetic resonance imaging, ultrasonography and examination to identify all clinical and subclinical hernias and repair them at the time of prostatectomy. This approach only subjects those patients at risk for symptomatic hernias to an additional procedure and decreases the post-prostatectomy hernia rate to hernias and repair of these hernias at the time of open radical retropubic prostatectomy (ORRP) decreases the incidence of clinical inguinal hernias (IHs) after ORRP. • Between 1 July 2007 and 31 July 2010, 281 consecutive men underwent ORRP by a single surgeon. • Of these men, 207 (74%) underwent comprehensive preoperative screening for IH, which included physical examination, upstanding ultrasonography and magnetic resonance imaging. • Between 12 and 24 months after ORRP, 178 (86%) of these men completed a questionnaire designed to capture development of clinical IHs. • Of the 178 evaluable patients, 92 (52%) were diagnosed preoperatively with IH by at least one diagnostic modality. • Forty-one and 51 of the men had bilateral or unilateral IHs, respectively for a total of 133 IHs. • No preoperative factor was significantly associated with the presence of an IH before prostatectomy. • No groin subjected to IH repair (IHR) at the time of ORRP developed a clinical IH compared with four of the 21 patients with postoperative IHs who did not

  17. A and B mode ultrasonography in preoperative evaluation of lens and posterior segment of dogs eyes with cataract

    Directory of Open Access Journals (Sweden)

    Bianca C. Martins

    2010-02-01

    Full Text Available Ultrasonography of the lens and posterior segment is an indispensable step in the preoperative evaluation of dogs with cataracts, since ophthalmoscopy is not feasible when there is opacification of the lens. This study evaluated the echographic conditions of cataractous lens and fundus of the eye in dogs affected by cataracts. The study was conducted in 30 dogs (56 eyes, 10 males and 20 females, with different types of cataracts at different stages of development. Echography in A and B modes, simultaneously, was carried out for the examination of the lens and posterior segment. The examinations revealed anterior cortical, posterior cortical and nuclear cataract in 12 eyes (21.4%, anterior cortical, posterior cortical, nuclear and posterior capsular in 23 eyes (41%, anterior cortical, posterior cortical and posterior capsular cataract in one eye (1.7%, anterior cortical and nuclear cataract in one eye (1.7%, anterior cortical, nuclear and posterior capsular cataract in five eyes (8.9%, and anterior cortical cataract in seven eyes (12.5%. Abnormal ultrasonographic alterations were observed in the posterior segment in 26 eyes evaluated (46.4%. Vitreal degeneration was detected in 12 eyes (21.4%, images of vitreal exudate or hemorrhage in seven eyes (12.5%, persistence of hyaloid artery in four eyes (7.1% and lens subluxation in three eyes (5.3%. The results obtained reiterate the importance of ultrasonography in canine patients presented for cataract surgery given that alterations of the posterior segment are difficult to identify in a clinical examination when the lens is opacified.A ultrassonografia do segmento posterior do bulbo do olho é etapa indispensável na avaliação de cães com catarata que serão submetidos à facectomia, uma vez que a oftalmoscopia não é factível quando há opacificação da lente, notadamente nas cataratas maduras. Este estudo avaliou as condições ecográficas da lente cataratogênica e do fundo de olho de c

  18. Analysis of image quality according to BMI of digital chest radiography: Focusing on bureau of radiological health evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Seong Jin [Gammaknife center, Inje University Haeundae Paik Hospital, Busan (Korea, Republic of); Im, In Chul [Dept. of Radiological Science, Dongeui University, Busan (Korea, Republic of); Cho, Ji Hwan [Dept. of Health Care Clinic, Inje University Busan Paik Hospital, Busan (Korea, Republic of)

    2017-03-15

    Visual evaluation of chest radiograph images is the most practical and effective method. This study compared the Body Mass Index, waist circumference, and mAs with chest radiographs of 351 women. The Bureau of Radiological Health method was used to evaluate the image quality of chest X-ray images by anatomical and physical methods. The average age of the subjects was 30.17±4.73 and the average waist circumference was 66.91±4.67 cm. The mean Body Mass Index value was 20.21±2.23, the mean value of mAs was 3.04±0.78, and the mean value of Bureau of Radiological Health was 79.83±8.45. When the Body Mass Index value increased, waist circumference and mAs mean value increased. The mean value of Body Mass Index was statistically significant(p<0.05) in Group 4 compared to Groups 1 and 2, with increasing Body Mass Index. Exposure control of the automatic exposure control system is considered to be well performed according to body thickness or Body Mass Index at the time of chest radiography. As the Body Mass Index increases, the thickness of the body increases and the breast thickness of the woman also increases. Therefore, it is considered that the exposure amount is changed by the automatic exposure control device to affect the image quality.

  19. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  20. [Axillary local anesthetic spread after the thoracic interfacial ultrasound block - A cadaveric and radiological evaluation].

    Science.gov (United States)

    Torre, Patricia Alfaro de la; Jones, Jerry Wayne; Álvarez, Servando López; Garcia, Paula Diéguez; Miguel, Francisco Javier Garcia de; Rubio, Eva Maria Monzon; Boeris, Federico Carol; Sacramento, Monir Kabiri; Duany, Osmany; Pérez, Mario Fajardo; Gordon, Borja de la Quintana

    2017-09-01

    Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter-fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper-intense signals in the axillary region. These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  1. Comparative evaluation among different materials to replace soft tissue in oral radiology studies

    Directory of Open Access Journals (Sweden)

    Maria de Paula Caldas

    2010-06-01

    Full Text Available OBJECTIVE: The aim of this study was to establish which materials afford better simulation of soft tissues in Oral Radiology studies. MATERIAL AND METHODS: The sample was composed of four materials in eleven different thicknesses to simulate the soft tissues of the face. The mean values of the relative amounts of radiographic contrast of the materials were determined and compared to a gold standard value, which was obtained from 20 patients who were referred to have periapical radiographs taken of the left mandibular molars. Data were subjected to statistical analysis with Dunnett's test (p<0.05. RESULTS: The mean value of the relative amounts of contrast encountered in the patients was 0.47, with a range between 0.36 and 0.64 for all 44 material/thickness combinations. The majority of the tested materials showed values close to those of the patients' tissues, without statistically signifcant differences among them. The values of only three materials/thickness combinations differed statistically from those of the patients' tissues. CONCLUSIONS: Based on the results of the present study, it may be concluded that except for utility wax (4 mm and 8 mm and water (4 mm, all materials tested at different thickness could be used as soft tissue substitute materials in Oral Radiology studies.

  2. Evaluation of the conditions and practices of radiological protection technicians in radiology, according to Ordinance 453; Avaliacao das condicoes e das praticas de protecao radiologica dos tecnicos em radiologia, segundo a portaria 453

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Rogerio Ferreira da

    2013-10-01

    Professionals in radiology suffer whole body exposure to low doses for long periods . The system of radiological protection should keep exposures below recommended thresholds, thus avoiding the stochastic effects that can be triggered with any dose level value, and there is not a threshold for induction of the same. Therefore it is important to use personal dosimeter for monitoring doses and protective equipment. The increase in procedures using ionizing radiation in recent years has been noted with concern, since many companies are not complying with the standards of protection. This is because some procedures may be performed without the need of surgery, which presents a greater risk to the patient. Furthermore, Brazilians are being exposed to radiation without necessity. The reasons range from radiological equipment miscalibrated to poorly trained staff. Thus we evaluate the conditions and practices of radiation protection technicians in radiology according to Ordinance 453 in Goiania, GO, Brazil. Through a descriptive survey with a quantitative approach, we used the technique of gathering information based on a questionnaire. From this survey, we identified the procedures used by radiation protection professionals and concluded that there are failures in the procedures for protecting patients and accompanying and in the training of the professionals. (author)

  3. Comparative evaluation of oral clonidine and midazolam as premedication on preoperative sedation and laryngoscopic stress response attenuation for the patients undergoing general anaesthesia

    Directory of Open Access Journals (Sweden)

    Anjan Das

    2013-07-01

    Full Text Available Context: Laryngoscopy and endotracheal intubation is associated detrimental hemodynamic changes like rise in blood pressure (BP, heart rate (HR leading to adverse cardiological outcome specially in susceptible individuals. Aims: To compare the blood pressure (BP and heart rate (HR changes during laryngoscopy and endotracheal intubation as well as to evaluate the preoperative sedation status between oral clonidine and oral midazolam as premedication for the patients undergoing general anesthesia (GA. Settings and Design: Fifty patients between 18 and 60 years of age of either sex of American Society of Anesthesiologists (ASA Grade I and II undergoing GA were randomly divided into two equal groups of 25 patients each. Group-C patients received clonidine 4 mcg/kg orally and Group-M patients received 0.5 mg/kg midazolam orally as premedication. Material s and Methods: After measuring baseline hemodynamic parameters patients of both groups received premedication. Preoperative sedation was assessed 2 hr after premedication administration. Standard anesthetic technique was followed. Hemodynamic (HR, BP parameters were noted baseline, immediately after laryngoscopy and intubation and 5 min after intubation to observe the stress response. Results and Statistical Analysis: A significant difference in pre-operative sedation between two groups (P < 0.05 and midazolam (group M produced significantly better sedation than clonidine (group C. Laryngoscopic stress response in group C was still at a lower level than baseline values and significantly (P < 0.005 less than group M. Conclusions: Oral midazolam is more effective in producing preoperative sedation than oral clonidine while on the contrary oral clonidine is more efficacious in reducing laryngoscopic stress response than oral midazolam. Laryngoscopy and intubation was better controlled by oral clonidine than midazolam.

  4. Evaluation of Current Computer Models Applied in the DOE Complex for SAR Analysis of Radiological Dispersion & Consequences

    Energy Technology Data Exchange (ETDEWEB)

    O' Kula, K. R. [Savannah River Site (SRS), Aiken, SC (United States); East, J. M. [Savannah River Site (SRS), Aiken, SC (United States); Weber, A. H. [Savannah River Site (SRS), Aiken, SC (United States); Savino, A. V. [Savannah River Site (SRS), Aiken, SC (United States); Mazzola, C. A. [Savannah River Site (SRS), Aiken, SC (United States)

    2003-01-01

    The evaluation of atmospheric dispersion/ radiological dose analysis codes included fifteen models identified in authorization basis safety analysis at DOE facilities, or from regulatory and research agencies where past or current work warranted inclusion of a computer model. All computer codes examined were reviewed using general and specific evaluation criteria developed by the Working Group. The criteria were based on DOE Orders and other regulatory standards and guidance for performing bounding and conservative dose calculations. Included were three categories of criteria: (1) Software Quality/User Interface; (2) Technical Model Adequacy; and (3) Application/Source Term Environment. A consensus-based limited quantitative ranking process was used to base an order of model preference as both an overall conclusion, and under specific conditions.

  5. Evaluation of radiological data of some saturated fatty acids using gamma ray spectrometry

    Science.gov (United States)

    Kore, Prashant S.; Pawar, Pravina P.; Palani Selvam, T.

    2016-02-01

    Radiological parameters such as mass attenuation coefficients (μm), total attenuation cross section (σtot), molar extinction coefficient (ε), mass energy absorption coefficient (μen/ρ) and effective electronic cross section (σt, el) of saturated fatty acids, namely butyric acid (C4H8O2), caproic acid (C6H12O2), enanthic acid (C7H14O2), caprylic acid (C8H16O2), pelargonic acid (C9H18O2) and valeric acid (C5H10O2) were measured using NaI(Tl)-based gamma spectrometry. Radioactive sources used in the study are 57Co, 133Ba, 137Cs, 54Mn, 60Co and 22Na. Gamma ray transmission method in a narrow beam good geometry set up was used in the study. The measured data were compared against Win-XCOM-based data. The agreement is within 1%.

  6. EVALUATING ROBOT TECHNOLOGIES AS TOOLS TO EXPLORE RADIOLOGICAL AND OTHER HAZARDOUS ENVIRONMENTS

    Energy Technology Data Exchange (ETDEWEB)

    Curtis W. Nielsen; David I. Gertman; David J. Bruemmer; R. Scott Hartley; Miles C. Walton

    2008-03-01

    There is a general consensus that robots could be beneficial in performing tasks within hazardous radiological environments. Most control of robots in hazardous environments involves master-slave or teleoperation relationships between the human and the robot. While teleoperation-based solutions keep humans out of harms way, they also change the training requirements to accomplish a task. In this paper we present a research methodology that allowed scientists at Idaho National Laboratory to identify, develop, and prove a semi-autonomous robot solution for search and characterization tasks within a hazardous environment. Two experiments are summarized that validated the use of semi-autonomy and show that robot autonomy can help mitigate some of the performance differences between operators who have different levels of robot experience, and can improve performance over teleoperated systems.

  7. Transcrestal Sinus Lift Procedure Approaching Atrophic Maxillary Ridge: A 60-Month Clinical and Radiological Follow-Up Evaluation

    Directory of Open Access Journals (Sweden)

    G. Lo Giudice

    2015-01-01

    Full Text Available Aim. The aim of this study was to assess the success and the survival rate of dental implants placed in augmented bone after sinus lifting procedures. Material and Methods. 31 patients were mainly enrolled for a residual upper jaw crest thickness of 3 mm. CBCT scans were performed before and after the augmentation technique and at the follow-up appointments, at 3, 6, 12, 24, and up to 60 months. The follow-up examination included cumulative survival rate of implants, peri-implant marginal bone loss, and the height of sinus floor augmentation. Results. This retrospective study on 31 patients and 45 implants later inserted in a less than 3 mm crest showed excellent survival rates (99.5%, one implant was lost before loading due to an acute infection after 24 days, and two implants did not osteointegrate and were removed after 3 months. The radiological evaluation showed an average bone loss of 0.25 mm (±0.78 mm at the first follow-up appointment (3 months up to 0.30 mm (±1.28 mm after 60-month follow-up. Conclusion. In this study it was reported how even in less than 3 mm thick crest a transcrestal technique can predictably be used with a long-term clinical and radiological outcome, giving patients excellent stability of the grafted material and healthy clinical results.

  8. Real time Monte Carlo simulation for evaluation of patient doses involved in radiological examinations

    Energy Technology Data Exchange (ETDEWEB)

    Fulea, D. [Institute of Public Health ' Prof.Dr.Iuliu Moldovan' , Cluj-Napoca (Romania); Cosma, C. [Babes-Bolyai Univ., Faculty of Physics, Cluj-Napoca (Romania)

    2006-07-01

    In order to apply the Monte Carlo simulation technique for usual radiological examinations we developed a Pc program, 'IradMed', written entirely in Java. The main purpose of this program is to compute the organ doses and the effective dose of patients, which are exposed at a X-ray beam having photon energies in 10 to 150 keV radiodiagnostic range. Three major radiological procedures are considered, namely mammography, radiography and CT. The fluoroscopy implies an irregular geometry and therefore it is neglected. Nevertheless, a gross estimation of patient doses can be made taking into account the fluoroscopy as being composed of several radiographic examinations applied in different anatomical regions. The interactions between radiation and matter are well-known, and the accuracy of the calculation is limited by the accuracy of the anatomical model used to describe actual patients and by characterisation of the radiation field applied. In this version of IradMed, it is assumed that the absorbed dose is equal with kerma for all tissues. No procedure has been used to take account of the finite range of the secondary electrons that are produced by photoelectric or Compton interactions. These ranges are small compared with the dimensions of the organs, and the absorbed dose will not change abruptly with distance except at boundary where composition and density change. However these boundary effects would have little effect in the determination of the average doses to almost all organs, except the active bone marrow which is treated separately. Another justification for this kerma approximation is the fact that the sum of all electron energies that exit the organ is statistically equal with the sum of all electron energies that enter in that particular organ. In this version of program, it is considered the following interactions: the Rayleigh scattering, the Compton scattering and the photoelectric effect. The Compton scattering is modeled by several

  9. Radiological Characteristics and Anatomical Risk Factors in the Evaluation of Hallux Valgus in Chinese Adults

    Institute of Scientific and Technical Information of China (English)

    Hailin Xu; Kaiji Jin; Zhongguo Fu; Mingtai Ma; Zhongdi Liu; Shuai An; Baoguo Jiang

    2015-01-01

    Background:There are no unified theories as to the anatomical changes that occur with hallux valgus,we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese adults.Methods:We reviewed 141 patients with hallux valgus (206 feet; 15 males,126 females; mean age,58.5 years).These patients attended Peking University People's Hospital from April 2008 to March 2014.All feet had intact radiological data,obtained using the Centricity RIS/PACS system.We measured hallux valgus angle (HVA),1-2 intermetatarsal angle (IMA),proximal articular set angle (PASA),distal articular set angle,hallux interphalangeal angle,metatarsocuneiform angle,size of the medial eminence of the distal first metatarsal,tibial sesamoid position,and joint congruity of the first metatarsophalangeal joint (MTPJ).Results:We found positive correlations between the HVA and IMA (r =0.279,P < 0.01) and HVA and PASA (r =0.358,P < 0.01),but not for IMA and PASA (P > 0.05).Feet were divided into three groups based on HVA severity.IMA (P < 0.05) and PASA (P < 0.05) in the mild group were significantly lower than that in the moderate and severe groups,with no significant difference determined for IMA or PASA between the moderate and severe groups (P > 0.05).Feet were then grouped based on the shape of the first metatarsal head.Using this grouping,HVA was significant higher in the rounded shape (19.92°) than in a flat shape (17.66°).The size of the medial eminence of the distal first metatarsal was positively correlated with HVA (r =0.185,P < 0.01).The medial eminence in the moderate and severe groups was significantly larger than that in the mild group; moderate and severe groups were not significantly different.Conclusions:PASA enlargement is an adaptive change during early hallux valgus formation,and decompensation leads to subdislocation in the first MTPJ.A rounded first metatarsal head would thus predispose a foot to hallux valgus

  10. Comparison of MR and fluoroscopic mucous fistulography in the pre-operative evaluation of infants with anorectal malformation: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Jose C.G.; Lotz, Jan W.; Pitcher, Richard D. [Stellenbosch University, Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital, Cape Town (South Africa); Sidler, Daniel [Stellenbosch University, Division of Pediatric Surgery, Department of Surgical Sciences, Tygerberg Academic Hospital, Cape Town (South Africa)

    2013-08-15

    Anorectal malformations are often associated with rectal pouch fistulas. Surgical correction requires accurate evaluation of the presence and position of such fistulas. Fluoroscopy is currently the chosen modality for the detection of fistulas. The role of MRI is unexplored. To compare the diagnostic accuracy of MR versus fluoroscopic fistulography in the pre-operative evaluation of infants with anorectal malformation. We conducted a pilot study of infants requiring defunctioning colostomy for initial management of anorectal malformation. Dynamic sagittal steady-state free-precession MRI of the pelvis was acquired during introduction of saline into the mucous fistulas. Findings were compared among MR fistulography, fluoroscopic fistulography and intraoperative inspection. Eight children were included. Median age at fistulography was 15 weeks, inter-quartile range 13-20 weeks; all were boys. There was full agreement among MR fistulography, fluoroscopic fistulography and surgical findings. The pilot data suggest that MR fistulography is promising in the pre-operative evaluation of children with anorectal malformation. (orig.)

  11. Evaluation of scatter radiation in digital radiological condition by using phostimulated luminescence (BaFBr:Eu{sup 2+})

    Energy Technology Data Exchange (ETDEWEB)

    Min, Jung Whan [Dept. of Radiological Science, Shin-Gu University, Sungnam (Korea, Republic of); Han, Seong Gyu [Dept. of Bio-convergence engineering, Graduate school, Korea University, Seoul (Korea, Republic of); Kim, Jung Min [Dept. of Radiological Science, Korea University, Seoul (Korea, Republic of); Lee, Joo Ah [Dept. of Oncology, Catholic University of Korea Incheon St.Mary,s Hospital, Incheon (Korea, Republic of); Kim, Ki Won [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Jeong, Hoi Woun [Dept. of Radiological Science, Beakseok Culture University, Cheonan (Korea, Republic of)

    2014-06-15

    The purpose of this study is evaluated scatter radiation in digital radiological condition by using photostimulated luminescence (BaFBr:Eu2+). Experiment condition changed kVp (from 50 kVp to 120 kVp), filed size (from 4 × 4 cm{sup 2} to 26 × 26 cm{sup 2}) and phantom thickness (from 1 cm to 15 cm). This method was analysed ImageJ and characteristic curve of CR. This results was scatter radiation to primary radiation ratio increased from 50 kVp to 70 kVp, and it was fixed at over 80 kVp. The scatter radiation to primary radiation ratio are increased according to increasing the ratio of field size. Scatter radiation is also increased by increasing the phantom thickness.

  12. Radiologic evaluation of the liver and gastrointestinal tract in rats infected with Taenia taeniaeformis.

    Science.gov (United States)

    Perry, R L; Williams, J F; Carrig, C B; Kaneene, J B; Schillhorn van Veen, T W

    1994-08-01

    In rats infected with the cestode Taenia taeniaeformis, hepatomegaly results from development of parasitic cysts in the liver. Diffuse nodular mucosal hyperplasia in the glandular region (corpus and antrum) of the stomach, and gross thickening of the intestinal mucosa also result. Between postinfection days (PID) 21 and 84, radiologic observations were made after oral administration of a barium sulfate suspension in T taeniaeformis-infected rats and in age/sex-matched controls. There was radiographic evidence of hepatic enlargement at PID 21. Enlargement of the gastric folds was first observed along the greater curvature of the stomach at PID 35. Fimbriation of small intestinal mucosal surfaces resulted from thickening of the intestinal villi and was observed in the duodenum at PID 21. Intestinal motility was assessed, and contractions were counted, using image intensification fluoroscopy, then were recorded on videotape. There were no significant differences between control and infected rats for gastric emptying time, intestinal transit time, and number of intestinal contractions per minute. Barium contrast radiography clearly indicated large gastric folds, thickening of the small intestinal villi, and hepatic enlargement, and was useful for assessing gastrointestinal motility.

  13. Radiological interventions in malignant biliary obstruction

    Institute of Scientific and Technical Information of China (English)

    Kumble Seetharama Madhusudhan; Shivanand Gamanagatti; Deep Narayan Srivastava; Arun Kumar Gupta

    2016-01-01

    Malignant biliary obstruction is commonly caused by gall bladder carcinoma, cholangiocarcinoma and metastatic nodes. Percutaneous interventions play an important role in managing these patients. Biliary drainage, which forms the major bulk of radiological interventions, can be pal iative in inoperable patients or pre-operative to improve liver function prior to surgery. Other interventions include cholecystostomy and radiofrequency ablation. We present here the indications, contraindications, technique and complications of the radiological interventions performed in patients with malignant biliary obstruction.

  14. Statistical analysis on the concordance of the radiological evaluation of fractures of the distal radius subjected to traction☆

    Science.gov (United States)

    Machado, Daniel Gonçalves; da Cruz Cerqueira, Sergio Auto; de Lima, Alexandre Fernandes; de Mathias, Marcelo Bezerra; Aramburu, José Paulo Gabbi; Rodarte, Rodrigo Ribeiro Pinho

    2016-01-01

    Objective The objective of this study was to evaluate the current classifications for fractures of the distal extremity of the radius, since the classifications made using traditional radiographs in anteroposterior and lateral views have been questioned regarding their reproducibility. In the literature, it has been suggested that other options are needed, such as use of preoperative radiographs on fractures of the distal radius subjected to traction, with stratification by the evaluators. The aim was to demonstrate which classification systems present better statistical reliability. Results In the Universal classification, the results from the third-year resident group (R3) and from the group of more experienced evaluators (Staff) presented excellent correlation, with a statistically significant p-value (p < 0.05). Neither of the groups presented a statistically significant result through the Frykman classification. In the AO classification, there were high correlations in the R3 and Staff groups (respectively 0.950 and 0.800), with p-values lower than 0.05 (respectively <0.001 and 0.003). Conclusion It can be concluded that radiographs performed under traction showed good concordance in the Staff group and in the R3 group, and that this is a good tactic for radiographic evaluations of fractures of the distal extremity of the radius. PMID:26962498

  15. Statistical analysis on the concordance of the radiological evaluation of fractures of the distal radius subjected to traction

    Directory of Open Access Journals (Sweden)

    Daniel Gonçalves Machado

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: The objective of this study was to evaluate the current classifications for fractures of the distal extremity of the radius, since the classifications made using traditional radiographs in anteroposterior and lateral views have been questioned regarding their reproducibility. In the literature, it has been suggested that other options are needed, such as use of preoperative radiographs on fractures of the distal radius subjected to traction, with stratification by the evaluators. The aim was to demonstrate which classification systems present better statistical reliability. RESULTS: In the Universal classification, the results from the third-year resident group (R3 and from the group of more experienced evaluators (Staff presented excellent correlation, with a statistically significantp-value (p < 0.05. Neither of the groups presented a statistically significant result through the Frykman classification. In the AO classification, there were high correlations in the R3 and Staff groups (respectively 0.950 and 0.800, withp-values lower than 0.05 (respectively <0.001 and 0.003. CONCLUSION: It can be concluded that radiographs performed under traction showed good concordance in the Staff group and in the R3 group, and that this is a good tactic for radiographic evaluations of fractures of the distal extremity of the radius.

  16. Evaluation of the composition of filters additional of equipment radiological intraoral by energy dispersive x-ray fluorescence (EDXRF)

    Energy Technology Data Exchange (ETDEWEB)

    Franca, Alana Caroline; Torres, Catarina A.M.P.; Rocha, Ana S.S.; Deniak, Valeriy; Lara, Alessandro L.; Paschuk, Sergei A., E-mail: alanacarolinef@gmail.com, E-mail: sergei@utfpr.edu.br [Universidade Tecnologica Federal do Parana (CPGEI/UTFPR), Curitiba, PR (Brazil). Programa de Pos-Graduacao em Engenharia Eletrica e Informatica Industrial; Fernandes, Angela; Westphalen, Fernando Henrique, E-mail: angelafernandes@ufpr.br [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Setor de Ciencias da Saude

    2013-07-01

    The need for high quality standards for radiographic images in order to make a diagnosis assertive, and being the additional filtration required in the intraoral X-ray equipment show the need of evaluating these filters. This study aims to examine the influence of the elemental composition of the filters of X-ray of dental intraoral equipment in the radiographic images quality. The filters analysis were performed by using the energy dispersive X-ray fluorescence method (EDXRF). Ten conventional filters were analysed. In this study, 33 radiographic exposures were performed using films: twenty radiographs in the incisor region and ten in the molar region, three exposures were also made in the same regions with same conditions without using filter. After radiographs development, optical density was measure and all radiographs were submitted to subjective evaluation by dental radiologists. Data obtained were correlated to effects evaluation of the elemental composition of all filters in the quality of the radiographic images. The elements found were: aluminum, cobalt, copper, sulfur, iron, manganese, titanium, zinc, and zirconium. The images obtained were identified in groups: Molars to 0.3 s; Incisors to 0.2 s; Incisors to 0.3 s, and for the group without filters. From the results obtained it was concluded that both unclear radiographs and ideal radiographs were produced by using filters of elementary common. Therefore, conventional filters evaluated were an acceptable option to produce quality images in dental radiology, despite differences in the composition of the alloys. (author)

  17. Fused 99m-Tc-GSA SPECT/CT imaging for the preoperative evaluation of postoperative liver function: can the liver uptake index predict postoperative hepatic functional reserve?

    Science.gov (United States)

    Yoshida, Morikatsu; Shiraishi, Shinya; Sakaguchi, Fumi; Utsunomiya, Daisuke; Tashiro, Kuniyuki; Tomiguchi, Seiji; Okabe, Hirohisa; Beppu, Toru; Baba, Hideo; Yamashita, Yasuyuki

    2012-04-01

    To evaluate the role of hepatic asialoglycoprotein receptor analysis in the preoperative estimation of postoperative hepatic functional reserve. We obtained technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) SPECT/CT fusion images in 256 patients with liver disease scheduled for hepatic resection. The liver uptake value corrected for body surface area [LUV(BSA)] and liver uptake ratio (LUR) of the remnant were preoperatively estimated based on the fused images. These values were compared with the postoperative hepatic functional reserve. Significant correlations were observed between LUV(BSA), LUR, and most conventional indicators of hepatic functional reserve. Postoperatively, nonpreserved liver functional reserve was observed in 15 of the 256 patients (5.8%). Remnant LUV(BSA) showed better correlation than remnant LUR or the other indicators. No patients with remnant LUV(BSA) above 28.0 manifested poor nonpreserved functional reserve. Using a LUV(BSA) of 27.0, it was possible to predict postoperative poor hepatic functional reserve at a sensitivity of 91%, specificity of 81%, and accuracy of 81% postoperatively. According to multivariate analysis, a low remnant LUV(BSA) was the only significant independent predictor of poor hepatic functional reserve. Our 99mTc-GSA SPECT/CT fusion imaging method was clinically useful for evaluating regional hepatic function and for predicting postoperative hepatic functional reserve.

  18. Evaluation of embryological sequences of ear anomalies and its radiological relevance

    Directory of Open Access Journals (Sweden)

    C Amarnath

    2016-01-01

    Full Text Available Aim: To correlate the sequence of embryological development of ear with radiological imaging. Materials and Methods: The study enrolled 23 patients of age group 11 months to 27 years with malformed external ear/microtia and hearing loss. The children with postoperative changes, acute hearing loss (such as infection, trauma were excluded from the study. We used high-resolution computed tomography, with axial and coronal sections to examine the temporal bones of patients. Results: Of the 23 cases, 12 cases had external ear anomaly and 11 cases had cochlear anomaly. In patients with the external ear anomaly, seven cases had associated middle ear malformations, one patient had associated middle and inner ear anomaly, one had anomalous course of facial nerve, and three cases had isolated external ear anomalies. In patients with inner ear anomalies, one patient had complete labyrinthine aplasia, one had cochlear dysplasia with incomplete cochlear turns, four had common cavity malformations, one had cystic featureless cochlea with dilated and cystic vestibule, two patients had small cochlea with the middle and apical turns coalescing to form a cystic apex, one patient had small rudimentary cochlea, and the other one had dilated vestibule and enlarged endolymphatic duct and sac with cochlear dysmorphism. Conclusion: Most of the children with malformed pinna had external auditory canal atresia with associated middle ear anomalies. Though the inner ear development is independent of external and middle ear development, we insist on the fact that insult during the 1 st month of embryogenesis can result in associated abnormalities involving external, middle, and inner ear. Developmental arrest at various stages of inner ear development results in various types of cochlear anomalies with associated vestibular, semicircular canal abnormalities, and rarely associated with middle and external ear anomalies. Hence, clear knowledge about embryology will help to

  19. Diagnostic and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

    2016-08-01

    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  20. Computers in radiology. The sedation, analgesia, and contrast media computerized simulator: a new approach to train and evaluate radiologists' responses to critical incidents

    Energy Technology Data Exchange (ETDEWEB)

    Medina, L.S.; Racadio, J.M. [Dept. of Radiology, Children' s Hospital Medical Center, Cincinnati, OH (United States); Schwid, H.A. [Dept. of Anesthesia, Veterans Administration Medical Center, University of Washington, Seattle, WA (United States)

    2000-05-01

    Background. Awareness and preparedness to handle sedation, analgesia, and contrast-media complications are key in the daily radiology practice. Objective. The purpose is to create a computerized simulator (PC-Windows-based) that uses a graphical interface to reproduce critical incidents in pediatric and adult patients undergoing a wide spectrum of radiologic sedation, analgesia and contrast media complications. Materials and methods. The computerized simulator has a comprehensive set of physiologic and pharmacologic models that predict patient response to management of sedation, analgesia, and contrast-media complications. Photorealistic images, real-time monitors, and mouse-driven information demonstrate in a virtual-reality fashion the behavior of the patient in crisis. Results. Thirteen pediatric and adult radiology scenarios are illustrated encompassing areas such as pediatric radiology, neuroradiology, interventional radiology, and body imaging. The multiple case scenarios evaluate randomly the diagnostic and management performance of the radiologist in critical incidents such as oversedation, anaphylaxis, aspiration, airway obstruction, apnea, agitation, bronchospasm, hypotension, hypertension, cardiac arrest, bradycardia, tachycardia, and myocardial ischemia. The user must control the airway, breathing and circulation, and administer medications in a timely manner to save the simulated patient. On-line help is available in the program to suggest diagnostic and treatment steps to save the patient, and provide information about the medications. A printout of the case management can be obtained for evaluation or educational purposes. Conclusion. The interactive computerized simulator is a new approach to train and evaluate radiologists' responses to critical incidents encountered during radiologic sedation, analgesia, and contrast-media administration. (orig.)

  1. Radiation dose evaluation in patients submitted to conventional radiological examinations; Avaliacoes de doses de radiacao em pacientes submetidos a exames radiologicos convencionais

    Energy Technology Data Exchange (ETDEWEB)

    Tilly Junior, Joao G

    1997-07-01

    This work presents the results of the evaluation of radiation dose delivered to the patients undergoing conventional radiological procedures. Based in the realized measurement some indicators are settled to quantitative appraisal of the radiological protection conditions offered to the population. Data assessment was done in the county of Curitiba, in Parana State, Brazil, from 12/95 to 04/96, in ten rooms of three different institutions, under 101 patients, adults with 70 {+-} 10 kg, during real examinations of chest PA, chest LAT and abdomen AP. (author)

  2. Evaluation of the Degree of Educational Goal Fulfillment of Theoretical Courses in Technology for Radiology Students in Hamadan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Safar Shams

    2010-05-01

    Full Text Available Background/Objective: Evaluation of educational programs is very important in the process of programming. Evaluation is a comparison between educational results and predetermined goals in order to make decision about programs. Via evaluation, one can judge about programs and of course can correct or change them if necessary. "nMaterials and Methods: In this study, the degree of fulfillment of educational goals for radiology students in technology has been evaluated from 1385 to 1386 by distributing questionnaires among these students. The relationship between fulfillment of educational goals and scores of students in different semesters were evaluated by statistical analysis. "nResults: About 24%, 96% and 100% of students of semester 1, 2 and 3 completely answered the ques-tions and the others were excluded from the study. About 79.3% of the first semester students of radiology assessed a medium fulfillment of educational goals, but in one case, public health lesson, most of them (64% believed in low fulfillment of goals. Second semester students of radiology, as the same ratio, assessed the fulfillment of goals as high, medium and low. Most of the third semester students (60.3% believed that the fulfillment of educational goals had been medium. Most of students believed that the degree of fulfillment of educational goals of courses taught by professors who were not members of the school was higher. There was no statistically significant relation between the fulfillment of educational goals and the score of students in related lessons. "nConclusion: The study revealed that the degree of fulfillment of educational goals for students in different semesters of Radiology was different. There were significant differences between fulfillment of educational goals in theoretical courses conducted by groups inside and outside the paramedical school. "nKeywords: Educational Planning, Vocational Education, Evaluation, Technology, Radiology Student

  3. Umbilical venous catheters placement evaluation on frontal radiogram: application of a simplified flow-chart for radiology residents.

    Science.gov (United States)

    Salerno, Sergio; Tudisca, Chiara; Murmura, Elena; Matranga, Domenica; La Tona, Giuseppe; Lo Re, Giuseppe; Lo Casto, Antonio

    2017-05-01

    Umbilical Venous Catheter (UVC) are commonly used in neonatal period; they can be not correctly positioned and could be associated with complications. The purpose of this article is to suggest a flow-chart to evaluate the placement of UVC, testing it in young radiologists-in-training. We developed a simple flow-chart to asses, steps by step, UVC placement considering its course and tip location (ideally placed in the atriocaval junction). We tested the flow-chart impact asking to 20 residents to evaluate the placement of 10 UVC before and after they familiarized with the flow-chart and the anatomical findings of a newborn. The agreement among the 20 students was evaluated too. The number of correct characterizations was different due to the administration of the flow-chart. One hundred and six correct UVC assessments at the beginning switched to 196 after the administration of the flow-chart (p = 0.0001). The observed agreement among the twenty radiology residents was statistically significant, both before (kappa = 0.41, p < 0.001) and after (kappa = 0.37, p < 0.001) the flow-chart administration. The developed flow-chart demonstrated to be useful in increasing residents performance in UVC placement assessment.

  4. Web-based training course for evaluating radiological dose assessment in NRC's license termination process.

    Science.gov (United States)

    Lepoire, D; Richmond, P; Cheng, J-J; Kamboj, S; Arnish, J; Chen, S Y; Barr, C; McKenney, C

    2008-08-01

    As part of the requirement for terminating the licenses of nuclear power plants or other nuclear facilities, license termination plans or decommissioning plans are submitted by the licensee to the U.S. Nuclear Regulatory Commission (NRC) for review and approval. Decommissioning plans generally refer to the decommissioning of nonreactor facilities, while license termination plans specifically refer to the decommissioning of nuclear reactor facilities. To provide a uniform and consistent review of dose modeling aspects of these plans and to address NRC-wide knowledge management issues, the NRC, in 2006, commissioned Argonne National Laboratory to develop a Web-based training course on reviewing radiological dose assessments for license termination. The course, which had first been developed in 2005 to target specific aspects of the review processes for license termination plans and decommissioning plans, evolved from a live classroom course into a Web-based training course in 2006. The objective of the Web-based training course is to train NRC staff members (who have various relevant job functions and are located at headquarters, regional offices, and site locations) to conduct an effective review of dose modeling in accordance with the latest NRC guidance, including NUREG-1757, Volumes 1 and 2. The exact size of the staff population who will receive the training has not yet been accurately determined but will depend on various factors such as the decommissioning activities at the NRC. This Web-based training course is designed to give NRC staff members modern, flexible access to training. To this end, the course is divided into 16 modules: 9 core modules that deal with basic topics, and 7 advanced modules that deal with complex issues or job-specific topics. The core and advanced modules are tailored to various NRC staff members with different job functions. The Web-based system uses the commercially available software Articulate, which incorporates audio, video

  5. An Evaluation of the Diagnostic Accuracy of the Grade of Preoperative Biopsy Compared to Surgical Excision in Chondrosarcoma of the Long Bones

    Directory of Open Access Journals (Sweden)

    Robert Jennings

    2010-01-01

    Full Text Available Chondrosarcoma is the second most common primary malignant bone tumour. Distinguishing between grades is not necessarily straightforward and may alter the disease management. We evaluated the correlation between histological grading of the preoperative image-guided needle biopsy and the resection specimen of 78 consecutive cases of chondrosarcoma of the femur, humerus, and tibia. In 11 instances, there was a discrepancy in histological grade between the biopsy and surgical specimen. Therefore, there was an 85.9% (67/78 accuracy rate for pre-operative histological grading of chondrosarcoma, based on needle biopsy. However, the accuracy of the diagnostic biopsy to distinguish low-grade from high-grade chondrosarcoma was 93.6% (73/78. We conclude that accurate image-guided biopsy is a very useful adjunct in determining histological grade of chondrosarcoma and the subsequent treatment plan. At present, a multidisciplinary approach, comprising experienced orthopaedic surgeons, radiologists, and pathologists, offers the most reliable means of accurately diagnosing and grading of chondrosarcoma of long bones.

  6. Interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Steinbrich, W. (ed.) (Basel Univ. (Switzerland). Inst. fuer Medizinische Radiologie); Gross-Fengels, W. (ed.) (Allgemeines Krankenhaus Harburg, Hamburg (Germany). Abt. fuer Klinische Radiologie)

    1993-01-01

    In interventional radiology adjunctive medical therapy can increase patient's comfort, and should further reduce the risks of the procedures. In order to fulfill the responsibility of the interventionist to the patients and to increase the success rate of the interventions, a profound knowledge of certain drugs is indispensable. This includes, for example, sedatives, analgesics, cardiovascular drugs and agents to prevent infections, thromboembolic complications or restenoses. Moreover, a good monitoring system during complex procedures will increase the safety of radiological interventions. These topics and several more are presented in this book. (orig.). 32 figs.

  7. Model evaluation of RIMPUFF within complex terrain using an 41Ar radiological dataset

    DEFF Research Database (Denmark)

    Dyer, Leisa L.; Astrup, Poul

    2012-01-01

    The newly updated atmospheric dispersion model RIMPUFF is evaluated using routine releases of 41Ar from the former HIFAR research reactor located in Sydney, Australia. A large number of 41Ar measurements from a network of environmental gamma detectors are used to evaluate the model under a range...... of atmospheric stability conditions within the complex terrain area. Model sensitivity of input data is analysed including meteorological station data, land use maps, surface roughness and wind interpolation schemes. Various model evaluation tools are used such as gamma dose rate plots, exploratory data analyses...... and relevant statistical performance measures. Copyright © 2012 Inderscience Enterprises Ltd....

  8. Radiological evaluation of double-outlet right ventricle - An analysis of cinecardioangiography in 44 cases -

    Energy Technology Data Exchange (ETDEWEB)

    Park, Cheong Hee; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    Double-outlet right ventricle is defined as follows: both great arteries arise completely or nearly completely from the right ventricle; neither semilunar valve is in fibrous continuity with either atrioventricular valve; and usually a ventricular septal defect is present and the only outlet from the left ventricle. A total of 44 cases of double-outlet right ventricle is analyzed, in which cineangiocardiographies were done at the Department of Radiology, Seoul National University Hospital in recent 4 year and 6 months, with specific reference to the segmental combinations, the height of conus, the relationship of great arteries, the location of ventricular septal defects, and associated anomalies. The results were as follows; 1. Among 44 cases, 36 cases had normal cardiac position, 4 cases had dextrocardia with situs inversus 2 cases had dextrocardia with situs solitus, 1 case had levocardia with situs inversus, and another 1 case had mesocardia with situs ambiguus. 2. Segmental sets were [S,D,D] in 36 cases, [I,L,L] in 3 cases, [I,D,D] in 2 cases, [S,D,L], [S,L,L] and [A,D,D] in 1 case respectively. 3. All cases had bilateral conus. Aortic valve rings were same level as pulmonary valve rings in 25 cases, lower than pulmonary valve rings in 17 cases in which 15 cases were type A., and higher than pulmonary valve rings in 2 cases. 4. The relation of the great arteries were normal in 15 cases, side-by-side in 13 cases, dextromalposition in 13 cases, and levomal position in 3 cases. 5. The position of the ventricular septal defects with respect to the origins of the great arteries is subaortic (type A and type B) in 23 cases, subpulmonary (type C) in 13 cases, doubly committed (type D) in 3 cases, and uncommitted (type E) in 5 cases. 6. Associated cardiac malformations are pulmonary stenosis in 24 which had all cases of type A and type E, aortic stenosis in 6 which were only in type C, left SVC in 6, abnormality of atrioventricular valve in 5, single coronary artery

  9. Anxiety in preoperative anesthetic procedures.

    Science.gov (United States)

    Valenzuela Millán, Jaquelyn; Barrera Serrano, José René; Ornelas Aguirre, José Manuel

    2010-01-01

    Preoperative anxiety is a common and poorly evaluated condition in patients who will undergo an anesthetic and surgical intervention. The objective of this study was to determine the prevalence of anxiety in a group of patients undergoing elective surgery, as assessed by the Amsterdam Anxiety Preoperative and Information (AAPI) scale. We studied 135 patients scheduled for elective surgery applying the AAPI scale 24 h before the surgical procedure to evaluate the presence of anxiety and patient characteristics. A descriptive analysis with mean +/- standard deviation for categorical variables was done. For intragroup differences, chi(2) test was used. Pearson correlation for the association between anxiety and postoperative complications was carried out. A value of p =0.05 was considered significant. One hundred six patients were surgically treated, 88% were female (average age 44 +/- 12 years). Some degree of preoperative anxiety was present in 72 patients (76%; p = 0.001) with a grade point average on the AAPI scale equal to 17 +/- 7 points, of which 95 (70%, OR = 5.08; p = 0.002) were females. Results of this study suggest the presence of high levels of preoperative anxiety in patients scheduled for elective surgery. The origin of the anxiety appears to be related to many factors that can be evaluated in pre-anesthetic consultation. Further study is needed to prevent the presence of this disorder.

  10. Investigation of errors by radiological technologists and evaluation of preventive measures: general and mobile X-ray examinations.

    Science.gov (United States)

    Igarashi, Hiroshi; Fukushi, Masahiro; Shinoda, Naoki; Miyamoto, Akira; Hirata, Masaharu; Ishidate, Miyako; Kuraishi, Masahiko; Doi, Kunio

    2010-07-01

    The first objective in this study was to identify the errors of incidents and accidents that occurred in general and mobile X-ray examinations. Based on the analysis of results, the second purpose in this study was to propose useful measures to prevent such errors. As much as 553 radiological technologists in the Gunma Prefecture were surveyed on their experience with errors related to general and mobile X-ray examinations. The questionnaire asked for descriptions of errors experienced during examinations and the responses given (multiple answers possible), and evaluations of the degree of busyness on a five-point scale. A total of 115 questionnaires were returned. Analysis revealed that there was no significant relationship between errors and degree of busyness for either general or mobile examinations. The most frequent error both in general and in mobile examinations was to X-ray a patient mistakenly, the cause of which was cited as failure to confirm the patient's name. After the use of solution priority number to evaluate proposed preventive measures, such as finger-pointing and call, independent double-checks, and verbal self-confirmation would be the simplest and most easily implemented countermeasure.

  11. Aspects on Image Quality in Radiologic Evaluation of the Urinary Tract

    OpenAIRE

    2012-01-01

    The focus of this document is on image quality as one of the factors fundamental for the diagnostic process. With the rising number of procedures and the trend towards more complicated examinations, urinary tract investigations was chosen in this work as a good clinical model for evaluation of the factors influencing image quality and of the ways of evaluating image quality. In paper I, a method is described for optimisation during the introduction of a new imaging system, with a focus on the...

  12. Clinical, Radiologic and scintigraphic evaluation of the results of A. Moore and Thompson prostheses in the management of femoral neck fractures

    OpenAIRE

    Kiran, Ugur; Orhan, Zafer; Parmaksizoglu, Atilla Sancar; Ozkaya, Ufuk; Yalaman, Okan; Yazıcı, Nüzhet

    2004-01-01

    140 patients had been operated due to femoral neck fractures in the Ortopaedics and Traumatology CIinic Taksim State Hospital during the period of 1985 to 1991 and of this group, 42 patient's results were clinically, radiologically and scintigraphically evaluated. We evaluated the technical criteria used in the A.Moore type and the Thompson type endoprostheses, and tried to emphasize the significance of Tc-99 bone scanning in assesment of the results of prosthetic replacement. In this study, ...

  13. Therapy evaluation and diagnostic accuracy in neuroendocrine tumours: assessment of radiological methods

    Energy Technology Data Exchange (ETDEWEB)

    Elvin, A.

    1993-01-01

    The diagnostic accuracy of ultrasonically guided biopsy-gun biopsies was assessed in a group of 47 patients with suspected pancreatic carcinoma. A correct diagnosis was obtained in 44 of the 47 patients (94%). Twenty-five patients with known neuroendocrine tumour disease were biopsied with 1.2 mm and 0.9 mm biopsy-gun needles. The influence of treatment-related fibrosis was also evaluated. The overall diagnostic accuracy with the 0.9 mm needle was 69% as compared to 92% with the 1.2 mm needle. In order to assess the diagnostic accuracy rate for radiologists with different experience of biopsy procedures 175 cases of renal biopsy-gun biopsies were evaluated. No statistical significant difference was found between the different operators. The role of duplex Doppler ultrasound in monitoring interferon treatment-related changes in carcinoid metastases was evaluated. It present duplex Doppler ultrasound does not seem to play a role in the evaluation of tumour therapy in carcinoid patients. Therapy response evaluation was performed with MR imaging in a group of 17 patients with neuroendocrine liver metastases. A significant difference was found between patients responding to and patients with failure of treatment in terms of tumour T1, contrast enhancement and signal intensity ratio. This indicates that MR investigation may be used in therapy monitoring of patients with neuroendocrine metastases. The neuroendocrine-differentiated colonic carcinoma cell line (LCC-18) was transplanted to 29 mice to establish a tumour/animal model that would allow the monitoring of changes with MR imaging induced by interferon therapy and to evaluate whether the therapeutic response could be modulated by different interferon dosages. Interferon does not seem to have any prolonged anti-proliferative effect on the LCC-18 tumour cell line when transplanted to nude mice.

  14. Observational evaluation of preoperative, intraoperative, and postoperative characteristics in 117 Brazilian women without uterine prolapse undergoing vaginal hysterectomy

    Science.gov (United States)

    Batista, Claudio Sergio; Osako, Takasi; Clemente, Eliana Mara; Batista, Fernanda Carvalhido Antonio; Osako, Maurício Takeshi Janiques

    2012-01-01

    Background Despite the introduction of minimally invasive approaches for various benign uterine problems, hysterectomy is often still performed abdominally, but the vaginal route should be used whenever possible. The aim of this study was to identify the preoperative, intraoperative, and postoperative characteristics of women undergoing vaginal hysterectomy in the absence of uterine prolapse. Methods A prospective, descriptive, quantitative, noncomparative study was conducted in 117 women between August 2009 and February 2011 in Petropolis, Rio de Janeiro, Brazil. The women included had a uterine indication for hysterectomy, their surgeries were performed by the same team, and they were followed up for 12 months. An adapted Pelvic Organ Prolapse Quantification system was used to check for uterine prolapse. Results The age range of the women was 33–59 years, uterine volume was 300–900 mL, and 73.50% has undergone prior cesarean section. The main indication for hysterectomy was uterine myoma (64.95%), with a surgery time of 30–60 minutes in 55 (59.82%) and 19 (15.98%) cases, respectively. Uterine volume reduction was performed in 41 (35.05%) cases, salpingectomy was the most common associated surgery (81.19%), and anesthesia was subdural (68.37%). Common intraoperative complications included bladder lesions (8.54%), with conversion to the abdominal route being necessary in one case (1.28%), and the most common postoperative complication being vaginal cupola granuloma (32.47%). There was a statistically significant relationship between surgery time and uterine volume (χ2 = 17.367; P = 0.002). Conclusion This study suggests that vaginal hysterectomy is a safe surgical procedure in view of its good performance and low complication rate. PMID:23071420

  15. Radiologic findings of abdominal wall endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2003-12-01

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.

  16. A combined pulmonary-radiology workshop for visual evaluation of COPD

    DEFF Research Database (Denmark)

    Barr, R Graham; Berkowitz, Eugene A; Bigazzi, Francesca

    2012-01-01

    The purposes of this study were: to describe chest CT findings in normal non-smoking controls and cigarette smokers with and without COPD; to compare the prevalence of CT abnormalities with severity of COPD; and to evaluate concordance between visual and quantitative chest CT (QCT) scoring....

  17. Development and evaluation of Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in a Nuclear Medicine Service

    Energy Technology Data Exchange (ETDEWEB)

    Krempser, Alexandre R., E-mail: krempser@peb.ufrj.br [Universidade Federal do Rio de Janeiro (PEB/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Biomedica; Soares, Alexandre B. [Universidade Federal do Rio de Janeiro (IF/UFRJ), Rio de Janeiro, RJ (Brazil). Inst. de Fisica; Corbo, Rossana [Universidade Federal do Rio de Janeiro (FM/UFRJ), Rio de Janeiro, RJ (Brazil). Dept. de Radiologia

    2011-07-01

    The quality management in Nuclear Medicine Services is a requirement of national and international standards. The Brazilian regulatory agency in health surveillance, the Agencia Nacional de Vigilancia Sanitaria (ANVISA), in its Resolucao de Diretoria Colegiada (Collegiate Directory Resolution) no. 38, requires the elaboration of documents describing the technical and clinical routine activities. This study aimed to elaborate, implement and evaluate Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in the Nuclear Medicine Service of a university hospital. Eighteen SOPs were developed, involving tasks related to dose calibrator, gamma camera, Geiger-Muller detectors and radiological protection activities. The performance of its application was evaluated for a period of six months. It was observed a reduction in 75% of reported operational errors and 42% of the number of reported incidents with contamination by radioactive material. The SOPs were adequate and successful in its application. New procedures involving clinical activities will also be developed and evaluated. (author)

  18. Evaluation of interobserver variability and diagnostic performance of developed MRI-based radiological scoring system for invasive placenta previa.

    Science.gov (United States)

    Ueno, Yoshiko; Maeda, Tetsuo; Tanaka, Utaru; Tanimura, Kenji; Kitajima, Kazuhiro; Suenaga, Yuko; Takahashi, Satoru; Yamada, Hideto; Sugimura, Kazuro

    2016-09-01

    To evaluate the interobserver variability and diagnostic performance of a developed magnetic resonance imaging (MRI)-based scoring system for invasive placenta previa. Prenatal MR images of 70 women were retrospectively evaluated, 18 of whom were diagnosed with invasive placenta. The six MR features (dark band on T2 -weighted images, intraplacental abnormal vascularity, placental bulge, heterogeneous placenta, myometrial thinning, and placental protrusion sign) were scored on 5-point Likert scale separately, and the cumulative radiological score (CRS) was defined as the sum of each score. Two more experienced radiologists (readers A and B) and two less experienced residents (readers C and D) calculated the CRS. Interobserver variability was assessed by measuring the intraclass correlation coefficient. Diagnostic performance was evaluated by means of receiver operating characteristic (ROC) analysis. Interobserver variability for CRS was excellent for the more experienced radiologists (0.85), and good for all readers (0.72) and the less experienced residents (0.66). The area under the ROC curve (Az) and accuracy (Acc) for CRS were significantly higher or equivalent to those of other MR features for all readers (Az and Acc for reader A; CRS, 0.92, 91.4%; intraplacental T2 dark band, 0.83, P = 0.009, 81.4%, P = 0.03; intraplacental abnormal vascularity, 0.9, P = 0.3, 90.0%, P = 1.00; placental bulge, 0.81, P = 0.0008, 80.0%, P = 0.02; heterogeneous placenta, 0.85, P = 0.11, 74.3%, P = 0.002; myometrial thinning, 0.84, P = 0.06, 60.0%, P placenta previa. J. Magn. Reson. Imaging 2016;44:573-583. © 2016 International Society for Magnetic Resonance in Medicine.

  19. Fire victim identification by post-mortem dental CT: Radiologic evaluation of restorative materials after exposure to high temperatures

    Energy Technology Data Exchange (ETDEWEB)

    Woisetschlaeger, Mischa, E-mail: Mischa.woisetschlager@lio.se [Center for Medical Image Science and Visualisation (CMIV), University Hospital Linkoeping, Linkoeping University, 58185 Linkoeping (Sweden); Lussi, Adrian, E-mail: anders.persson@cmiv.lio.se [Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern (Switzerland); Persson, Anders, E-mail: adrian.lussi@zmk.unibe.ch [Center for Medical Image Science and Visualisation (CMIV), University Hospital Linkoeping, Linkoeping University, 58185 Linkoeping (Sweden); Jackowski, Christian, E-mail: christian.jackowski@irm.uzh.ch [Center for Medical Image Science and Visualisation (CMIV), University Hospital Linkoeping, Linkoeping University, 58185 Linkoeping (Sweden); Institute of Legal Medicine, University of Zuerich, Winterthurerstrasse 190/52, 8057 Zuerich (Switzerland)

    2011-11-15

    Objectives: The aim of this study was to evaluate the use of high resolution CT to radiologically define teeth filling material properties in terms of Hounsfield units after high temperature exposure. Methods: 122 human molars with 10 different filling materials at defined filling diameters were examined. The teeth were CT scanned both before and after the exposure to different temperatures. After image reconstruction, the teeth and filling materials were analyzed regarding their morphology and Hounsfield units (HU) using an extended HU scale. Results: The majority of filling materials diminished in size at temperatures {>=}400 deg. C. HU values were stable for all materials up till 200 deg. C, and only slightly changed up to 600 deg. C. Cerec, Dyract and dentin showed only minor changes in HU at all temperatures. The other materials, inclusive enamel, showed specific patterns, either increasing or decreasing in HU with increasing temperatures over 600 deg. C. Conclusions: Over 600 deg. C the filling materials show specific patterns that can be used to discriminate filling materials. Ultra high resolution CT may improve the identification processes in fire victims. Existing 3D visualization presets for the dentition can be used until 600 deg. C and have to be optimized for bodies exposed to higher temperatures.

  20. Is radiological evaluation as good as computer-based volumetry to assess hippocampal atrophy in Alzheimer's disease?

    Energy Technology Data Exchange (ETDEWEB)

    Boutet, Claire; Drier, Aurelie; Dormont, Didier; Lehericy, Stephane [Groupe Hospitalier Pitie-Salpetriere, Department of Neuroradiology, AP-HP, Paris Cedex 13 (France); Universite Pierre et Marie Curie-Paris 6, Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, UMR-S975, Paris (France); Inserm, Paris (France); CNRS, Paris (France); ICM-Institut du Cerveau et de la Moelle epiniere, Paris (France); Chupin, Marie; Colliot, Olivier [Universite Pierre et Marie Curie-Paris 6, Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, UMR-S975, Paris (France); Inserm, Paris (France); CNRS, Paris (France); ICM-Institut du Cerveau et de la Moelle epiniere, Paris (France); Equipe Cogimage-CRICM, Paris Cedex 13 (France); Sarazin, Marie [Universite Pierre et Marie Curie-Paris 6, Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, UMR-S975, Paris (France); Inserm, Paris (France); CNRS, Paris (France); ICM-Institut du Cerveau et de la Moelle epiniere, Paris (France); Groupe Hospitalier Pitie-Salpetriere, Department of Neurology, Institut de la Memoire et de la Maladie d' Alzheimer-IM2A, Paris Cedex 13 (France); Mutlu, Gurkan [Groupe Hospitalier Pitie-Salpetriere, Urgences Cerebro-Vasculaires, Universite Pierre et Marie Curie-Paris 6, Paris Cedex 13 (France); Hopital Saint-Louis, Inserm, Universite Paris 7-Denis Diderot, Paris (France); Pellot, Audrey [Groupe Hospitalier Pitie-Salpetriere, Department of Neuroradiology, AP-HP, Paris Cedex 13 (France); Collaboration: And the Alzheimer' s Disease Neuroimaging Initiative

    2012-12-15

    Hippocampus volumetry is a useful surrogate marker for the diagnosis of Alzheimer's disease (AD). Our purpose was to compare visual assessment of medial temporal lobe atrophy made by radiologists with automatic hippocampal volume and to compare their performances for the classification of AD, mild cognitive impairment (MCI) and cognitively normal (CN). We studied 30 CN, 30 MCI and 30 AD subjects. Six radiologists with two levels of expertise performed two readings of medial temporal lobe atrophy. Medial temporal lobe atrophy was evaluated on coronal three-dimensional T1-weighted images using Scheltens scale and compared with hippocampal volume obtained using a fully automatic segmentation method (Spearman's rank coefficient). Visual assessment of medial temporal lobe atrophy was correlated with hippocampal volume (p < 0.01). Classification performances between MCI converter and CN was better using volumetry than visual assessment of non-expert readers whereas classification of AD and CN did not differ between visual assessment and volumetry except for the first reading of one non-expert (p = 0.03). Visual assessment of medial temporal lobe atrophy by radiologists was well correlated with hippocampal volume. Radiological assessment is as good as computer-based volumetry for the classification of AD, MCI non-converter and CN and less good for the classification of MCI converter versus CN. Use of Scheltens scale for assessing hippocampal atrophy in AD seems thus justified in clinical routine. (orig.)

  1. Radiological imaging of lymph nodes for diagnostic evaluation and follow-up; Radiologische Bildgebung von Lymphknoten in Diagnostik und Verlaufskontrolle

    Energy Technology Data Exchange (ETDEWEB)

    Mende, U. [Abt. Klinische Radiologie und Poliklinik, Radiologische Universitaetsklinik Heidelberg (Germany)

    2002-06-01

    CT, MR imaging and sonography are the radiological modalities of choice complementing the conventional methods of anamnesis, clinical examination, laboratory findings, and cellular analysis in primary diagnostics, therapy monitoring, and follow-up of pathological lymph nodes. Final selection of methods will depend on the patients' individual conditions, physical constraints, local availability, and economic boundary conditions. Diagnostic criteria such as spreading patterns, morphology, structure, vascularisation and restriction should be evaluated in the light of case history and clinical findings, so as to permit selection of the most suitable methods for a 'functional imaging' that will answer the clinical queries. In no case, however, will even the most sophisticated imaging method make redundant the pathohistological diagnosis. (orig./CB) [German] Neben Anamnese, klinischer Untersuchung, Laborparametern und feingeweblicher Sicherung bilden die radiologischen Schnittbildverfahren Computertomographie, Magnetresonanztomographie und Sonographie einen Eckpfeiler in Primaerdiagnostik, Therapie-Monitoring und Verlaufskontrolle pathologischer Lymphknoten. Erkrankung des Patienten, physikalische Grenzen, logistische Verfuegbarkeit und oekonomische Erfordernisse bestimmen die Methodenauswahl. Die Kriterienn Ausbreitungsmuster, Morphologie, Struktur, Vaskularisation und Begrenzung sind nur unter Beruecksichtigung von Vorgeschichte und Klinik zu werten. Ziel ist ein 'functional imaging', welches die therapierelevanten Fragen des Klinikers beantwortet. Dennoch ist die Bildgebung, selbst durch Kombination komplementaerer Verfahren und subtile Auswertung, nicht in der Lage, die pathohistologische Diagnose zu ersetzen. (orig.)

  2. Observational evaluation of preoperative, intraoperative, and postoperative characteristics in 117 Brazilian women without uterine prolapse undergoing vaginal hysterectomy

    Directory of Open Access Journals (Sweden)

    Osako MT

    2012-09-01

    Full Text Available Claudio Sergio Batista,1 Takasi Osako,2 Eliana Mara Clemente,2 Fernanda Carvalhido Antonio Batista,3 Maurício Takeshi Janiques Osako41Department of Gynecology and Obstetrics of Faculty of Medicine of Petropolis, Petropolis, Rio de Janeiro, Brazil; 2Gynecology and Obstetrics, Casa Providencia Hospital, Petropolis, Rio de Janeiro, Brazil; 3School of Medicine of Technical Educational Foundation Souza Marques, Rio de Janeiro, Brazil; 4School of Medicine of University Gama Filho, Rio de Janeiro, BrazilBackground: Despite the introduction of minimally invasive approaches for various benign uterine problems, hysterectomy is often still performed abdominally, but the vaginal route should be used whenever possible. The aim of this study was to identify the preoperative, intraoperative, and postoperative characteristics of women undergoing vaginal hysterectomy in the absence of uterine prolapse.Methods: A prospective, descriptive, quantitative, noncomparative study was conducted in 117 women between August 2009 and February 2011 in Petropolis, Rio de Janeiro, Brazil. The women included had a uterine indication for hysterectomy, their surgeries were performed by the same team, and they were followed up for 12 months. An adapted Pelvic Organ Prolapse Quantification system was used to check for uterine prolapse.Results: The age range of the women was 33–59 years, uterine volume was 300–900 mL, and 73.50% has undergone prior cesarean section. The main indication for hysterectomy was uterine myoma (64.95%, with a surgery time of 30–60 minutes in 55 (59.82% and 19 (15.98% cases, respectively. Uterine volume reduction was performed in 41 (35.05% cases, salpingectomy was the most common associated surgery (81.19%, and anesthesia was subdural (68.37%. Common intraoperative complications included bladder lesions (8.54%, with conversion to the abdominal route being necessary in one case (1.28%, and the most common postoperative complication being vaginal

  3. Patologias do compartimento iliopsoas: avaliação radiológica Iliopsoas compartment lesions: a radiological evaluation

    Directory of Open Access Journals (Sweden)

    Alberto Ribeiro de Souza Leão

    2007-08-01

    account for almost all the lesions affecting the iliopsoas compartment. By means of a retrospective analysis of radiological studies in patients with iliopsoas compartment lesions whose diagnosis was confirmed by anatomopathological evaluation or clinical follow-up, we have reviewed its anatomy as well as the main forms of involvement, with the purpose of identifying radiological signs that may help to narrow down the potential differential diagnoses. As each lesion is approached we will discuss the main radiological findings such as presence of gas in pyogenic abscesses, bone destruction and other bone changes of vertebral bodies in lesions secondary to tuberculosis, involvement of fascial planes in cases of neoplasms, and differences in signal density and intensity of hematomas secondary to hemoglobin degradation, among others. So, we have tried to present cases depicting the most frequent lesions involving the iliopsoas compartment, with emphasis on those signs that can lead us to a more specific etiological diagnosis.

  4. Evaluation of Radiological Protection in Catheter Room%导管室放射防护评价

    Institute of Scientific and Technical Information of China (English)

    陶功福; 张枫

    2014-01-01

    目的:评价放射防护在导管室介入治疗中的应用价值。方法在导管室60例介入手术中应用各类防护措施,利用BH3103B便携式辐射仪检测X线辐射平均剂量率,分析防护措施的效果。结果铅玻璃防护屏有效防护率为95.2%,铅防护服防护效率为94.9%,床下铅橡胶帘防护效率为88.9%,上述防护器材前后辐射剂量率差异均具统计学意义(P<0.01)。距X线球管1~2 m处的射线衰减量为60.2%,距球管1~3 m处的射线衰减量为90.9%,1~2m和1~3m之间的X线剂量率差异具有统计学意义(P<0.01)。结论采用防护措施后可明显降低X射线对医护人员的危害。%Objective To evaluate the application value of radiological protection in interventional treatments conducted in catheter room. Methods The effects of various kinds of radiological protection measures used in 60 cases of interventional operations were analyzed with BH3103B portable radiation detector which was used to measure the average dose rate of X-ray. Results There were significant differences between the radiation dose rate which was measured in front of lead-glass protecting screen and the radiation dose rate which was measured behind of lead-glass protecting screen (P<0.01), whose effective protection rate was 95.2%. There were signiifcant differences between the radiation dose rate which was measured in front of lead protective clothing and the radiation dose rate which was measured behind of lead protective clothing (P<0.01), whose effective protection rate was 94.9%. There were signiifcant differences between the radiation dose rate which was measured in front of under-bed lead-rubber shield and the radiation dose rate which was measured behind of under-bed lead-rubber shield (P<0.01), whose effective protection rate was 88.9%. The attenuation rate of X-ray which was 1~2 m away from the tube was 60.2%while that of X-ray which was 1~3 m away from the tube was 90.9%. There were

  5. Avaliação por imagem nos candidatos ao implante coclear: correlação radiológico-cirúrgica Evaluation by imaging methods of cochlear implant candidates: radiological and surgical correlation

    Directory of Open Access Journals (Sweden)

    Luiz Rodolpho Pena Lima Júnior

    2008-06-01

    surgery between May 2003 and October 2006 were studied. The preoperative muldisciplinary selection process included CT associated or not with MRI. RESULTS: The final sample was composed of 100 patients after 4 patients with no records of radiological exams were excluded. Patients were divided into two groups. The accuracy of group A (CT only was 69.69%, the sensitivity was 36.36%, the specificity was 86.36%, the Positive Predictive Value (PPV was 57.14%, and the Negative Predictive Value (NPV was 73.07%; the accuracy of group B (CT and MRI was 80.59%, the sensitivity was 38.46%, the specificity was 90.74%, the PPV was 50.0%, and the NPV was 85.96%. CONCLUSION: The preoperative radiological evaluation by CI was effective in identifying anatomic abnormalities, allowing surgeons to avoid, or at least be aware of, possible complications. This study demonstrated that CT and MRI were superior to CT alone.

  6. Evaluation of volume and solitary bone cyst remodeling using conventional radiological examination

    Energy Technology Data Exchange (ETDEWEB)

    Glowacki, Maciej; Melzer, Piotr [Karol Marcinkowski University of Medical Sciences, Department of Paediatric Orthopaedics, Poznan (Poland); Ignys-O' Byrne, Anna [J. Strus City Hospital, Department of Radiology, Poznan (Poland); Ignys, Iwona [Karol Marcinkowski University of Medical Sciences, Department of Paediatric Gastroenterology and Metabolic Diseases, Poznan (Poland); Mankowski, Przemyslaw [Karol Marcinkowski University of Medical Sciences, Department of Paediatric Surgery, Traumatology and Urology, Poznan (Poland)

    2010-03-15

    To evaluate cyst remodeling, including complete healing and recurrence, and its relation to the cyst volume in two groups of patients, using curettage and bone grafting or methylprednisolone injection. A retrospective analysis was carried out on data from 132 patients with solitary bone cyst, where 79 (59.9%) had undergone curettage and bone grafting and 53 (40.1%) had been administered methylprednisolone injection, with a mean time to follow up of 12 years. The cyst volume was evaluated from conventional radiographs and the method originally reported by Goebel et al. to evaluate the volume of Ewing's sarcoma. The results were analyzed using the criteria of Neer et al. and Capanna et al. The mean cyst volume was 36.8 cm{sup 3}. Recurrence was noted in 16 (20.2%) patients treated with curettage and in nine (17.0%) treated with methylprednisolone. Cyst volume in patients treated with curettage and bone grafting ranged from 8.3 cm{sup 3} to 100.0 cm{sup 3} and with methylprednisolone from 14.0 cm{sup 3} to 50.6 cm{sup 3}. In neither group was the cyst volume related to recurrence. Volumes from 1.3 cm{sup 3} to 81.9 cm{sup 3} were stated for patients treated with curettage and bone grafting, when complete healing was observed; they were significantly lower than for those of the total group of patients who underwent curettage and bone grafting. 1. An association between solitary cyst volume and recurrence in patients treated with either bone curettage and grafting or methylprednisolone was not found. 2. The frequency of complete healing in patients treated with bone curettage and grafting decreased with an increase in the cyst volume. (orig.)

  7. EVALUATION OF RADIOLOGICAL SIGNIFICANCE OF RARE-EARTH METALS WITH NATURAL RADIOACTIVE ISOTOPES

    Directory of Open Access Journals (Sweden)

    E. P. Lisachenko

    2013-01-01

    Full Text Available Among the rare-earth metals with natural radioactive isotopes, lantan, lutetium and samarium are allocated a relatively high specific activity. The formation of the additional external radiation keep it close to the significance of the materials to the radiation categories of materials with a high content of natural radionuclides of uranium and thorium family, lanthanum value is much less. Samarium, with acceptable toxicology content in the working area, forms the internal exposure to the limits for professionals. The use of these elements in science and industry requires the radiation-hygienic evaluation.

  8. Evaluation of internal contamination levels after a radiological dispersal device incident using portal monitors.

    Science.gov (United States)

    Palmer, R C; Hertel, N E; Ansari, A; Manger, R P; Freibert, E J

    2012-08-01

    Following a radioactive dispersal device (RDD) incident, it may be necessary to evaluate the internal contamination levels of a large number of potentially affected individuals to determine if immediate medical follow-up is necessary. Since the current laboratory capacity to screen for internal contamination is limited, rapid field screening methods can be useful in prioritising individuals. This study evaluated the suitability of a radiation portal monitor for such screening. A model of the portal monitor was created for use with models of six anthropomorphic phantoms in Monte Carlo N-Particle Transport Code Version 5 (MCNP) X-5 Monte Carlo Team (MCNP-A General Monte Carlo N-Particle Transport Code Version 5. LA-CP-03-0245. Vol. 2. Los Alamos National Laboratory, 2004.). The count rates of the portal monitor were simulated for inhalation and ingestion of likely radionuclides from an RDD for each of the phantoms. The time-dependant organ concentrations of the radionuclides were determined using Dose and Risk Calculation Software Eckerman, Leggett, Cristy, Nelson, Ryman, Sjoreen and Ward (Dose and Risk Calculation Software Ver. 8.4. ORNL/TM-2001/190. Oak Ridge National Laboratory, 2006.). Portal monitor count rates corresponding to a committed effective dose E(50) of 10 mSv are reported.

  9. Preoperative ultrasonographic evaluation of the contralateral patent processus vaginalis at the level of the internal inguinal ring is useful for predicting contralateral inguinal hernias in children: a prospective analysis.

    Science.gov (United States)

    Kaneda, H; Furuya, T; Sugito, K; Goto, S; Kawashima, H; Inoue, M; Hosoda, T; Masuko, T; Ohashi, K; Ikeda, T; Koshinaga, T; Hoshino, M; Goto, H

    2015-08-01

    The current study aimed to verify the usefulness of preoperative ultrasonographic evaluation of contralateral patent processus vaginalis (PPV) at the level of the internal inguinal ring. This was a prospective study of patients undergoing unilateral inguinal hernia repair at two institutions during 2010-2011. The sex, age at initial operation, birth weight, initial operation side, and the preoperative diameter of the contralateral PPV as determined using ultrasonography (US) were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of the preoperative major diameter of the contralateral PPV. The follow-up period was 36 months. All 105 patients who underwent unilateral hernia repair completed 36 months of follow-up, during which 11 patients (10.5 %) developed a contralateral hernia. The following covariates were not associated with contralateral hernia development: sex (p = 0.350), age (p = 0.185), birth weight (p = 0.939), and initial operation side (p = 0.350). The preoperative major diameter of the contralateral PPV determined using US was significantly wider among patients with a contralateral hernia than those without a contralateral hernia (p = 0.001). When the 105 patients were divided into two groups according to cut-off values of the preoperative major diameter of the contralateral PPV (wide group, >2.0 mm; narrow group, ≤2.0 mm), a significant association was observed between the preoperative major diameter of the contralateral PPV and patient outcomes (p = 0.001). We used US and confirmed the usefulness of a preoperative evaluation of the major diameter of the contralateral PPV at the level of the internal inguinal ring in pediatric patients with unilateral inguinal hernias.

  10. Preoperative evaluation of pulmonary artery morphology and pulmonary circulation in neonates with pulmonary atresia - usefulness of MR angiography in clinical routine

    Directory of Open Access Journals (Sweden)

    Kawel Nadine

    2010-09-01

    Full Text Available Abstract Background To explore the role of contrast-enhanced magnetic resonance angiography (CE-MRA in clinical routine for evaluating neonates with pulmonary atresia (PA and to describe their pulmonary artery morphology and blood supply. CE-MRA studies of 15 neonates with PA (12 female; median weight: 2900 g were retrospectively evaluated by two radiologists in consensus. Each study was judged to be either diagnostic or non-diagnostic depending on the potential to evaluate pulmonary artery morphology and pulmonary blood supply. In those cases where surgery or conventional angiocardiography was performed results were compared. Results CE-MRA was considered diagnostic in 87%. Pulmonary artery morphology was classified as "confluent with (n = 1 and without (n = 1 main pulmonary artery", "non-confluent" (n = 6 or "absent" (n = 7. Source of pulmonary blood supply was "a persistent arterial duct" (n = 12, "a direct" (n = 22 or "indirect (n = 9 aortopulmonary collateral artery (APCA" or "an APCA from the ascending aorta" (n = 2. In no patient were there any additional findings at surgery or conventional angiocardiography which would have changed the therapeutic or surgical approach. Conclusions CE-MRA is a useful diagnostic tool for the preoperative evaluation of the morphology of pulmonary arteries and blood supply in neonates with PA. In most cases diagnostic cardiac catheterization can be avoided.

  11. [A quality evaluation in requests for thoracic radiology in chronic pathology at a health center].

    Science.gov (United States)

    Cabedo García, V R; Cantos Escudero, R; Corbella y Jané, A; Saturno, P J

    1994-02-15

    To improve the quality of thoracic x-ray requests during chronic illness, presenting criteria for indication in HTA, LCFA and TBC. Intervention study of quality improvement. Can Misses Health Centre in Ibiza. The General Practitioners at the above centre. In this study we proposed to evaluate the work of the doctors at our Health Centre in correctly requesting x-ray explorations on the basis of two explicit, standard criteria: 1) the reason for the thorax x-ray request must be stated in the clinical notes. 2) Thorax x-rays requested for LCFA, HTA and TBC must be correctly indicated. The use of structured criteria in thorax x-ray requests for chronic patients appears to lead to greater quality in requests for this complementary exploration.

  12. Preoperative magnetic resonance imaging evaluation of semitendinosus tendon in anterior cruciate ligament reconstruction: Does this have an effect on graft choice?

    Science.gov (United States)

    Cobanoglu, Mutlu; Ozgezmez, Ferit Tufan; Omurlu, Imran Kurt; Ozkan, Ilhan; Savk, Sevki Oner; Cullu, Emre

    2016-01-01

    Background: Anterior cruciate ligament (ACL) reconstruction with ST autograft is sometimes unsuccessful because of harvested thin graft. Magnetic resonance imaging (MRI) can be a useful tool to evaluate the thickness of the graft. This study is performed to evaluate whether there is any correlation between diameters and cross-sectional area (CSA) of the semitendinosus tendon (ST) on the preoperative magnetic MRI and the diameter of the 4-stranded ST autograft in ACL reconstruction. Materials and Methods: Seventy patients who underwent single-bundle ACL reconstruction with 4-stranded ST for full-thickness ACL ruptures were included in this study. Anteroposterior (AP) and mediolateral (ML) diameters of ST at the levels of the joint line (JL) and femoral physeal line (PL), and also CSA at these levels were measured on T2-weighted fat-suppressed MRI examinations. The data obtained were compared with intraoperatively measured diameters of 4-stranded ST autograft. Correlations between variables were evaluated using Spearman's rho. Receiver operating characteristic and area under the curve statistics were used to evaluate the cut-off value for the correlation between 4-stranded ST graft diameter of 8 mm and CSA (mm2) on MRI. Results: On MRI measurements, no correlation was found between AP diameters at the level of the JL and 4-stranded ST diameter (P = 0.180). However, correlations were found between diameter of 4-stranded ST and ML diameter at the level of JL (P = 0.003) and PL (P = 0.002), AP diameter at the level of the PL (P = 0.009), CSA at the level of the JL (P < 0.001) and at the level of PL (P < 0.001). Correlation between the diameter of 4-stranded ST and CSA at both levels was more significant than that between AP-ML diameters of ST and diameter of autograft. The cut-off value for the 8 mm diameter CSA of 4-stranded ST was 5.9 mm2 at the JL and 8.99 mm2 at the PL. Conclusion: Preoperative MRI evaluation of CSA at the JL of the ST is a reliable parameter to

  13. Comparative assessment of diagnostic value of electrodiagnostic methods and radiologic evaluations in patients with clinical signs of cervical radiculopathy

    Directory of Open Access Journals (Sweden)

    S.A. Moosavi

    2006-01-01

    Full Text Available Background and purpose: Cervical radiculopathy is one of the most common diseases that must be diagnosed early and properly to prevent its serious side effects. For this purpose different paraclinical methods such as MRI, X-ray, EMG, NCV and SSEP are used. Each of these methods has its limitations and some of them are expensive or invassive. The aim of this study was to compare the electrodiagnostic and radiologic methods in diagnosis of cervical radiculopathy.Materials and Methods: In this study 36 patients (22 Female, l4 Male with complaint of cervical pain radiated to upper limbs were evaluated. The evaluation included EMG, NCV, MRI, X-ray and SSEP. Exclusion criteria were fracture dislocation and infection of bone joints or soft tissues .MRI and X-ray were performed in MRI centers of Isfahan, Sepahan and Alzahra hospital in Isfahan city. MRI was graded on severity of 1 to 3. EMG, NCV and SSEP were performed in electrodiagnostic center of Alzahra hospital by one professional technician. Results were compared with text books and analyzed by SPSS software.Results: Sensitivity of SSEP was 28.6% and specifity was 100%. Partial agreement between SSEP and MRI existed in moderate and severe cervical involvements (P = 0.005. Frequencies of abnormalities were: EMG 50%, NCV 5.6%, X-ray 33.3% and MRI 77.8%.Conclusion: This study shows that SSEP has lower value than EMG in diagnosis of cervical radiculopathy. Also in a patient with cervical radiculopathy, cervical MRI and EMG of upper limbs are necessary. SSEP abnormalities in the presence of moderate and severe MRI changes such as myelopathy, are more valuable. Therefore, SSEP in cervical radiculopathy is recommended before surgery.

  14. A STUDY OF COMPARATIVE EVALUATION OF PREOPERATIVE SKIN PREPARATION WITH CHLORHEXIDINE-ALCOHOL VERSUS POVIDONE-IODINE IN PREVENTION OF SURGICAL SITE INFECTIONS

    Directory of Open Access Journals (Sweden)

    Geetha Danasekaran

    2017-05-01

    Full Text Available BACKGROUND Surgical site infections is a dangerous condition posing a heavy burden on the patient and social health system. The use of preoperative skin preparation by effective antiseptic plays an important role in reducing postoperative wound infections. Hence, the present study was undertaken to compare and evaluate the efficacy of 2% chlorhexidine-alcohol versus 5% povidone-iodine in abdominal surgeries for prevention of SSI. MATERIALS AND METHODS The present one year randomised controlled trial was conducted in the Department of General Surgery, Government Rajaji Hospital, Madurai, over a period from 2014 to 2015 on 120 patients undergoing elective abdominal surgeries. The patients were divided into two groups by computer randomisation that is Group A (chlorhexidine-alcohol group and Group B (povidone-iodine group. The surgical wounds were examined for any infections present. RESULTS Most of the patients were males in both the groups (73.33% and 61.67% in group A and B, respectively. Half of the patients (50% in both the groups had chronic appendicitis. The mean duration of surgery in group A was 44.66 ± 5.86 minutes, and in group B, it was 45.00 ± 6.24 minutes. Staphylococcus aureus (1.67% in group A and 10% in group B was the most common organism isolated after skin preparation. After the application of antiseptic agents, there was reduction of bacterial colonisation in both the groups, but significant reduction was seen in chlorhexidine group. In group A, two patients had superficial SSIs compared to 14 patients in group B (p=0.001. The mean length of hospital stay in group A was significantly less (7.20 ± 1.10 vs. 8.67 ± 3.17. CONCLUSION Preoperative skin cleansing with chlorhexidine significantly reduces risk of postoperative SSIs and colonisation of bacteria in clean abdominal surgeries.

  15. Eletrocardiografia pré-operatória em 474 cães Pre-operative electrocardiography evaluation in 474 dogs

    Directory of Open Access Journals (Sweden)

    C.F. Carvalho

    2009-06-01

    Full Text Available Foram realizadas avaliações eletrocardiográficas pré-operatórias em 474 cães, machos e fêmeas, com o objetivo de analisar a frequência de alterações eletrocardiográficas e sua relação com indicação cirúrgica, sexo, idade, raça, peso, escore corporal (obesidade, histórico e sinais físicos de doenças cardíacas. As alterações eletrocardiográficas foram observadas em 220 animais (46%, sendo mais frequentes nos machos (n=116; 52,7%. O aumento na duração do QRS foi a alteração mais observada (n=54; 24,5%. Sugere-se o exame eletrocardiográfico de rotina na avaliação pré-cirúrgica, independentemente de idade, peso, histórico ou sinais físicos de cardiopatia.Pre-operative electrocardiographic evaluations were done in 474 male and female dogs to analyze the frequency of electrocardiographic alterations and its relation with the surgical indication according to age, breed, weight, body score (obesity, and history and physical signs of cardiac diseases. The electrocardiographic alterations occurred in 220 (46% animals, being more frequent in males (n=116; 52.7%. The increase in QRS duration was the most observed alteration (n=54; 24.5%. The electrocardiographic alterations in the pre-operative are common, which suggests that the performing of electrocardiographic exam in the pre-operative is independent of the age, weight, surgical problem, or signs of cardiopathy on clinical exam.

  16. Transient ischemic attacks: electrophysiological (conventional and topographic EEG) and radiological (CCT) evaluation.

    Science.gov (United States)

    Madkour, O; Elwan, O; Hamdy, H; Elwan, H; Abbas, A; Taher, M; Abdel-Kader, A

    1993-10-01

    The value of electrophysiological tests: conventional electroencephalography (EEG), topographic EEG analysis as well as computerized tomography (CT) in the diagnosis and evaluation of 25 patients with manifestations of transient ischemic attacks (TIA) in the domain of the carotid system was assessed. Normal CT was the rule in TIA patients except in 8% of the cases, where nonspecific changes of brain atrophy were described. Conventional EEG, topographic EEG and spectral analysis could detect abnormalities in 48%, 80% and 64% of TIA cases respectively. None of the abnormal EEG records could be missed by topographic EEG analysis. 32% of the records were diagnosed as abnormal by topographic EEG, while conventional EEG failed to detect abnormalities. Spectral analysis of the EEG results revealed a significant decrease regarding mean high limit alpha percent power, and a significant increase regarding mean low and high limit theta percent power, as well as a significant increase of the mean high limit of the slow activities (delta + theta)/fast activities (alpha + beta) percent power ratio in the TIA group as compared to the normal control group.

  17. Radiologic evaluation of adenoids and tonsils in children with obstructive sleep apnea: Plain films and fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kreplick Fernbach, S.; Brouillette, T.; Riggs, T.W.; Hunt, C.E.

    1983-07-01

    Twenty-six children with obstructive sleep apnea were evaluated by lateral neck radiographs during wakefulness, and by polygraphic monitoring and upper airway fluoreoscopy during natural sleep. Children with craniofacial abnormalities, palatal surgery, and central nervous system disease were excluded from the study. Moderate or marked enlargement of tonsils and adenoids was noted on lateral neck radiographs of 18 of 26 patients. An objective measure of adenoidal enlargement, the adenoidal-nasopharyngeal ratio, correlated well with subjective judgment of adenoidal size but was not generally more useful than subjective estimation. Upper airway fluroescopy demonstrated the site and mechanism of obstruction in all patients. Because all children with moderate to marked adenotonsillar enlargement demonstrated obstruction at the adenoidal or tonsillar level on fluoroscopy, we now screen children with suspected sleep apnea with lateral airway radiographs and polysomnography. Fluoroscopy is reserved for children with mild adenotosillar enlargement, craniofacial dysplasia, prior cleft palate repair, or neuromuscular disorders. These results suggest that the pathogenesis of obstuctive sleep apnea in children involve anatomic factors which narrow the upper airway, sleep-related hypotonia of pharyngeal dilator musculature, and compensatory mechanisms to prevent or alleviate asphyxia.

  18. Radiological and histopathological evaluation of experimentally-induced periapical lesion in rats

    Directory of Open Access Journals (Sweden)

    Renata Cordeiro Teixeira

    2011-10-01

    Full Text Available OBJECTIVE: This study evaluated experimentally-induced periapical bone loss sites using digital radiographic and histopathologic parameters. MATERIAL AND METHODS: Twenty-seven Wistar rats were submitted to coronal opening of their mandibular right first molars. They were radiographed at 2, 15 and 30 days after the operative procedure by two digital radiographic storage phosphor plates (Digora®. The images were analyzed by creating a region of interest at the periapical region of each tooth (ImageJ and registering the corresponding pixel values. After the sacrifice, the specimens were submitted to microscopic analysis in order to confirm the pulpal and periapical status of the tooth. RESULTS: There was significant statistically difference between the control and test sides in all the experimental periods regarding the pixel values (two-way ANOVA; p<0.05. CONCLUSIONS: The microscopic analysis proved that a periapical disease development occurred during the experimental periods with an evolution from pulpal necrosis to periapical bone resorption.

  19. Evaluation Of The Radiological Situation In Algeria After The Algeciras Incident

    Directory of Open Access Journals (Sweden)

    A. NOUREDDINE

    2012-12-01

    Full Text Available The present study has been carried out in the framework of our environmental monitoring programme and immediately after being informed by the IAEA of possible accidental releases of 137 Cs into the air, which might have been released between May 25 th and the first of June 1998 from the Acerinox factory in Algeciras (Spain. Algericas is the region where a steel-processing factory has been set up. During the work procedure, a radioactive source of 137 Cs passed through the furnace resulting in accidental releases into the atmosphere. This radioactive contamination was detected in France, Switzerland, Italy and Germany, and some radioactivity measurements were carried out by the Commissariat A l'Energie Atomique to evaluate the gamma radiation status in areas selected in Algeria. The approach adopted in our case was to start in situ gamma-radiation measurements and to collect air and soil samples as well from a selected area in Algiers. Afterwards, and in order to have more reliable results, a sampling program was carried out in July 1998, in the frame of which some sampling stations were established in the west of Algeria, based upon Algerian meteorological data during the period of incident. A total number of 16 environmental samples from 9 stations, namely, soil, sediment, vegetation and seawater were collected, followed by in situ gamma radiation measurements in each sampling location. Soil, sediment and vegetation samples were analysed by direct gamma spectrometry, whereas, sea water samples were analysed radiochemically using microcrystalline AMP for coprecipitation and gamma counted. Taking into consideration the background levels of radioactivity in the studied areas, obtained by our previous monitoring programs, the results obtained do not show any increase of 137 Cs resulting from the incinerated Caesium source in the Acerinox steel factory in Algeciras, Spain. The conclusion drawn by this work is that the investigated area was not

  20. Evaluation Of The Radiological Situation In Algeria After The Algeciras Incident

    Directory of Open Access Journals (Sweden)

    A. NOUREDDINE

    2003-12-01

    Full Text Available The present study has been carried out in the framework of our environmental monitoring programme and immediately after being informed by the IAEA of possible accidental releases of 137 Cs into the air, which might have been released between May 25 th and the first of June 1998 from the Acerinox factory in Algeciras (Spain. Algericas is the region where a steel-processing factory has been set up. During the work procedure, a radioactive source of 137 Cs passed through the furnace resulting in accidental releases into the atmosphere. This radioactive contamination was detected in France, Switzerland, Italy and Germany, and some radioactivity measurements were carried out by the Commissariat A l'Energie Atomique to evaluate the gamma radiation status in areas selected in Algeria. The approach adopted in our case was to start in situ gamma-radiation measurements and to collect air and soil samples as well from a selected area in Algiers. Afterwards, and in order to have more reliable results, a sampling program was carried out in July 1998, in the frame of which some sampling stations were established in the west of Algeria, based upon Algerian meteorological data during the period of incident. A total number of 16 environmental samples from 9 stations, namely, soil, sediment, vegetation and seawater were collected, followed by in situ gamma radiation measurements in each sampling location. Soil, sediment and vegetation samples were analysed by direct gamma spectrometry, whereas, sea water samples were analysed radiochemically using microcrystalline AMP for coprecipitation and gamma counted. Taking into consideration the background levels of radioactivity in the studied areas, obtained by our previous monitoring programs, the results obtained do not show any increase of 137 Cs resulting from the incinerated Caesium source in the Acerinox steel factory in Algeciras, Spain. The conclusion drawn by this work is that the investigated area was not

  1. Preoperative evaluation of colorectal liver metastases: comparison between gadoxetic acid-enhanced 3.0-T MRI and contrast-enhanced MDCT with histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Scharitzer, M.; Ba-Ssalamah, A.; Ringl, H.; Koelblinger, C.; Weber, M. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Gruenberger, T. [Medical University of Vienna, Department of Surgery, Vienna (Austria); Schima, W. [Department of Radiology, KH Goettlicher Heiland, KH der Barmherzigen Schwestern and St Josef-Krankenhaus, Vienna (Austria)

    2013-08-15

    The aim of this prospective study was to compare the diagnostic performance of 64-row MDCT and gadoxetic-acid-enhanced MRI at 3.0 T in patients with colorectal liver metastases in correlation with histopathological findings. Lesions detected at MDCT and MRI were interpreted by three blinded readers and compared with histopathological workup as the term of reference. Two subgroups of lesions were additionally evaluated: (1) metastases smaller than 10 mm and (2) lesions in patients with and without steatosis of the liver, assessed histopathologically. Surgery and histopathological workup revealed 81 colorectal liver metastases in 35 patients and diffuse metastatic involvement in 3 patients. In a lesion-by-lesion analysis, significant sensitivity differences could only be found for reader 1 (P = 0.035) and reader 3 (P = 0.003). For segment-based evaluation, MRI was more sensitive only for reader 3 (P = 0.012). The number of false-positive results ranged from 3 to 12 for MDCT and 8 to 11 for MRI evaluation. In the group of small lesions, the sensitivity differed significantly between both methods (P = 0.003). In patients with hepatic steatosis, MRI showed a trend toward better performance than MDCT, but without statistical performance. The 3.0-T MRI with liver-specific contrast agents is the preferred investigation in the preoperative setting, especially for the assessment of small colorectal liver metastases. (orig.)

  2. Hand-held echocardiography in the setting of pre-operative cardiac evaluation of patients undergoing non-cardiac surgery: results from a randomized pilot study.

    Science.gov (United States)

    Cavallari, Ilaria; Mega, Simona; Goffredo, Costanza; Patti, Giuseppe; Chello, Massimo; Di Sciascio, Germano

    2015-06-01

    Transthoracic echocardiography is not a routine test in the pre-operative cardiac evaluation of patients undergoing non-cardiac surgery but may be considered in those with known heart failure and valvular heart disease or complaining cardiac symptoms. In this setting, hand-held echocardiography (HHE) could find a potential application as an alternative to standard echocardiography in selected patients; however, its utility in this context has not been investigated. The aim of this pilot study was to evaluate the conclusiveness of HHE compared to standard echocardiography in this subset of patients. 100 patients scheduled for non-cardiac surgery were randomized to receive a standard exam with a Philips Ie33 or a bedside evaluation with a pocket-size imaging device (Opti-Go, Philips Medical System). The primary endpoint was the percentage of satisfactory diagnosis at the end of the examination referred as conclusiveness. Secondary endpoints were the mean duration time and the mean waiting time to perform the exams. No significant difference in terms of conclusiveness between HHE and standard echo was found (86 vs 96%; P = 0.08). Mean duration time of the examinations was 6.1 ± 1.2 min with HHE and 13.1 ± 2.6 min with standard echocardiography (P cardiac surgery, since it provided similar information but it was faster and earlier performed compared to standard echocardiography.

  3. Evaluation of the radiological risks associated with the routine transport of radioactive material within Michigan

    Science.gov (United States)

    Steinman, Rebecca Lee

    Radioactive materials play an important role in modern society. In addition to providing electrical power and supporting national defense, radioisotopes play significant roles in the fields of medicine, research, manufacturing, and industry. Since most of these materials are not manufactured or disposed of at the site where they are used, they must be transported between various processing, use, storage, and disposal facilities. This dissertation examines the mathematical model used to predict the collective dose to the population that resides along a potential transport route, commonly called the off-link dose. The currently accepted RADTRAN and RISKIND transient dose models are reviewed. Then three new individual transient dose models are derived by assuming that a point, line, or surface cylinder can approximate the actual transport package. Groundscatter effects were investigated using a Monte Carlo simulation of the surface cylinder model and found to contribute no more than 12% to the total individual dose from a passing shipment of radioactive material, thus not warranting explicit inclusion in the newly derived transient dose models. All five of the individual transient dose models were evaluated for representative shipments of spent nuclear fuel and low-level waste within the State of Michigan and compared to experimentally measured doses. The individual dose for the Michigan shipment scenarios was found to be on the order of 1 murem. Comparison to the experimental measurements revealed that RISKIND consistently predicts the best estimate of the measured dose, followed closely by the surface cylinder model. RADTRAN consistently over predicted the measured dose by at least a factor of two. Finally, the line dose model is integrated over strips of uniform population along the transport route to arrive at the collective off-link population dose. This off-link dose model was incorporated into an ArcView application using the Avenue scripting language. Then

  4. CLINICAL AND RADIOLOGICAL EVALUATION OF NEW - ONSET EPILETIC SEIZURES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Chalapathi Rao

    2015-09-01

    Full Text Available BACKGROUND: Epilepsy is one of the most familiar neurological disorders which can cause bodily injury and death from inadequately treated or untreated cases. The imaging and EEG of new onset seizures is done with different indications, to identify an acute illness as the underline course for the seizure and possible neurological deficit. To this purpose we have evaluated new onset seizures in adult patients in correlation with their clinical profile, Electroencephalography (EEG and Computerized tomography (CT imaging of brain. METHODS: This cro ss sectional study was studied in 100 adult patients, presenting with seizures attending the Emergency department, General Medicine and Neurology wards and OPD of Tertiary care teaching hospital during the period of March 2006 to March 2008. All the patien ts were examined clinically and subjected to CT imaging of brain and EEG. Other necessary blood investigations were also done. Correlation between various seizures and CT scan brain and EEG were studied. Descriptive statistics were used to analyze the data . RESULTS: 63% of patients were in the age group of 20 - 39 years, 63% were males and 37% were females. 65% presented with GTCS, 35% with partial seizures. CT scan was found abnormal in 49.2% patients in GTCS, 71.4% in partial seizures. EEG showed abnormal p attern in 39% patients. 40% of the patients with partial seizures had epileptic form discharges. 33% patients had focal lesions on CT brain with normal EEG. CONCLUSION: Generalized Tonic clonic seizures were the commonest type of seizures was present, seen mostly in male patients. CT scan brain was abnormal in 57% of the patients. Neurocysticercosis and calcified granuloma were the commonest causes for seizures up to 3 rd decade of life. Majority of the patients with focal lesions on CT scan brain had epileptic form discharges on EEG which indicate a strong correlation of EEG with CT findings. Initiating the treatment with antiepileptic drugs was

  5. CLINICAL EVALUATION OF PREOPERATIVE SKIN PREPARATION WITH AQUEOUS POVIDONE IODINE ONLY AND IN COMBINATION WITH ALCHOLIC CHLORHEXIDINE IN PATIENTS UNDERGOING ELECTIVE AND EMERGENCY SURGERIES

    Directory of Open Access Journals (Sweden)

    Latchu

    2015-10-01

    Full Text Available INTRODUCTION: Many techniques are there for skin preparation before surgery, the commonest being initial scrub with antiseptic soap solution, followed by painting the prepared area with antiseptic paint solution. But degerming of the skin can be done with antiseptics us ed for less than one minute which is as effective as five minute scrub with germicidal soap solution followed by painting with antiseptics . AIMS AND OBJECTIVES : 1. To evaluate the efficacy of povidone iodine alone and antiseptic agent containing alcoholic chlorhexidine with povidone iodine in preoperative skin preparation by taking swab culture. 2. To compare the rate of postoperative wound infection in both the groups . METHODS: STUDY DESIGN: Comparative study conducted on 100 patients in two groups. STUDY SETTING: Sri Venkateswara Medical College Tirupathi SOURCE OF DATA: 100 Patients (50 in each Group undergoing elective and emergency surgery admitted in the Department of General Surgery in S.V.R.R. Government General Hospital, Tirupati from 2013 to 2014. INCLUSION CRITERIA: 1. Patients undergoing elective & emergency surgery in department of general surgery. 2. Patients with no focus of infection anywhere on the body. 3. Patients irrespective of their age and sex. 4. Patients neither immunocompromised nor on any long term steroids. 5. Patients undergoing mes h repair of hernia are also included. EXCLUSION CRITERIA: 1. Immuno compromised patients and patients on long term steroids. 2. Patients with septicemia. 3. Patients suffering from malignancies or undergoing chemotherapy or radiation therapy. 4. Contaminat ed surgeries in which viscus was opened were excluded from the study. 5. Patients with co - morbid medical conditions like diabetes, hypertension etc. METHOD OF COLLECTION OF DATA: In each case preoperatively, detailed history was taken and routine investiga tions like haemoglobin, total count, differential count, ESR, RBS and chest X - ray, ultrasound were done to

  6. Evaluation of the Internet precence of diagnostic radiology units at German universities; Evaluation der Internetpraesenzen diagnostisch-radiologischer Institute deutscher Universitaetskliniken

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, J.; Siegmund, M.; Voelk, M.; Feuerbach, S.; Strotzer, M. [Institut fuer Roentgendiagnostik, Klinikum der Universitaet Regensburg (Germany)

    2002-09-01

    Purpose. Analyzing the availability and the contents of the internet homepages of the radiological departments of German universities.Material and method. In June and July 2001 the internet homepages of 36 radiological departments of German universities were evaluated in a study. A medical student experienced in using the world wide web examined the websites concerning the following criteria: research, teaching, informations for patients, clinical topics and general information. Additionally an evaluation of the technical standard of the presentation was performed.Results. 31 of the 36 radiological departments presented a homepage in the world wide web. The subject research was presented by 29 institutes. Also 29 departments provided information concerning teaching in their presentations. In 24 cases informations especially for patients were given. In all topics there is a huge variety of the quality and quantity of the provided information throughout the different institutions. 21 homepages available without restriction during the study period; 3 were nearly completely under construction. Multimedia techniques were only used in 2 homepages. The structural hierarchy of the webpages was in the average only two or three levels. Only 6 providers presented an additional version of their homepage in english.Conclusion. In the moment the possibility of internet-presentation is sub-optimal used by the responsible persons of the radiological institutions. The main emphasis is on research and teaching. There is nearly no use of multimedial elements in the presentations. Only a minority of the homepages can be read by international viewers because of the lack of an english version of the pages. (orig.) [German] Fragestellung. Analyse der Internetpraesenz und des Internetangebots der radiologisch-diagnostischen Abteilungen deutscher Universitaetskliniken.Methodik. Im Juni und Juli 2001 wurde in dieser Studie das Angebot von 36 deutschen radiologischen Fakultaeten durch einen

  7. Current evaluation of the information about Radiological Protection in Internet; Evaluacion actual de la informacion sobre proteccion radiologica en Internet

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz-Cruces, R.; Marco, M.; Villanueva, I.

    2003-07-01

    To analyze the current situation about the pedagogic information on radiological protection training which could be found in Internet. More than 756 web-pages have been visited in Internet about Radiological Protection in the nuclear and medical fields, providing information mainly focusing on information to the members of the public. In this search were used internet Searching Appliance (as Copernicus, Google and Scirus), using key words related with this subject (as Radiological Protection and Health Safety), getting the internet address of organizations, societies and investigation groups. Only a low percentage (less than 5 per cent) of these addresses content information on Radiological Protection for the members of the public, including information about the regulator Organizations, and which are the objectives for protection of the members of the public against ionization radiation (from the point of view of the use of the ionization radiation in the medical and nuclear field). This work attempts to propose the use of internet as a tool for informing the members of the public in matter of radiological protection, as first link in the chain of the training and education. (Author)

  8. Comparison of toxicological and radiological aspects of K basins sludge

    Energy Technology Data Exchange (ETDEWEB)

    RITTMANN, P.D.

    1999-10-27

    The composition of various K Basins sludge is evaluated for its toxicological and radiological impacts downwind from accidents. It is shown that the radiological risk evaluation guidelines are always more limiting than the toxicological risk evaluation guidelines.

  9. Evaluating factors affecting the permeability of emulsions used to stabilize radioactive contamination from a radiological dispersal device.

    Science.gov (United States)

    Fox, Garey A; Medina, Victor F

    2005-05-15

    Present strategies for alleviating radioactive contamination from a radiological dispersal device (RDD) or dirty bomb involve either demolishing and removing radioactive surfaces or abandoning portions of the area near the release point. In both cases, it is imperative to eliminate or reduce migration of the radioisotopes until the cleanup is complete or until the radiation has decayed back to acceptable levels. This research investigated an alternative strategy of using emulsions to stabilize radioactive particulate contamination. Emergency response personnel would coat surfaces with emulsions consisting of asphalt or tall oil pitch to prevent migration of contamination. The site can then be evaluated and cleaned up as needed. In order for this approach to be effective, the treatment must eliminate migration of the radioactive agents in the terror device. Water application is an environmental condition that could promote migration into the external environment. This research investigated the potential for water, and correspondingly contaminant, migration through two emulsions consisting of Topein, a resinous byproduct during paper manufacture. Topein C is an asphaltic-based emulsion and Topein S is a tall oil pitch, nonionic emulsion. Experiments included water adsorption/ mobilization studies, filtration tests, and image analysis of photomicrographs from an environmental scanning electron microscope (ESEM) and a stereomicroscope. Both emulsions were effective at reducing water migration. Conductivity estimates were on the order of 10(-80) cm s(-1) for Topein C and 10(-7) cm s(-1) for Topein S. Water mobility depended on emulsion flocculation and coalescence time. Photomicrographs indicate that Topein S consisted of greater and more interconnected porosity. Dilute foams of isolated spherical gas cells formed when emulsions were applied to basic surfaces. Gas cells rose to the surface and ruptured, leaving void spaces that penetrated throughout the emulsion. These

  10. Functional and radiological evaluation of acute acromioclavicular dislocation treated with anchors without eyelet: comparison with other techniques

    Directory of Open Access Journals (Sweden)

    Alexandre Tadeu do Nascimento

    Full Text Available ABSTRACT OBJECTIVE: To assess the repair results of acromioclavicular dislocations (ACJD grades III and V, with anchors without eyelet, when compared with other techniques, and to evaluate factors that can affect the final result. METHODS: A retrospective study of 36 patients with ACJD grades III and V in the Rockwood classification, 12 treated with anchors without eyelet, 11 with one tightrope, six with two tightropes, and six with subcoracoid cerclage, operated from September 2012 to February 2015. Patients were assessed radiographically and through DASH, UCLA, the visual analog scale of pain (VAS and the Short-Form 36 (SF-36. Surgical time and the possible influence of some factors in the outcome were also assessed. RESULTS: The mean DASH score was 6.7; UCLA, 32.9; VAS, 1.2; and SF-36, 79.47. Radiographically, the final mean measurement was 9.93 mm, with no statistical difference between the groups. The mean surgical time for Group I was 31 min; Group II, 19 min; Group III, 29 min; and Group IV, 59 min. There was a significant difference between Groups II and IV when compared with the study group. The initial and immediate post-operative ACJD measurements ACJD were correlated with the final measure. CONCLUSION: The repair of acute ACJD with anchors without eyelet is as effective as the other methods, with significantly shorter operative time when compared with the subcoracoid cerclage technique. The final radiological result is influenced by the coracoclavicular initial distance and the immediate postoperative measurement.

  11. Computational radiology for orthopaedic interventions

    CERN Document Server

    Li, Shuo

    2016-01-01

    This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

  12. Gadofosveset-enhanced MR imaging for the preoperative evaluation of potential living kidney donors. Correlation with intraoperative findings

    Energy Technology Data Exchange (ETDEWEB)

    Kuhlemann, J.; Blondin, D.; Reichelt, D.; Heinen, W.; Scherer, A.; Lanzman, R.S. [Universitaetsklinikum Duesseldorf (Germany). Inst. fuer Radiologie; Grotemeyer, D. [Universitaetsklinikum Duesseldorf (Germany). Klinik fuer Gefaesschirurgie und Nierentransplantation; Zgoura, P. [Universitaetsklinikum Duesseldorf (Germany). Klinik fuer Nephrologie

    2010-11-15

    Purpose: The purpose of this study was to evaluate the blood pool contrast agent gadofosveset for MR angiography (MRA) of the renal vasculature in living kidney donors (LKD). Materials and Methods: Of the 28 consecutive potential LKDs (13 men, 15 women; mean age 55.14 years {+-} 11.97) initially included in this prospective study, 20 patients underwent surgery and were considered for further evaluation. 7 acquisitions of a 3D T1-weighted FLASH sequence were performed following administration of gadofosveset for the assessment of the vascular anatomy and collecting system at predefined time points at 1.5 T. All MR exams were prospectively analyzed by 2 radiologists in consensus mode prior to surgery. In addition, ROI-based relative SNR measurements were performed in the vena cava inferior and abdominal aorta. Results: MR image acquisition was completed in all 20 potential living donors. In 8 donors an additional CT scan was available for further comparison with the collateral anatomy, resulting in a total of 28 analyzed kidneys. MRA disclosed 36 renal arteries, since 8 accessory arteries were found in 8 subjects. One accessory artery and one case of fibromuscular dysplasia were missed by MRA. The venous anatomy and the collecting system were assessed correctly with MRI. In addition, MRI diagnosed two renal cell carcinomas. The overall sensitivity and positive predictive value of gadofosveset-enhanced MRI on a per kidney basis were 92.9 % and 100 %, respectively. Conclusion: Gadofosveset enables accurate evaluation of potential LKDs. (orig.)

  13. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of); Hallym University Medical Center, Department of Radiology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of)

    2016-11-15

    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  14. Evaluation of radiological workstations and web-browser-based image distribution clients for a PACS project in hands-on workshops

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, Thomas; Handgraetinger, Oliver; Voellmy, Daniel R.; Marincek, Borut; Wildermuth, Simon [Department of Medical Radiology, Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich (Switzerland); Link, Juergen [Kantonal Hospital Winterthur, Winterthur (Switzerland); Ploner, Ricardo [Municipal Hospital Triemli, Zurich (Switzerland)

    2004-05-01

    The methodology and outcome of a hands-on workshop for the evaluation of PACS (picture archiving and communication system) software for a multihospital PACS project are described. The following radiological workstations and web-browser-based image distribution software clients were evaluated as part of a multistep evaluation of PACS vendors in March 2001: Impax DS 3000 V 4.1/Impax Web1000 (Agfa-Gevaert, Mortsel, Belgium); PathSpeed V 8.0/PathSpeed Web (GE Medical Systems, Milwaukee, Wis., USA); ID Report/ID Web (Image Devices, Idstein, Germany); EasyVision DX/EasyWeb (Philips Medical Systems, Eindhoven, Netherlands); and MagicView 1000 VB33a/MagicWeb (Siemens Medical Systems, Erlangen, Germany). A set of anonymized DICOM test data was provided to enable direct image comparison. Radiologists (n=44) evaluated the radiological workstations and nonradiologists (n=53) evaluated the image distribution software clients using different questionnaires. One vendor was not able to import the provided DICOM data set. Another vendor had problems in displaying imported cross-sectional studies in the correct stack order. Three vendors (Agfa-Gevaert, GE, Philips) presented server-client solutions with web access. Two (Siemens, Image Devices) presented stand-alone solutions. The highest scores in the class of radiological workstations were achieved by ID Report from Image Devices (p<0.005). In the class of image distribution clients, the differences were statistically not significant. Questionnaire-based evaluation was shown to be useful for guaranteeing systematic assessment. The workshop was a great success in raising interest in the PACS project in a large group of future clinical users. The methodology used in the present study may be useful for other hospitals evaluating PACS. (orig.)

  15. RADIOLOGICAL EVALUATION OF THE LONG-TERM EFFECTS OF RESECTION OF THE DISTAL ULNA IN RHEUMATOID-ARTHRITIS

    NARCIS (Netherlands)

    VANGEMERT, AML; SPAUWEN, PHM

    1994-01-01

    28 patients have been studied after distal ulnar resection on one side. The operated hand has been compared with the hand on which no operation has been performed, using X-rays which had been taken pre-operatively and 4 to 8 years post-operatively. Only patients with no difference or a difference of

  16. [Preoperative evaluation of adult patients prior to elective, non-cardiac surgery: joint recommendations of German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery and German Society of Internal Medicine].

    Science.gov (United States)

    2010-11-01

    Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest-x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate and publish recommendations on the preoperative evaluation of adult patients prior to elective, non-cardiac and non-lung resection surgery. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and updating when new validated evidence becomes available.

  17. [Preoperative evaluation of adult patients prior to elective, non-cardiac surgery. Joint recommendations of German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery and German Society of Internal Medicine].

    Science.gov (United States)

    2011-09-01

    Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest-x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate and publish recommendations on the preoperative evaluation of adult patients prior to elective, non-cardiac and non-lung resection surgery. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and updating when new validated evidence becomes available.

  18. [Preoperative evaluation of adult patients before elective, noncardiothoracic surgery : Joint recommendation of the German Society of Anesthesiology and Intensive Care Medicine, the German Society of Surgery, and the German Society of Internal Medicine].

    Science.gov (United States)

    Zwissler, B

    2017-06-01

    Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e. g. blood chemistry, ECG, spirometry, chest x‑ray) can contribute to a reduction of perioperative risk is often not very well known or is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate recommendations on the preoperative evaluation of adult patients prior to elective, noncardiothoracic surgery, which were initially published in 2010. These recommendations have now been updated based on the current literature and existing international guidelines. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and

  19. Noncontrast-Enhanced Magnetic Resonance Versus Computed Tomography Angiography in Preoperative Evaluation of Potential Living Renal Donors

    DEFF Research Database (Denmark)

    Blankholm, Anne Dorte; Pedersen, Bodil G; Østrat, Ernst Ø

    2015-01-01

    RATIONALE AND OBJECTIVES: Living renal donors undergo an extensive examination program. These examinations should be as safe, gentle, and patient friendly as possible. To compare computed tomography angiography (CTA) and an extensive magnetic resonance imaging (MRI) protocol without contrast agents...... to observations from nephrectomy in living renal donors and to evaluate whether noncontrast-enhanced MRI can replace CTA for vessel assessment in living renal donors. MATERIAL AND METHODS: CTA and MRI results were compared to observations from nephrectomy, which served as the reference standard. Fifty......-one potential kidney donors underwent imaging, and 31 donated a kidney. Comparisons in sensitivity, specificity, and accuracy were made with respect to the number of arteries, early branching, and the number of veins. Agreement was assessed using Cohen's kappa. The exact McNemar's test was used to test...

  20. 77 FR 46766 - Public Meeting To Discuss Revision of “Criteria for Preparation and Evaluation of Radiological...

    Science.gov (United States)

    2012-08-06

    ... Power Plants'' (NUREG-0654/FEMA-REP- 1, Rev. 1) AGENCY: Federal Emergency Management Agency, DHS. ACTION... Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants,'' NUREG-0654/FEMA... Power Plants,'' NUREG-0654/FEMA- REP-1, Rev. 1. The document is available online at...

  1. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, N.; Møller, Ann Merete;

    2010-01-01

    Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text......; pooled RR 10.76 (95% confidence interval (CI) 4.55 to 25.46, two trials) and RR 1.41 (95% CI 1.22 to 1.63, five trials) respectively. Four trials evaluating the effect on long-term smoking cessation found a significant effect; pooled RR 1.61 (95% CI 1.12 to 2.33). However, when pooling intensive...

  2. Evaluation of intraoperative bleeding during an endoscopic surgery of nasal polyposis after a pre-operative single dose versus a 5-day course of corticosteroid.

    Science.gov (United States)

    Atighechi, Saeid; Azimi, Mohammad Reza; Mirvakili, Seyyed Abbas; Baradaranfar, Mohammad Hossein; Dadgarnia, Mohammad Hossein

    2013-09-01

    Nasal polyps are associated with the inflammation of the nasal cavity and the sinus mucosa. When medical treatment cannot solve a patient's problem, a functional endoscopic sinus surgery may be indicated. Bleeding impairs the surgery field during operation and increases the operation risk and time. Pre-operative corticosteroids can reduce bleeding during surgery. In this study, we have evaluated the effect of pre-operative single-dose prednisolone (1 mg/Kg/dose 24 h before surgery) versus 5-day prednisolone (1 mg/Kg/day before operation) on the bleeding volume and the surgery field quality during FESS. In this mono blind randomized clinical trial, 80 patients with bilateral nasal polyps were randomly assigned in two groups. The first group (A) received a single dose of 1 mg/Kg/dose prednisolone on the day before the surgery. The second group (B) received 1 mg/Kg/day prednisolone for 5 days before the operation. The patients were operated on under general anesthesia through the same protocol. The mean arterial blood pressure was 70-80 mm Hg in both groups. The surgeons were not aware of the patients' group. The bleeding volume and the surgeons' opinion about the surgery field quality were recorded at the end of the procedure and analyzed by Chi-square and t test. The two groups were not significantly different in their overall demographic and clinical characteristics. The mean bleeding volume during the operation was 266.5 ± 96.31 ml in group A and 206 ± 52.81 ml in group B; there was a significant difference between the groups (P value = 0.038). There was no significant difference between the groups in the surgeons' opinion about the surgery field quality (P value = 0.09). In conclusion, unlike a single dose (1 mg/kg/dose), treatment with 5-day prednisolone (1 mg/kg/day) can reduce blood loss during FESS more efficiently and may improve the surgery field quality slightly. But this difference is not clinically significant.

  3. An evaluation of preoperative and postoperative ventilation and perfusion lung scintigraphy in the screening for pulmonary embolism after elective orthopedic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Keenan, A.M.; Palevsky, H.I.; Steinberg, M.E.; Hartman, K.M.; Alavi, A.; Lotke, P.A. (Univ. of Pennsylvania, Philadelphia (USA))

    1991-01-01

    One hundred two patients undergoing elective knee or hip arthroplasty were studied with radionuclide ventilation scans (V) and perfusion scans (Q) preoperatively (preop) and postoperatively (postop) to assess their relative value in the diagnosis of asymptomatic pulmonary embolism (PE) after orthopedic surgery. Postop Q were read in combination with preop V and Q and postop V using prospective investigation of pulmonary embolism diagnosis (PIOPED) criteria. Of 25 postop Q interpreted as either high or intermediate probability for PE, preop Q were judged useful in 96%; the postop V were useful in 78%; and the preop V were not helpful in any of the cases. Of 63 postop Q interpreted as low probability, preop Q were useful in 74%; the postop V were useful in only 33%; and the preop V were useful in only one case. When postop Q were read as normal (14 cases), none of the three auxiliary studies were found to be useful. Overall, postop V were more helpful than preop Q in only 2%, and preop V contributed significantly in only 1%. This experience suggests that preop Q alone is the most useful adjunct to the postop Q in the postoperative evaluation for PE. The authors conclude that to screen for asymptomatic PE after elective orthopedic surgery, preop Q should be performed in all cases, preop V are not necessary, and postop V need be performed only if a baseline preop Q is not available.

  4. Preoperative evaluation of neurovascular relationship by using contrast-enhanced and unenhanced 3D time-of-flight MR angiography in patients with trigeminal neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Zhou; Zhiling, Liu; Chuanfu, Li; Qingshi Zeng (Dept. of Radiology, Qilu Hospital of Shandong Univ., Jinan (China)), email: zengqingshi@yahoo.cn; Chuncheng, Qu (Dept. of Neurosurgery, the Second Hospital of Shandong Univ., Jinan (China)); Shilei, Ni (Dept. of Neurosurgery, Qilu Hospital of Shandong Univ., Jinan (China))

    2011-10-15

    Background Microvascular decompression is an etiological strategy for the therapy of trigeminal neuralgia (TN). Preoperative identification of neurovascular compression, therefore, could have an impact on the determination of appropriate treatment for TN. Purpose To evaluate the value of contrast-enhanced and unenhanced three-dimensional (3D) time-of-flight (TOF) MR angiography in the visualization of neurovascular relationship in patients with TN. Material and Methods Thirty-seven patients with unilateral TN underwent unenhanced and contrast-enhanced 3D TOF MR angiography with a 3.0-T MR system. Images were reviewed by a radiologist blinded to clinical details. Vascular contact with the trigeminal nerve was identified, and the nature of the involved vessels (artery or vein) was determined. All patients underwent microvascular decompression. Results In 37 patients with TN, contrast-enhanced 3D TOF MR angiography identified surgically verified neurovascular contact in 35 of 36 symptomatic nerves, and there was no false-positive. Based on surgical findings, the sensitivity of MR imaging was 97.2% and specificity 100%. The nature of the offending vessel was correctly identified in 94.4% of the patients by using the combination of contrast-enhanced and unenhanced MR angiography. Conclusion Contrast-enhanced 3D TOF MR angiography is useful in the detection of vascular contact with the trigeminal nerve in patients with TN, and this MR imaging in combination with unenhanced MR angiography could help in the identification of the nature of the responsible vessels

  5. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

    Energy Technology Data Exchange (ETDEWEB)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Kanazawa, Susumu [Okayama University Medical School, Departments of Radiology, Okayama (Japan); Miyoshi, Shinichiro [Okayama University Medical School, General Thoracic Surgery, Okayama (Japan)

    2016-01-15

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. (orig.)

  6. Preoperative evaluation of neurovascular relationship by using contrast-enhanced and unenhanced 3D time-of-flight MR angiography in patients with trigeminal neuralgia.

    Science.gov (United States)

    Zhou, Qin; Liu, Zhiling; Li, Chuanfu; Qu, Chuncheng; Ni, Shilei; Zeng, Qingshi

    2011-10-01

    Microvascular decompression is an etiological strategy for the therapy of trigeminal neuralgia (TN). Preoperative identification of neurovascular compression, therefore, could have an impact on the determination of appropriate treatment for TN. To evaluate the value of contrast-enhanced and unenhanced three-dimensional (3D) time-of-flight (TOF) MR angiography in the visualization of neurovascular relationship in patients with TN. Thirty-seven patients with unilateral TN underwent unenhanced and contrast-enhanced 3D TOF MR angiography with a 3.0-T MR system. Images were reviewed by a radiologist blinded to clinical details. Vascular contact with the trigeminal nerve was identified, and the nature of the involved vessels (artery or vein) was determined. All patients underwent microvascular decompression. In 37 patients with TN, contrast-enhanced 3D TOF MR angiography identified surgically verified neurovascular contact in 35 of 36 symptomatic nerves, and there was no false-positive. Based on surgical findings, the sensitivity of MR imaging was 97.2% and specificity 100%. The nature of the offending vessel was correctly identified in 94.4% of the patients by using the combination of contrast-enhanced and unenhanced MR angiography. Contrast-enhanced 3D TOF MR angiography is useful in the detection of vascular contact with the trigeminal nerve in patients with TN, and this MR imaging in combination with unenhanced MR angiography could help in the identification of the nature of the responsible vessels.

  7. The diagnostic value of time-resolved MR angiography with Gadobutrol at 3 T for preoperative evaluation of lower extremity tumors: Comparison with computed tomography angiography.

    Science.gov (United States)

    Wu, Gang; Jin, Teng; Li, Ting; Li, Xiaoming

    2016-01-01

    To evaluate the diagnostic value of time resolved magnetic resonance angiography with interleaved stochastic trajectory (TWIST) using Gadobutrol for preoperative evaluation of lower extremity tumors. This prospective study was approved by the local Institutional Review Board. 50 consecutive patients (31 men, 19 women, age range 18-80 years, average age 42.7 years) with lower extremity tumors underwent TWIST and computed tomography angiography (CTA). Image quality of TWIST and CTA were evaluated by two radiologists according to a 4-point scale. The degree of arterial stenosis caused by tumor was assessed using TWSIT and CTA separately, and the intra-modality agreement was determined using a kappa test. The number of feeding arteries identified by TWIST was compared with that by CTA using Wilcoxon signed rank test. The ability to identify arterio-venous fistulae (AVF) were compared using a chi-square test. Image quality of TWIST and CTA were rated as 3.88 ± 0.37 and 3.97 ± 0.16, without statistically significant difference (P = 0.135). Intra-modality agreement was excellent for the assessment of arterial stenosis (kappa = 0.806 ± 0.073 for Reader 1, kappa = 0.805 ± 0.073 for Reader 2). Readers identified AVF with TWIST in 27 of 50 cases, and identified AVF with CTA in 14 of 50 (P < 0.001). Mean feeding arteries identified with TWIST was significantly more than that with CTA (2.08 ± 1.72 vs 1.62 ± 1.52, P = 0.02). TWIST is a reliable imaging modality for the assessment of lower extremity tumors. TWIST is comparable to CTA for the identification of AVF and feeding arteries.

  8. Evaluation of the Entrance Skin Dose in Animals Undergoing Diagnostic Radiology Using LiF, Mg, Ti Thermoluminescence Dosimetry (TLD-100

    Directory of Open Access Journals (Sweden)

    Sedigheh Sina

    2016-06-01

    Full Text Available Introduction According to the International Commission on Radiological Protection publication numbers 60 and 21, the environmental control standards should ensure human and other species protection to a desirable degree. Since application of radiographic procedures in Veterinary Medicine has increased significantly, in this study, we aimed to evaluate the entrance skin dose to the animals (e.g., dogs, cats, horses, and birds undergoing diagnostic radiology. Materials and Methods The entrance skin dose to the animals in different radiology procedures were estimated through a indirect estimation using the output of X-ray tubes and b direct measurement using LiF:Mg, Ti  (TLD-100  thermoluminescence dosimeter. Regression analysis was performed for comparison of the two methods. The animals included in this study were cats, dogs, small birds, horses, parrots, and chough. Results The dose received by the animals varied from 20 mGy to 1189.2 mGy, depending on the animal thickness, focal spot to surface distance, imaging technique, and animal type. Conclusion Optimized procedures are suggested for obtaining high-quality images, with a reasonably low dose imposed to the animals.

  9. Financial accounting for radiology executives.

    Science.gov (United States)

    Seidmann, Abraham; Mehta, Tushar

    2005-03-01

    The authors review the role of financial accounting information from the perspective of a radiology executive. They begin by introducing the role of pro forma statements. They discuss the fundamental concepts of accounting, including the matching principle and accrual accounting. The authors then explore the use of financial accounting information in making investment decisions in diagnostic medical imaging. The paper focuses on critically evaluating the benefits and limitations of financial accounting for decision making in a radiology practice.

  10. Radiological findings after endoscopic incision of ureterocele

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Cheon, Jung Eun [Chungmu General Hospital, Chungmu (Korea, Republic of); Seok, Eul Hye [Seran General Hospital, Seoul (Korea, Republic of); Cha, Joo Hee [Green General Hospital, Seoul(Korea, Republic of); Choi, Guk Myung [Halla General Hospital, Cheju (Korea, Republic of)

    2001-01-01

    Endoscopic incision of ureterocele is considered a simple and safe method for decompression of urinary tract obstruction above ureterocele. The purpose of this study was to evaluate the radiological findings after endoscopic incision of ureterocele. We retrospectively reviewed the radiological findings (ultrasonography (US), intravenous urography, and voiding cystourethrography(VCU)) in 16 patients with ureterocele who underwent endoscopic incision (mean age at surgery, 15 months; M:F 3:13; 18 ureteroceles). According to the postoperative results, treatment was classified as successful when medical treatment was still required, and second operation when additional surgical treatment was required. Postoperative US (n=10) showed that in all patients, urinary tract obstruction was relieved: the kidney parenchima was thicker and the ureterocele was smaller. Intravenous urography (n=8), demonstrated that in all patients, urinary tract obstruction and the excretory function of the kidney had improved. Postoperative VCU indicated that in 92% of patients (12 of 13), endoscopic incision of the ureterocele led to vesicoureteral reflux(VUR). Of these twelve, seven (58%) showed VUR of more than grade 3, while newly developed VUR was seen in five of eight patients (63%) who had preoperative VCU. Surgery was successful in four patients (25%), partially successful in three (19%), and a second operation-on account of recurrent urinary tract infection and VUR of more than grase 3 during the follow-up period-was required by nine (56%). Although endoscopic incision of a ureterocele is a useful way of relieving urinary tract obstruction, an ensuing complication may be VUR. Postoperative US and intravenous urography should be used to evaluate parenchymal change in the kidney and improvement of uronary tract obstructon, while to assess the extend of VUR during the follow-up period , postoperative VCU is required.

  11. Evaluation of clinicians' knowledge and practices regarding medical radiological exposure: findings from a mixed-methods investigation (survey and qualitative study)

    Science.gov (United States)

    Lumbreras, B; Vilar, J; González-Álvarez, I; Guilabert, M; Parker, L A; Pastor-Valero, M; Domingo, M L; Fernández-Lorente, M F; Hernández-Aguado, I

    2016-01-01

    Objectives To assess the impact of initiatives aiming to increase clinician awareness of radiation exposure; to explore the challenges they face when communicating with patients; to study what they think is the most appropriate way of communicating the long-term potential risks of medical radiological exposure to patients. Design A quantitative and qualitative evaluation through a survey and focal groups. Setting San Juan Hospital and Dr Peset Hospital (Southeast Spain) and clinicians from Spanish scientific societies. Participants The surveys were answered (a) in person (216: all the radiologists (30), urologists (14) and surgeons (44) working at both participant hospitals; a sample of general practitioners from the catchment area of one hospital (45), and a consecutive sample of radiologists attending a scientific meeting (60)) or (b) electronically through Spanish scientific societies (299: radiologists (45), pneumologists (123), haematologists (75) and surgeons (40)). Clinicians were not randomly selected and thus the results are limited by the diligence of the individuals filling out the survey. Primary and secondary outcome measures Clinicians' knowledge and practices regarding medical radiological exposure, and what they considered most appropriate for communicating information to patients. Results Nearly 80% of the clinicians surveyed had never heard of the European recommendations. Fewer than 20% of the clinicians surveyed identified correctly the radiation equivalence dose of intravenous urography or barium enema. It was reported by 31.7% that they inform patients about the long-term potential risks of ionising radiation. All participants agreed that the most appropriate way to present information is a table with a list of imaging tests and their corresponding radiation equivalence dose in terms of chest X-rays and background radiation exposure. Conclusions Medical radiological exposure is frequently underestimated and rarely explained to patients. With a

  12. Radiological safety and control

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Kyeong Won; You, Young Soo; Chang, Sea Young; Yoon, Yeo Chang; Yoon, Suk Chul; Kim, Jang Yeol; Lee, Tae Young; Lee, Bong Jae; Kim, Bong Hwan; Lee, Jong Il; Jeong, Juk Yeon; Lee, Sang Yeol; Jeong, Kyung Ki; Jeong, Rae Ik; Kim, Jong Su; Han, Young Dae; Lee, Hyung Sub; Kim, Chang Kyung [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-01-01

    This report describes the annual results of radiological safety and control program. This program includes working area monitoring (WAM), personnel radiation monitoring (PRM), education for radiation protection (ERP), preparing for KMRR operation and developing QA program on personal dose evaluation. As a result, the objectives of radiation protection have been achieved satisfactorily through the WAM, PRM and ERP. The QA program on personal dose evaluation has been approved by the MOST according to the Ministerial Ordinance (No. 1992-15). KAERI has also been authorized as a specialized processor for personal dose evaluation. 32 tabs., 20 figs. (Author) .new.

  13. CT pre-operative planning of a new semi-implantable bone conduction hearing device

    Energy Technology Data Exchange (ETDEWEB)

    Law, Eric K.C.; Bhatia, Kunwar S.S. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Hong Kong, SAR (China); Tsang, Willis S.S.; Tong, Michael C.F. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Hong Kong, SAR (China); Shi, Lin [The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, SAR (China); The Chinese University of Hong Kong, Chow Yuk Ho Technology Center for Innovative Medicine, Hong Kong, SAR (China)

    2016-06-15

    Accommodating a novel semi-implantable bone conduction hearing device within the temporal bone presents challenges for surgical planning. This study describes the utility of CT in pre-operative assessment of such an implant. Retrospective review of pre-operative CT, clinical and surgical records of 16 adults considered for device implantation. Radiological suitability was assessed on CT using 3D simulation software. Antero-posterior (AP) dimensions of the mastoid bone and minimum skull thickness were measured. CT planning results were correlated with operative records. Eight and five candidates were suitable for device placement in the transmastoid and retrosigmoid positions, respectively, and three were radiologically unsuitable. The mean AP diameter of the mastoid cavity was 14.6 mm for the transmastoid group and 4.6 mm for the retrosigmoid group (p < 0.05). Contracted mastoid and/or prior surgery were predisposing factors for unsuitability. Four transmastoid and five retrosigmoid positions required sigmoid sinus/dural depression and/or use of lifts due to insufficient bone capacity. A high proportion of patients being considered have contracted or operated mastoids, which reduces the feasibility of the transmastoid approach. This finding combined with the complex temporal bone geometry illustrates the importance of careful CT evaluation using 3D software for precise device simulation. (orig.)

  14. FIXATION OF FRACTURES OF THE DISTAL EXTREMITY OF THE RADIUS USING THE MODIFIED KAPANDJI TECHNIQUE: EVALUATION OF THE RADIOLOGICAL RESULTS.

    Science.gov (United States)

    Neto, Antonio Piva; Lhamby, Fabio Colla

    2011-01-01

    To demonstrate a simple and efficacious option for treating fractures of the distal extremity of the radius using Kirschner wires. Between September 2008 and April 2009, 48 patients with fractures of the distal extremity of the radius, classified as A3 according to the AO classification, were treated surgically using a modification of the Kapandji technique. Out of the 48 wrists operated, 42 (87.5%) presented postoperative measurements within the acceptable limits. We used the parameters of McQuenn and Caspers who considered that the radial angulation should be wider than 19° and the volar angulation should be narrower than -12°. All the postoperative volar inclination measurements were narrower than -3°. The mean preoperative radial inclination was 13.14° and the mean postoperative value was 21.18°. The mean preoperative volar inclination was 28.75° and the mean postoperative value was 3.31°. The mean preoperative radial height was 5.25 mm and the mean postoperative value was 9.48 mm. The technique described here had excellent stability for treating fractures of the distal extremity of the radius classified as A3. It was easy to implement and minimally invasive, with minimal surgical complications, and it was inexpensive.

  15. Hypoxia related growth factors and p53 in preoperative sera from patients with colorectal cancer--evaluation of the prognostic significance of these agents.

    Science.gov (United States)

    Sulkowski, Stanislaw; Wincewicz, Andrzej; Zalewski, Bogdan; Famulski, Waldemar; Lotowska, Joanna Maria; Koda, Mariusz; Sobaniec-Lotowska, Maria Elzbieta; Mysliwiec, Michal; Baltaziak, Marek; Pawlak, Krystyna; Sulkowska, Mariola

    2009-01-01

    Insulin-like growth factor-I (IGF-I) and vascular endothelial growth factor (VEGF) belong to a group of hypoxia related proteins. IGF-I induces expression of VEGF and decomposes wild type p53 in cancer cell lines. The goal of our study was to evaluate serum IGF-I, VEGF and p53 with respect to overall and disease free survival of patients with colorectal cancer (CRC) patients compared with healthy volunteers. Preoperative blood samples from 125 patients with CRC and 16 healthy volunteers were examined using ELISA for serum IGF-I, p53 and VEGF concentrations. Concentrations of p53 and VEGF were significantly higher in CRC patients than in controls (p<0.0006 and p<0.0001, respectively). IGF-I was not statistically different between both groups. Serum IGF-I showed negative correlation with p53 in CRC patients (p<0.04, r=-0.193). IGF-I and VEGF showed negative correlation in poorly differentiated cancers (G3) (p<0.03, r=-0.339). Patients with VEGF concentrations that were above average for the cancer population survived for a shorter period of time (p=0.065 in evaluation of overall survival and 0.071 in estimation of disease-free survival during a 3-year follow-up) compared with patients with serum VEGF lower than the highest values seen in controls. Comparisons between serum IGF-I and p53 appear to confirm the metabolism of p53 by IGF-I. Serum VEGF showed prognostic significance in our study. Serum concentrations of IGF-I and VEGF did not show positive correlation, as expected due to IGF-I induction of VEGF in malignant colon cell lines.

  16. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Makino, Masahiro [Kyoto Prefectural Univ. of Medicine (Japan). Research Inst. for Neurological Diseases and Geriatrics

    2001-12-01

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9{+-}9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with {>=}50% luminal narrowing was detected in 29.2% of the subjects, and that with {>=}75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing {>=}50% luminal narrowing was detected in 38.2% of subjects, and that showing {>=}75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid

  17. MRI in preoperative evaluation of chronic paranasal sinusitis - a comparison with CT; MRT in der praeoperativen Diagnostik der chronischen Sinusitis im Vergleich mit der CT

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, F.; Habermann, C.R.; Welger, J.; Steiner, P.; Rozeh, B.; Buecheler, E. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Radiologie; Knaape, A.; Metternich, F. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde; Schoder, V. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Inst. fuer Mathematik und Datenverarbeitung in der Medizin

    2001-04-01

    Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T{sub 2}-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good correlation in the detection of mucosal pathologies ({kappa}=0.46-0.87) and anatomic variants ({kappa}=0.55-0.86). All important anatomical structures could be evaluated sufficiently with MRI for preoperative management. Both diagnostic tools showed an unsatisfactory correlation with intraoperative findings in the ethmoidal complex and maxillary sinus ({tau}=-0.08-0.3). (orig.) [German] Zielsetzung: Einschaetzung des Stellenwertes der MRT in der Beurteilung der praeoperativen Diagnostik der chronischen Sinusitis und Vergleich mit koronarer CT und intraoperativem Befund. Material und Methodik: 42 Patientinnen mit klinischen Zeichen einer chronischen Sinusitis wurden jeweils innerhalb eines Tages mittels CT und MRT untersucht. Am Folgetag wurde eine transnasale endoskopische Operation an den Nasennebenhoehlen durchgefuehrt. Die CT erfolgte in Bauchlage und koronarer Schichtfuehrung (5 mm Schichtdicke und Tischvorschub). Die MRT wurde an einem 1,5 T-Geraet in Rueckenlage mittels Kopfspule durchgefuehrt. Eingesetzt wurden koronare Protonen-w-, T

  18. Pediatric fasting times before surgical and radiologic procedures: benchmarking institutional practices against national standards.

    Science.gov (United States)

    Williams, Catherine; Johnson, Pat A; Guzzetta, Cathie E; Guzzetta, Philip C; Cohen, Ira Todd; Sill, Anne M; Vezina, Gilbert; Cain, Sherry; Harris, Christine; Murray, Jodi

    2014-01-01

    Prolonged preoperative fasting can be associated with adverse outcomes, particularly in children. Our aims were to assess the time pediatric patients fasted prior to surgical or radiologic procedures and evaluate whether fasting (NPO) orders complied with national guidelines. We measured NPO start time, time of last intake, and time test or surgery was scheduled, took place, or was cancelled in 219 pediatric patients. Findings demonstrate that pediatric patients experienced prolonged fasting before procedures and that the majority of NPO orders were non-compliant with national guidelines. We have developed strategies to reduce fasting times and ensure compliance with recommended national fasting standards.

  19. Radiological features of mucocele of the appendix

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, P.

    1988-12-01

    The clinical features of mucocele of the appendix are nonspecific, and a correct preoperative diagnosis based on abdominal pain, a palpable mass in the right lower quadrant, and conventional radiography is rare. The diagnosis of appendiceal mucocele has become easier with the utilisation of the recent imaging techniques ultrasonography and computed tomography. Six patients with mucocele of the appendix are presented, and the characteristic radiological features and differential diagnosis are discussed.

  20. Radiology illustrated. Hepatobiliary and pancreatic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn (ed.) [Seoul National Univ. Hospital (Korea, Republic of). Dept. of Radiology

    2014-04-01

    Clear, practical guide to the diagnostic imaging of diseases of the liver, biliary tree, gallbladder, pancreas, and spleen. A wealth of carefully selected and categorized illustrations. Highlighted key points to facilitate rapid review. Aid to differential diagnosis. Radiology Illustrated: Hepatobiliary and Pancreatic Radiology is the first of two volumes that will serve as a clear, practical guide to the diagnostic imaging of abdominal diseases. This volume, devoted to diseases of the liver, biliary tree, gallbladder, pancreas, and spleen, covers congenital disorders, vascular diseases, benign and malignant tumors, and infectious conditions. Liver transplantation, evaluation of the therapeutic response of hepatocellular carcinoma, trauma, and post-treatment complications are also addressed. The book presents approximately 560 cases with more than 2100 carefully selected and categorized illustrations, along with key text messages and tables, that will allow the reader easily to recall the relevant images as an aid to differential diagnosis. At the end of each text message, key points are summarized to facilitate rapid review and learning. In addition, brief descriptions of each clinical problem are provided, followed by both common and uncommon case studies that illustrate the role of different imaging modalities, such as ultrasound, radiography, CT, and MRI.

  1. Radiological classification of renal angiomyolipomas based on 127 tumors

    Directory of Open Access Journals (Sweden)

    Prando Adilson

    2003-01-01

    Full Text Available PURPOSE: Demonstrate radiological findings of 127 angiomyolipomas (AMLs and propose a classification based on the radiological evidence of fat. MATERIALS AND METHODS: The imaging findings of 85 consecutive patients with AMLs: isolated (n = 73, multiple without tuberous sclerosis (TS (n = 4 and multiple with TS (n = 8, were retrospectively reviewed. Eighteen AMLs (14% presented with hemorrhage. All patients were submitted to a dedicated helical CT or magnetic resonance studies. All hemorrhagic and non-hemorrhagic lesions were grouped together since our objective was to analyze the presence of detectable fat. Out of 85 patients, 53 were monitored and 32 were treated surgically due to large perirenal component (n = 13, hemorrhage (n = 11 and impossibility of an adequate preoperative characterization (n = 8. There was not a case of renal cell carcinoma (RCC with fat component in this group of patients. RESULTS: Based on the presence and amount of detectable fat within the lesion, AMLs were classified in 4 distinct radiological patterns: Pattern-I, predominantly fatty (usually less than 2 cm in diameter and intrarenal: 54%; Pattern-II, partially fatty (intrarenal or exophytic: 29%; Pattern-III, minimally fatty (most exophytic and perirenal: 11%; and Pattern-IV, without fat (most exophytic and perirenal: 6%. CONCLUSIONS: This proposed classification might be useful to understand the imaging manifestations of AMLs, their differential diagnosis and determine when further radiological evaluation would be necessary. Small (< 1.5 cm, pattern-I AMLs tend to be intra-renal, homogeneous and predominantly fatty. As they grow they tend to be partially or completely exophytic and heterogeneous (patterns II and III. The rare pattern-IV AMLs, however, can be small or large, intra-renal or exophytic but are always homogeneous and hyperdense mass. Since no renal cell carcinoma was found in our series, from an evidence-based practice, all renal mass with detectable

  2. Preoperative preparation of children

    Directory of Open Access Journals (Sweden)

    Priya Reshma Aranha

    2017-01-01

    Full Text Available Surgery is a stressful and anxiety provoking experience for children. Millions of children undergo surgery every year. The majority of children experience significant preoperative anxiety which intern can affect their recovery. Preoperative anxiety may bring about physical and physiological changes in children, which can be particularly evident in terms of increased heart rate and blood pressure. To identify various strategies used to minimize the preoperative anxiety of children and update their clinical effectiveness among children undergoing surgery, the authors searched PubMed, MEDLINE, CINAHL, ScienceDirect, Google Scholar, Scopus, and Cochrane Library for identifying the relevant studies and retrieved available literature. It is concluded that utilization of the strategies available to reduce the preoperative anxiety of children will be a promising intervention to reduce anxiety, to promote relaxation, satisfaction, and speedy recovery. Many of these techniques are simple, cost-effective and can be easily carried out by nurses. It is essential to use the age appropriate and individualized methods in preparing children for surgery. Further research is required to strengthen the evidence.

  3. Preoperative localization in primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sanson; Kitamura, Hiroyuki; Takagita, Shin-ichi; Maetani, Toshiki; Iwahashi, Yuka; Miyazaki, Masakazu; Yamamoto, Norio [Tenri Hospital, Nara (Japan)

    1998-04-01

    Between 1992 and 1996, 31 cases (8 men and 23 women) with primary hyperparathyroidism (PHPT) were treated in our department. In this study, we compared which of the preoperative localization methods was most useful in the detection of PHPT. The sensitivity for detection of abnormal parathyroid glands was 88.6% on ultrasonography (US), 76.9% on magnetic resonance imaging (MRI), 74.3% on Tl-Tc subtraction scintigraphy and 68.8% on computed tomography. We concluded that US should be performed first, with MRI as a supplementary method, for the detection of abnormal parathyroid glands and the evaluation of invasion within the body. (author)

  4. Comparative evaluation of oral gabapentin versus clonidine as premedication on preoperative sedation and laryngoscopic stress response attenuation for the patients undergoing general anesthesia

    Directory of Open Access Journals (Sweden)

    Saikat Majumdar

    2015-01-01

    Results and Analysis: Preoperative sedation between two groups were similar but group C attenuated HR, systolic blood pressure (SBP, diastolic blood pressure (DBP, and mean blood pressure (MBP more significantly before induction, during L and I, 1, 3, and 5 min, following L and I, while comparing with group G. Again gabapentin-reduced HR, BP, (SBP, DBP, MBP significantly more at 7 and 10 min after L and I on comparison clonidine. Conclusion: Oral clonidine is equally effective in producing preoperative sedation in comparison to oral gabapentin, while on the contrary oral clonidine is more efficacious in reducing laryngoscopic stress response than oral gabapentin.

  5. Radiological Control Manual

    Energy Technology Data Exchange (ETDEWEB)

    1993-04-01

    This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records.

  6. Quality of life evaluation of workers for diagnostic radiology services; Avaliacao da qualidade de vida dos trabalhadores de servicos de radiodiagnostico

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Ivani Martins

    2011-07-01

    The main objective of this study was to evaluate the quality of life (QOL) of diagnostic radiology services workers at a hospital of Sao Paulo city. It aimed also to draw the profile of these workers identifying the variables, as its influence on their quality of life. A descriptive exploratory study with qualitative and quantitative approaches was carried out. The data were collected using the questionnaires: the abbreviated instrument for the assessment of the QOL, World Health Organization Quality of Life Instrument bref (WHOQOL-bref) and a questionnaire including the social demographic variables, work conditions and the variables that express the lifestyle of individuals, both questionnaires self-applied. The sample was formed by 118 workers, among them: physicians, technologists/technicians in radiology, nurses, technicians and assistants in nursing, and others health professionals. The data analysis included descriptive statistics, nonparametric tests and the use of a linear regression model. The reliability of the instrument for the studied sample was verified by Cronbach's Alpha Coefficient ({alpha}). The WHOQOL-bref proved to be an adequate instrument, with a good level of internal consistency ({alpha}=0.884), being easily and quickly administrated for the evaluation of the QOL. The study provided an overview of the perception of quality of life of the studied group. (author)

  7. Evaluation of tissue-equivalent materials to be used as human brain tissue substitute in dosimetry for diagnostic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, C.C., E-mail: cassio.c.ferreira@gmail.co [Departamento de Fisica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil); Ximenes Filho, R.E.M., E-mail: raimundoximenes@hotmail.co [Departamento de Fisica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil); Vieira, J.W., E-mail: jwvieira@br.inter.ne [Centro Federal de Educacao Tecnologica de Pernambuco (CEFET-PE), Av. Professor Luiz Freire, 500 Curado, CEP 50740-540, Recife (Brazil); Escola Politecnica de Pernambuco, Universidade de Pernambuco (EPP/UPE), Rua Benfica, 455, Madalena, CEP 50720-001, Recife (Brazil); Tomal, A., E-mail: alessandratomal@pg.ffclrp.usp.b [Departamento de Fisica e Matematica, FFCLRP, Universidade de Sao Paulo, Ribeirao Preto-SP 14040-90 (Brazil); Poletti, M.E., E-mail: poletti@ffclrp.usp.b [Departamento de Fisica e Matematica, FFCLRP, Universidade de Sao Paulo, Ribeirao Preto-SP 14040-90 (Brazil); Garcia, C.A.B., E-mail: cgarcia@ufs.b [Departamento de Quimica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil); Maia, A.F., E-mail: afmaia@ufs.b [Departamento de Fisica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil)

    2010-08-15

    Tissue-equivalent materials to be used as substitutes for human brain tissue in dosimetry for diagnostic radiology have been investigated in terms of calculated total mass attenuation coefficient ({mu}/{rho}), calculated mass energy-absorption coefficient ({mu}{sub en}/{rho}) and absorbed dose. Measured linear attenuation coefficients ({mu}) have been used for benchmarking the calculated total mass attenuation coefficient ({mu}/{rho}). The materials examined were bolus, nylon (registered) , orange articulation wax, red articulation wax, PMMA (polymethylmethacrylate), bees wax, paraffin I, paraffin II, pitch and water. The results show that water is the best substitute for brain among the materials investigated. The average percentage differences between the calculated {mu}/{rho} and {mu}{sub en}/{rho} coefficients for water and those for brain were 1.0% and 2.5%, respectively. Absorbed doses determined by Monte Carlo methods confirm water as being the best brain substitute to be used in dosimetry for diagnostic radiology, showing maximum difference of 0.01%. Additionally this study showed that PMMA, a material often used for the manufacturing of head phantoms for computed tomography, cannot be considered to be a suitable substitute for human brain tissue in dosimetry.

  8. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Møller, A; Villebro, N

    2005-01-01

    Smokers have a substantially increased risk of intra- and postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence. The preoperative period may be a well chosen time to offer smoking cessation interventions due to increased patient motivation....

  9. Economic evaluation of angiographic interventions including a whole-radiology in- and outpatient care; Wirtschaftliche Evaluation angiographischer Interventionen einschliesslich einer radiologischen stationaeren und ambulanten Patientenbetreuung

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.; Abel, K.; Krupski, G.; Lorenzen, J.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

    2006-01-01

    Purpose: To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. Materials and Methods: The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called ''ambulant operation'' (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Results: Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 Euro, the profits in our university hospital range between -872 Euro and +3411 Euro (mean: +1348 Euro). On the other hand, those angiographic interventions suitable for ''ambulant operation'' generate average profits of +372 Euro, if only direct costs are considered. The data of outpatient radiological interventions average between 381 Euro up to 1612 Euro lower than compared with profits obtained from in patient care. (orig.)

  10. Changes in compliance rates of evaluation criteria after health care accreditation: Mainly on radiologic technologists working at University Hospitals in Daejeon area

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Eun Ju; Kim, Hyun Joo [Dept. of Public Health, The Graduate School of Konyang University, Daejeon (Korea, Republic of); Lee, Jin Yong [Public Health Medical Service, Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Bae, Seok Hwan [Dept. of Radiological Science, Konyang University, Daejeon (Korea, Republic of)

    2013-12-15

    This study aimed to assess whether the changes in compliance rates of evaluation criteria after healthcare accreditation among radiologic technologists working at four university hospitals which had acquired healthcare accreditation in Daejeon metropolitan area. In this study, the evaluation criteria of healthcare accreditation were reclassified and reevaluated to three areas which include patient safety, staff safety, and environmental safety. Each area has eight, three, and five questions, respectively. Each compliance rate was quantitatively measured on a scale of 0 to 10 before and after in this study. The result shows that the overall compliance rates were decreased on all areas compared to the time healthcare accreditation was obtained. The compliance rate of hand hygiene was drastically reduced. To maintain the compliance rates, not only individuals but healthcare organizations should simultaneously endeavor. In particular, healthcare organizations should make an effort to provide continuous education opportunity to their workers and supervise the compliance regularly.

  11. [Preoperative assessment of lung disease patients.].

    Science.gov (United States)

    Ramos, Gilson; Ramos Filho, José; Pereira, Edísio; Junqueira, Marcos; Assis, Carlos Henrique C

    2003-02-01

    Lung complications are the most frequent causes of postoperative morbidity-mortality, especially in lung disease patients. So, those patients should be preoperatively carefully evaluated and prepared, both clinically and laboratorially. This review aimed at determining surgical risk and at establishing preoperative procedures to minimize peri and postoperative morbidity-mortality in lung disease patients. Major anesthetic-surgical repercussions in lung function have already been described. Similarly, we tried to select higher-risk patients, submitted or not to lung resection. To that end, clinical and laboratorial propedeutics were used. Finally, a proposal of a preoperative algorithm was presented for procedures with lung resection. Lung disease patients, especially those with chronic evolution, need to be preoperatively thoroughly evaluated. ASA physical status and Goldmans cardiac index are important risk forecasting factors for lung disease patients not candidates for lung resection. Adding to these criteria, estimated postoperative max VO2, FEV1 and diffusion capacity are mandatory for some patients submitted to lung resection. beta2-agonists and steroids should be considered in the preoperative period of these patients.

  12. Educational treasures in Radiology: The Radiology Olympics - striving for gold in Radiology education

    OpenAIRE

    Talanow, Roland

    2010-01-01

    This article focuses on Radiology Olympics (www.RadiologyOlympics.com) - a collaboration with the international Radiology community for Radiology education, Radiolopolis (www.Radiolopolis.com). The Radiology Olympics honour the movers and shakers in Radiology education and offer an easy to use platform for educating medical professionals based on Radiology cases.

  13. Educational treasures in Radiology: The Radiology Olympics - striving for gold in Radiology education

    OpenAIRE

    Talanow, Roland

    2010-01-01

    This article focuses on Radiology Olympics (www.RadiologyOlympics.com) - a collaboration with the international Radiology community for Radiology education, Radiolopolis (www.Radiolopolis.com). The Radiology Olympics honour the movers and shakers in Radiology education and offer an easy to use platform for educating medical professionals based on Radiology cases.

  14. Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review

    Science.gov (United States)

    Garewal, Devinder; Evans, Mathew; Taylor, David; Hoy, Gregory A.; Barwood, Shane; Connell, David

    2013-01-01

    Background To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability. Methods Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography. Results Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm2 reconstituted surgically by a bone block of 225.4 (73.8) mm2. Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy. PMID:27582905

  15. Evaluation of temporal difference limen in preoperative non-invasive ear canal audiometry as a predictive factor for speech perception after cochlear implantation

    Directory of Open Access Journals (Sweden)

    Saku T. Sinkkonen

    2014-03-01

    Full Text Available The temporal difference limen (TDL can be measured with noninvasive electrical ear canal stimulation. The objective of the study wa to determine the role of preoperative TDL measurements in predicting patients’ speech perception after cochlear implantation. We carried out a retrospective chart analysis of fifty-four cochlear implant (CI patients with preoperative TDL and postoperative bisyllabic word recognition measurements in Helsinki University Central Hospital between March 1994 and March 2011. Our results show that there is no correlation between TDL and postoperative speech perception. However, patient’s advancing age correlates with longer TDL but notdirectly with poorer speech perception. The results are in line with previous results concerning the lack of predictive value of preoperativ TDL measurements in CI patients.

  16. Measurements of diagnostic examination performance using quantitative apparent diffusion coefficient and proton MR spectroscopic imaging in the preoperative evaluation of tumor grade in cerebral gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Server, Andres, E-mail: a.s.alonso@medisin.uio.no [Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo University Hospital-Ullevaal and University of Oslo, Kirkeveien 166, NO-0407 Oslo (Norway); Kulle, Bettina, E-mail: b.k.andreassen@medisin.uio.no [Department of Biostatistics, University of Oslo, Oslo (Norway); Gadmar, Oystein B., E-mail: gays@uus.no [Interventional Centre, Oslo University Hospital and Institute for Hospital Medicine, University of Oslo, Oslo (Norway); Josefsen, Roger, E-mail: roos@uus.no [Department of Neurosurgery, Oslo University Hospital-Ullevaal, Oslo (Norway); Kumar, Theresa, E-mail: thku@uus.no [Department of Pathology, Oslo University Hospital-Ullevaal, Oslo (Norway); Nakstad, Per H., E-mail: pena@uus.no [Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo University Hospital-Ullevaal and University of Oslo, Kirkeveien 166, NO-0407 Oslo (Norway)

    2011-11-15

    . Results: Statistical analysis demonstrated a threshold minimum ADC tumor value of 1.07 to provide sensitivity, specificity, PPV, and NPV of 79.7%, 60.0%, 88.7%, and 42.9% respectively, in determining high-grade gliomas. Threshold values of 1.35 and 1.78 for peritumoral Cho/Cr and Cho/NAA metabolite ratios resulted in sensitivity, specificity, PPV, and NPV of 83.3%, 85.1%, 41.7%, 97.6%, and 100%, 57.4%, 23.1% and 100% respectively for determining high-grade gliomas. Significant differences were noted in the ADC tumor values and ratios, peritumoral Cho/Cr and Cho/NAA metabolite ratios, and tumoral Cho/NAA ratio between low- and high-grade gliomas. The combination of mean ADC tumor value, maximum ADC tumor ratio, peritumoral Cho/Cr and Cho/NAA metabolite ratios resulted in sensitivity, specificity, PPV, and NPV of 91.5%, 100%, 100% and 60% respectively. Conclusion: Combining DWI and MRSI increases the accuracy of preoperative imaging in the determination of glioma grade. MRSI had superior diagnostic performance in predicting glioma grade compared with DWI alone. The predictive values are helpful in the clinical decision-making process to evaluate the histologic grade of tumors, and provide a means of guiding treatment.

  17. Carcinoid tumours of the lung and the ‘PEPPS’ approach: evaluation of preoperative bronchoscopic tumour debulking as preparation for subsequent parenchyma-sparing surgery

    Science.gov (United States)

    Neuberger, Michael; Hapfelmeier, Alexander; Schmidt, Michael; Gesierich, Wolfgang; Reichenberger, Frank; Morresi-Hauf, Alicia; Hatz, Rudolf A; Lindner, Michael

    2015-01-01

    Background Preoperative bronchoscopic tumour ablation has been suggested as a beneficial treatment for bronchopulmonary carcinoid tumours, although data regarding its effects and long-term outcome are lacking. Methods In our case-matched cohort study with 208 patients with bronchopulmonary carcinoid tumours we investigated the role of preoperative bronchoscopic interventions before subsequent surgery and analysed the safety of this Procedure of Endobronchial Preparation for Parenchyma-sparing Surgery (PEPPS) based on metastasis and recurrence rates as well as survival data from 1991 to 2010. The subsequent surgery was classified into parenchyma-sparing procedures and classical lobectomies, bilobectomies and pneumonectomies. Data were obtained from the tumour registry and medical reports. Outcomes were the frequency of parenchyma-sparing surgery after bronchoscopic treatment as well as rates of metastasis, recurrence and survival. Results 132 of 208 carcinoids were located centrally. Among them, 77 patients could be recanalised preoperatively. After bronchoscopic preparation, the rate of subsequent parenchyma-sparing surgery methods was higher (p=0.021). The effect was measured by the number of segments removed. The 10-year survival rate was 89% (typical carcinoids) and 68% (atypical carcinoids), respectively. After applying PEPPS, long-term survival was slightly higher (p=0.23). Metastasis and recurrence rates showed no relevant differences between the bronchoscopically treated or non-treated groups, or between the two types of surgery classes or between the PEPPS and non-PEPPS groups. Conclusions After preoperative bronchoscopic treatment, parenchyma-sparing surgery techniques can be applied more frequently. Furthermore, we detected no negative effects after PEPPS based on metastasis, recurrence and survival rates. PMID:26203359

  18. Evaluation of the radiologic potential due to the nuclear submarine visits to the Rio de Janeiro port; Avaliacao do impacto radiologico potencial relativo a visita de submarinos nucleares ao Porto do Rio de Janeiro

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Jose Francisco

    2004-07-01

    Brazil is signatory of international protocols related to the visit of nuclear-powered vessels, aircraft carriers and submarines to Brazilian ports. The submarines, during their stay in Brazilian ports, inform that there is no release of radioactive material to the environment. However, the possibility of occurrence of accidents with environmental releases from PWR reactors is real. Between 1993 and 2003, 13 nuclear submarines visited Brazilian ports. This work aimed to evaluate the potential impact due to the visits of nuclear-powered ships and submarines to the port of the city of Rio de Janeiro, in relation to releases of radioactive materials to the environment, considering both routine releases and accidental situations. The models selected to perform the assessments took into account the scenarios to be simulated. Simple, but conservative methodologies were used for the evaluation of routine releases. For accidental releases, the dynamics of the materials dispersion into the environment were considered. The present study was mainly focalized on the initial phase of an accident. The doses for the crew of the Brazilian navy ships, for IRD teams performing environmental monitoring, and for the population around the Guanabara Bay, close to the points of anchorage, were assessed. The results indicated that, in normal operational conditions, no significant radiological impact due to the visit of nuclear submarines to the port of the city of Rio de Janeiro is expected, even considering the occurrence of small routine radionuclide releases. The analysis of accidental releases, however, indicated that the submarines should be located at a minimum distance of 2,5 km from inhabited areas in the coast of the Guanabara Bay. The need for environmental control and training of the teams involved in the attendance of the submarines, during the period of their visit, was also considered. The need for revising the procedures for the preoperational surveys to be performed at the

  19. Radiology Aide. Instructor Key [and] Student Manual.

    Science.gov (United States)

    Hartwein, Jon; Dunham, John

    This manual can be used independently by students in secondary health occupations programs or by persons receiving on-the-job training in a radiology department. The manual includes an instructor's key that provides answers to the activity sheets and unit evaluations. The manual consists of the following five units: (1) orientation to radiology;…

  20. Radiology Aide. Instructor Key [and] Student Manual.

    Science.gov (United States)

    Hartwein, Jon; Dunham, John

    This manual can be used independently by students in secondary health occupations programs or by persons receiving on-the-job training in a radiology department. The manual includes an instructor's key that provides answers to the activity sheets and unit evaluations. The manual consists of the following five units: (1) orientation to radiology;…

  1. Radiological health aspects of uranium milling

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, D.R.; Stoetzel, G.A.

    1983-05-01

    This report describes the operation of conventional and unconventional uranium milling processes, the potential for occupational exposure to ionizing radiation at the mill, methods for radiological safety, methods of evaluating occupational radiation exposures, and current government regulations for protecting workers and ensuring that standards for radiation protection are adhered to. In addition, a survey of current radiological health practices is summarized.

  2. [Evaluation of preoperative non-invasive ventilation in thoracic surgery for lung cancer: the preOVNI study GFPC 12-01].

    Science.gov (United States)

    Paleiron, N; André, M; Grassin, F; Chouaïd, C; Venissac, N; Margery, J; Couturaud, F; Noël-Savina, E; Tromeur, C; Vinsonneau, U; Vedrine, L; Leroyer, C; Nowak, E; Berard, H; Thomas, P; Brouchet, L; Bagan, P; Fournel, P; Mottier, D; Robinet, G

    2013-03-01

    Surgical resection is the best treatment for stage I and II non-small cell lung cancer. Despite an improvement in the perioperative management of cancer patients and specialization of surgical teams, morbidity and mortality remains significant. Non-invasive ventilation (NIV) is an effective therapeutic option in hypercapnic respiratory failure. It also improves functional and gasometric parameters when undertaken before surgery. The objective of the preOVNI study is to demonstrate that preoperative non-invasive ventilation for 7 days, at home, reduces the postoperative respiratory and cardiovascular complications of lung resection surgery, in a high-risk population. A prospective, randomized, controlled open-labelled multicentric French study, under the supervision of the Groupe Français de Pneumocancérologie (GFPC), comparing 7 days of preoperative non-invasive ventilation with standard treatment. Inclusion criteria are: patients suitable for lobectomy or segmentectomy for primary bronchial carcinoma and presenting with obstructive or restrictive lung disease, obesity or chronic cardiac insufficiency. The primary criterion is a composite one, including all respiratory and cardiac complications. The number of patients is 150 in each treatment arm, 300 in total. We think that preoperative NIV will be able to reduce the rate of postoperative complications. If this objective is achieved, the management of these patients could be changed. Copyright © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  3. Development of a Method for Evaluating the Existing Patient Radiation Protection Protocols in Interventional Radiology Unit of University-Affiliated Hospitals in Isfahan

    Directory of Open Access Journals (Sweden)

    Parvaneh Shokrani

    2010-05-01

    Full Text Available Since the late 1960s, the use of interventional procedures utilizing radiology in medicine has increased significantly and continues to grow. There are also possible longer-term effects for surviving patients-mainly induction of cancers. The International Commission on Radiological Protection considers that there is no dose below which there is zero risk and therefore, minimizing the risk by confining the irradiation field and constraining the dose is highly desirable. There are a lot of national and international organs that work regarding radiation protection. These organs suggest a lot of code for patient radiation protection based on research and evidence. Per-sonnel dose monitoring is performed by the radiation safety officer but radiation protection of the patient is the responsibility of the physician and medical physicist. The aim of this research was the evaluation of patient radiation protection protocols in university hospitals in the city of Isfahan with respect to international protocols."nThis investigation was done in two interventional radiology units of Isfahan university-affiliated hospitals. The following international protocols related to patient protection were used as the standard protocols AAPM Report NO. 70, ICRP Publication 85, and IAEA SAFETY GUIDE No. RS-G-1.5. The recommendations of these protocols were ranked and classified into 3 questionnaires. These questionnaires included recommendations about factors that affect the dose to patients, factors that affect staff doses, and procurement. These questionnaires were used to evaluate the patient radiation protection protocols currently used in Isfahan university hospitals against the above international protocols. In this investigation, we used letter 'A' and 'B' for description of the two hospitals. "nFor interventional radiology units the following agreements and disagreements were observed when the local protocols were compared to the international

  4. Society of Interventional Radiology

    Science.gov (United States)

    ... REPORT IR QUARTERLY JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY NEWSLETTERS Practice Resources Practice Resources PRACTICE RESOURCES QUALITY ... REPORT IR QUARTERLY JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY NEWSLETTERS Practice Resources PRACTICE RESOURCES QUALITY IMPROVEMENT STANDARDIZED ...

  5. Interventional Radiology: Stroke

    Science.gov (United States)

    ... REPORT IR QUARTERLY JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY NEWSLETTERS Practice Resources Practice Resources PRACTICE RESOURCES QUALITY ... REPORT IR QUARTERLY JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY NEWSLETTERS Practice Resources PRACTICE RESOURCES QUALITY IMPROVEMENT STANDARDIZED ...

  6. Society of Interventional Radiology

    Science.gov (United States)

    ... Search Patient information Membership Directory (SIR login) Interventional Radiology General News Multiple procedure payment reduction (MPPR) rate ... contact Eleanore Moye . Learn more . American Board of Radiology Announces Maintenance of Certification Part 3: ABR diplomates ...

  7. Laenderyggens degeneration og radiologi

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Gosvig, Kasper Kjaerulf; Sonne-Holm, Stig

    2006-01-01

    and significant relationships between radiological findings and subjective symptoms have both been notoriously difficult to identify. The lack of consensus on clinical criteria and radiological definitions has hampered the undertaking of properly executed epidemiological studies. The natural history of LBP...

  8. Pre-operative anaemia.

    Science.gov (United States)

    Clevenger, B; Richards, T

    2015-01-01

    Pre-operative anaemia is a relatively common finding, affecting a third of patients undergoing elective surgery. Traditionally associated with chronic disease, management has historically focused on the use of blood transfusion as a solution for anaemia in the peri-operative period. Data from large series now suggest that anaemia is an independent risk associated with poor outcome in both cardiac and non-cardiac surgery. Furthermore, blood transfusion does not appear to ameliorate this risk, and in fact may increase the risk of postoperative complications and hospital length of stay. Consequently, there is a need to identify, diagnose and manage pre-operative anaemia to reduce surgical risk. Discoveries in the pathways of iron metabolism have found that chronic disease can cause a state of functional iron deficiency leading to anaemia. The key iron regulatory protein hepcidin, activated in response to inflammation, inhibits absorption of iron from the gastrointestinal tract and further reduces bioavailability of iron stores for red cell production. Consequently, although iron stores (predominantly ferritin) may be normal, the transport of iron either from the gastrointestinal tract or iron stores to the bone marrow is inhibited, leading to a state of 'functional' iron deficiency and subsequent anaemia. Since absorption from the gastrointestinal tract is blocked, increasing oral iron intake is ineffective, and studies are now looking at the role of intravenous iron to treat anaemia in the surgical setting. In this article, we review the incidence and impact of anaemia on the pre-operative patient. We explain how anaemia may be caused by functional iron deficiency, and how iron deficiency anaemia may be diagnosed and treated.

  9. Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase

    Science.gov (United States)

    Guerrero-Orriach, José Luis; Ariza-Villanueva, Daniel; Florez-Vela, Ana; Garrido-Sánchez, Lourdes; Moreno-Cortés, María Isabel; Galán-Ortega, Manuel; Ramírez-Fernández, Alicia; Alcaide Torres, Juan; Fernandez, Concepción Santiago; Navarro Arce, Isabel; Melero-Tejedor, José María; Rubio-Navarro, Manuel; Cruz-Mañas, José

    2016-01-01

    Purpose To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV) dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL) and neuronal enolase. Methods This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan. Levosimendan was administered preoperatively on the day before surgery. All patients were considered high risk of cardiac and perioperative renal complications. Cardiac function was assessed by echocardiography, renal function by urinary N-GAL levels, and the acute kidney injury scale. Neuronal damage was assessed by neuron-specific enolase levels. Results After surgery, no significant variations were found in mean and SE levels of N-GAL (14.31 [28.34] ng/mL vs 13.41 [38.24] ng/mL), neuron-specific enolase (5.40 [0.41] ng/mL vs 4.32 [0.61] ng/mL), or mean ± SD creatinine (1.06±0.24 mg/dL vs 1.25±0.37 mg/dL at 48 hours). RV dilatation decreased from 4.23±0.7 mm to 3.45±0.6 mm and pulmonary artery pressure from 58±18 mmHg to 42±19 mmHg at 48 hours. Conclusion Preoperative administration of levosimendan has shown a protective role against cardiac, renal, and neurological damage in patients with a high risk of multiple organ dysfunctions undergoing cardiac surgery. PMID:27143905

  10. Preoperative diagnosis and radiographic findings of a freely movable mucocele of the vermiform appendix

    Energy Technology Data Exchange (ETDEWEB)

    Shukunami, K.-I.; Kaneshima, M.; Kotsuji, F. [Fukui Medical Univ., Dept. of Obstetrics and Gynecology, Matsuoka-Cho, Yoshida-Gun, Fukui (Japan)

    2000-10-01

    Mucocele of the vermiform appendix is rarely diagnosed before surgery, although radiologic and ultrasonographic (US) findings have been reported. To our knowledge, there have been no previous reports of 2 different radiologic images of the cyst in the same patient during the preoperative period. We present 2 different shapes and locations of a freely movable mucocele of the appendix as it appeared before surgery. (author)

  11. Validation of the French version of the Amsterdam preoperative anxiety and information scale (APAIS)

    National Research Council Canada - National Science Library

    Maurice-Szamburski, Axel; Loundou, Anderson; Capdevila, Xavier; Bruder, Nicolas; Auquier, Pascal

    2013-01-01

    .... The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-report questionnaire comprising six questions that have been developed and validated to evaluate the preoperative anxiety of patients...

  12. Evaluation of preoperative high magnetic field motor functional MRI (3 Tesla) in glioma patients by navigated electrocortical stimulation and postoperative outcome.

    Science.gov (United States)

    Roessler, K; Donat, M; Lanzenberger, R; Novak, K; Geissler, A; Gartus, A; Tahamtan, A R; Milakara, D; Czech, T; Barth, M; Knosp, E; Beisteiner, R

    2005-08-01

    The validity of 3 Tesla motor functional magnetic resonance imaging (fMRI) in patients with gliomas involving the primary motor cortex was investigated by intraoperative navigated motor cortex stimulation (MCS). Twenty two patients (10 males, 12 females, mean age 39 years, range 10-65 years) underwent preoperative fMRI studies, performing motor tasks including hand, foot, and mouth movements. A recently developed high field clinical fMRI technique was used to generate pre-surgical maps of functional high risk areas defining a motor focus. Motor foci were tested for validity by intraoperative motor cortex stimulation (MCS) employing image fusion and neuronavigation. Clinical outcome was assessed using the Modified Rankin Scale. FMRI motor foci were successfully detected in all patients preoperatively. In 17 of 22 patients (77.3%), a successful stimulation of the primary motor cortex was possible. All 17 correlated patients showed 100% agreement on MCS and fMRI motor focus within 10 mm. Technical problems during stimulation occurred in three patients (13.6%), no motor response was elicited in two (9.1%), and MCS induced seizures occurred in three (13.6%). Combined fMRI and MCS mapping results allowed large resections in 20 patients (91%) (gross total in nine (41%), subtotal in 11 (50%)) and biopsy in two patients (9%). Pathology revealed seven low grade and 15 high grade gliomas. Mild to moderate transient neurological deterioration occurred in six patients, and a severe hemiparesis in one. All patients recovered within 3 months (31.8% transient, 0% permanent morbidity). The validation of clinically optimised high magnetic field motor fMRI confirms high reliability as a preoperative and intraoperative adjunct in glioma patients selected for surgery within or adjacent to the motor cortex.

  13. Evaluation of a new electronic preoperative reference marker for toric intraocular lens implantation by two different methods of analysis: Adobe Photoshop versus iTrace.

    Science.gov (United States)

    Farooqui, Javed Hussain; Sharma, Mansi; Koul, Archana; Dutta, Ranjan; Shroff, Noshir Minoo

    2017-01-01

    The aim of this study is to compare two different methods of analysis of preoperative reference marking for toric intraocular lens (IOL) after marking with an electronic marker. Cataract and IOL Implantation Service, Shroff Eye Centre, New Delhi, India. Fifty-two eyes of thirty patients planned for toric IOL implantation were included in the study. All patients had preoperative marking performed with an electronic preoperative two-step toric IOL reference marker (ASICO AE-2929). Reference marks were placed at 3-and 9-o'clock positions. Marks were analyzed with two systems. First, slit-lamp photographs taken and analyzed using Adobe Photoshop (version 7.0). Second, Tracey iTrace Visual Function Analyzer (version 5.1.1) was used for capturing corneal topograph examination and position of marks noted. Amount of alignment error was calculated. Mean absolute rotation error was 2.38 ± 1.78° by Photoshop and 2.87 ± 2.03° by iTrace which was not statistically significant (P = 0.215). Nearly 72.7% of eyes by Photoshop and 61.4% by iTrace had rotation error ≤3° (P = 0.359); and 90.9% of eyes by Photoshop and 81.8% by iTrace had rotation error ≤5° (P = 0.344). No significant difference in absolute amount of rotation between eyes when analyzed by either method. Difference in reference mark positions when analyzed by two systems suggests the presence of varying cyclotorsion at different points of time. Both analysis methods showed an approximately 3° of alignment error, which could contribute to 10% loss of astigmatic correction of toric IOL. This can be further compounded by intra-operative marking errors and final placement of IOL in the bag.

  14. Can pre-operative computed tomography predict the need for a thoracic approach for removal of retrosternal goitre?

    Science.gov (United States)

    Qureishi, Ali; Garas, George; Tolley, Neil; Palazzo, Fausto; Athanasiou, Thanos; Zacharakis, Emmanouil

    2013-01-01

    A best evidence topic was written according to a structured protocol. The question addressed was whether in patients with retrosternal goitre the need for a thoracic approach can be predicted using pre-operative CT. A total of 381 papers were identified using the reported search protocol of which 7 represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group studied, study type, relevant outcomes and results are tabulated. The evidence on this subject is poor, none of the studies were randomised, only one used controls (historical) and all studies were retrospective. Despite these limitations, CT represents the gold-standard imaging modality in the pre-operative evaluation of patients with retrosternal goitre. CT is essential to define the extent and position of a retrosternal goitre. The literature suggests that CT is the single most valuable pre-operative investigation predicting whether a sternotomy or lateral thoracotomy will be necessary for removal of the retrosternal goitre. Although pre-operative CT does not have the precision to predict whether a thoracic approach is required in all cases, the presence of certain radiological features such as extension of the goitre below the aortic arch or into the posterior mediastinum, a dumbbell shape and a thoracic component that is wider than the thoracic inlet are all associated with the need for a thoracic approach. In some cases a pre-operative CT will not only determine that a thoracic approach is mandatory but it will also guide the surgeon upon the type of thoracic approach.

  15. Diagnosis of periprosthetic infection following total hip arthroplasty – evaluation of the diagnostic values of pre- and intraoperative parameters and the associated strategy to preoperatively select patients with a high probability of joint infection

    Directory of Open Access Journals (Sweden)

    Perka Carsten

    2008-07-01

    Full Text Available Abstract Background The correct diagnosis of a prosthetic joint infection (PJI is crucial for adequate surgical treatment. The detection may be a challenge since presentation and preoperative tests are not always obvious and precise. This prospective study was performed to evaluate a variety of pre- and intraoperative investigations. Furthermore a detailed evaluation of concordance of each preoperative diagnosis was performed, together with a final diagnosis to assess the accuracy of the pre-operative assumption of PJI. Methods Between 01/2005 and 02/2007, a prospective analysis was performed in 50 patients, who had a two stage revision because of assumed PJI. Based on clinical presentation, radiography, haematological screening, or early failure, infection was assumed and a joint aspiration was performed. Depending upon these findings, a two stage revision was performed, with intra-operative samples for culture and histological evaluation obtained. Final diagnosis of infection was based upon the interpretation of the clinical presentation and the pre- and intraoperative findings. Results In 37 patients a positive diagnosis of PJI could be made definitely. The histopathology yielded the highest accuracy (0.94 in identification of PJI and identified 35 of 37 infections (sensitivity 0.94, specificity 0.94, positive-/negative predictive value 0.97/0.86. Intra-operative cultures revealed sensitivities, specificities, positive-/negative predictive values and accuracy of 0.78, 0.92, 0.96, 0.63 and 0.82. These values for blood screening tests were 0.95, 0.62, 0.88, 0.80, and 0.86 respectively for the level of C-reactive protein, and 0.14, 0.92, 0.83, 0.29 and, 0.34 respectively for the white blood-cell count. The results of aspiration were 0.57, 0.5, 0.78, 0.29, and 0.54. Conclusion The detection of PJI is still a challenge in clinical practice. The histopathological evaluation emerges as a highly practical diagnostic tool in detection of PJI

  16. Establishing a general practitioner led minor injury service: mixed methods evaluation at 10 months with an emphasis on use of radiology by GPs in the out-of-hours setting.

    LENUS (Irish Health Repository)

    Redmond, P

    2013-06-01

    A mixed methods study was conducted to evaluate a recently established general practitioner (GP) led minor injury (MI) service; it included a patient feedback study, a qualitative enquiry into the experience of the MI GPs, and analysis of use of radiology.

  17. Terminal valve of sapheno-femoral junction: a comparative assessment between pre-operative color-duplex ultrasound and intra-operative evaluation

    Directory of Open Access Journals (Sweden)

    Attilio Cavezzi

    2013-01-01

    Full Text Available According to literature data, up to 59% of incompetent great saphenous veins (GSV have no reflux at the terminal valve (TV of the saphenofemoral junction (SFJ. The aim was to compare color duplex ultrasound (CDU investigation and direct intra-operative assessment of competence of the TV at SFJ. A prospective comparative study was performed on 28 patients, who consecutively presented for surgical intervention for their primary varicose veins of the lower limbs with GSV incompetence. CDU assessment was performed pre-operatively to define GSV and SFJ terminal valve morphology and hemodynamics. Under local anesthesia these patients underwent SFJ disconnection (crossectomy and segmental inverted saphenous stripping of the incompetent GSV tract + phlebectomy of the varicose tributaries. SFJ disconnection was performed in four stages in an ascending fashion: I division of GSV below the lower SFJ tributaries, II disconnection of lower SFJ tributaries, III disconnection of upper tributaries, IV flush to CFV ligature of GSV stump. After the completion of stage I, the SFJ stump was opened and kept open when needed throughout the subsequent stages, in order to highlight any possible blood leak through the SFJ stump. To highlight intraoperative blood leak from SFJ stump visual observation was carried out both during respiration and when performing Valsalva maneuver and manual compression of homolateral iliac fossa. As to pre-operative CDU all limbs showed GSV reflux and they were divided in two groups according to TV competence (group A or incompetence (group B. Group A comprised 18 patients (6 M and 12 F, mean age 50.6 years. Group B included 10 patients (4 M and 6 F, mean age 54.8 years. Mean calibre of GSV at proximal/mid thigh was 6.4 mm in group A and 7.8 in group B. Concerning the intra-operative findings: in the group A, 5 patients had blood leak in the SFJ stump after stage I, 4 patients showed blood leak after stage II. After completion of stage III

  18. Preoperative anxiety in neurosurgical patients.

    Science.gov (United States)

    Perks, Anna; Chakravarti, Sucharita; Manninen, Pirjo

    2009-04-01

    Anxiety is common in surgical patients, with an incidence of 60% to 92%. There is little information on the incidence and severity of preoperative anxiety in patients scheduled for neurosurgery. The aim of this study was to measure the level of preoperative anxiety in neurosurgical patients and to assess any influencing factors. After the Institutional Review Board approval and informed written consent, 100 patients booked for neurosurgery were interviewed preoperatively. Each patient was asked to grade their preoperative anxiety level on a verbal analog scale, Amsterdam Preoperative Anxiety and Information Scale, and a set of specific anxiety-related questions. The anxiety scores and the responses to the questions were compared between the sex, age, weight, diagnosis, and history of previous surgery. The mean age (+/-SD) was 50+/-13 years. The preoperative diagnosis was tumor (n=64), aneurysm (n=14), and other (n=22). Overall verbal analog scale was 5.2+/-2.7; the score was higher for female (5.8+/-2.8) than male patients (4.6+/-2.5) (PAmsterdam Preoperative Anxiety and Information Scale anxiety and knowledge scores were greater for surgery than for anesthesia. Questionnaire results showed that the most common anxieties were waiting for surgery, physical/mental harm, and results of the operation. In conclusion, our study showed that neurosurgical patients have high levels of anxiety, with a higher incidence in females. There was a moderately high need for information, particularly in patients with a high level of preoperative anxiety.

  19. Radiology of bacterial pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Vilar, Jose E-mail: vilar_jlu@gva.es; Domingo, Maria Luisa; Soto, Cristina; Cogollos, Jonathan

    2004-08-01

    Bacterial pneumonia is commonly encountered in clinical practice. Radiology plays a prominent role in the evaluation of pneumonia. Chest radiography is the most commonly used imaging tool in pneumonias due to its availability and excellent cost benefit ratio. CT should be used in unresolved cases or when complications of pneumonia are suspected. The main applications of radiology in pneumonia are oriented to detection, characterisation and follow-up, especially regarding complications. The classical classification of pneumonias into lobar and bronchial pneumonia has been abandoned for a more clinical classification. Thus, bacterial pneumonias are typified into three main groups: Community acquired pneumonia (CAD), Aspiration pneumonia and Nosocomial pneumonia (NP).The usual pattern of CAD is that of the previously called lobar pneumonia; an air-space consolidation limited to one lobe or segment. Nevertheless, the radiographic patterns of CAD may be variable and are often related to the causative agent. Aspiration pneumonia generally involves the lower lobes with bilateral multicentric opacities. Nosocomial Pneumonia (NP) occurs in hospitalised patients. The importance of NP is related to its high mortality and, thus, the need to obtain a prompt diagnosis. The role of imaging in NP is limited but decisive. The most valuable information is when the chest radiographs are negative and rule out pneumonia. The radiographic patterns of NP are very variable, most commonly showing diffuse multifocal involvement and pleural effusion. Imaging plays also an important role in the detection and evaluation of complications of bacterial pneumonias. In many of these cases, especially in hospitalised patients, chest CT must be obtained in order to better depict these associate findings.

  20. Negative predictive value of preoperative computed tomography in determining pathologic local invasion, nodal disease, and abdominal metastases in gastric cancer

    Science.gov (United States)

    Kagedan, D.J.; Frankul, F.; El-Sedfy, A.; McGregor, C.; Elmi, M.; Zagorski, B.; Dixon, M.E.; Mahar, A.L.; Vasilevska-Ristovska, J.; Helyer, L.; Rowsell, C.; Swallow, C.J.; Law, C.H.; Coburn, N.G.

    2016-01-01

    Background Before undergoing curative-intent resection of gastric adenocarcinoma (ga), most patients undergo abdominal computed tomography (ct) imaging to determine contraindications to resection (local invasion, distant metastases). However, the ability to detect contraindications is variable, and the literature is limited to single-institution studies. We sought to assess, on a population level, the clinical relevance of preoperative ct in evaluating the resectability of ga tumours in patients undergoing surgery. Methods In a provincial cancer registry, 2414 patients with ga diagnosed during 2005–2008 at 116 institutions were identified, and a primary chart review of radiology, operative, and pathology reports was performed for all patients. Preoperative abdominal ct reports were compared with intraoperative findings and final pathology reports (reference standard) to determine the negative predictive value (npv) of ct in assessing local invasion, nodal involvement, and intra-abdominal metastases. Results Among patients undergoing gastrectomy, the npv of ct imaging in detecting local invasion was 86.9% (n = 536). For nodal metastasis, the npv of ct was 43.3% (n = 450). Among patients undergoing surgical exploration, the npv of ct for intra-abdominal metastases was 52.3% (n = 407). Conclusions Preoperative abdominal ct imaging reported as negative is most accurate in determining local invasion and least accurate in nodal assessment. The poor npv of ct should be taken into account when selecting patients for staging laparoscopy. PMID:27536178

  1. Poul Erik Andersen's radiological work on Osteochondrodysplasias and interventional radiology

    DEFF Research Database (Denmark)

    Andersen, Poul Erik

    2011-01-01

    Hospital. His significant experience and extensive scientific work has led to many posts in the Danish Society of Interventional Radiology, the European Society of Radiology and the Cardiovascular and Interventional Radiological Society of Europe, where he is a fellow and has passed the European Board...... of Interventional Radiology - The European qualification in Interventional Radiology....

  2. Evaluation of the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer, according to the American College of Radiology criteria

    Science.gov (United States)

    Boaventura, Camila Silva; Rodrigues, Daniel Padilha; Silva, Olimpio Antonio Cornehl; Beltrani, Fabrício Henrique; de Melo, Rayssa Araruna Bezerra; Bitencourt, Almir Galvão Vieira; Mendes, Gustavo Gomes; Chojniak, Rubens

    2017-01-01

    Objective To evaluate the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer. Materials and Methods This was a retrospective, single-center study, conducted by reviewing medical records and imaging reports. We included 1060 female patients who underwent magnetic resonance imaging of the pelvis at a cancer center between January 2013 and June 2014. The indications for performing the examination were classified according to the American College of Radiology (ACR) criteria. Results The mean age of the patients was 52.6 ± 14.8 years, and 49.8% were perimenopausal or postmenopausal. The majority (63.9%) had a history of cancer, which was gynecologic in 29.5% and nongynecologic in 34.4%. Of the patients evaluated, 44.0% had clinical complaints, the most common being pelvic pain (in 11.5%) and bleeding (in 9.8%), and 34.7% of patients had previously had abnormal findings on ultrasound. Most (76.7%) of the patients met the criteria for undergoing magnetic resonance imaging, according to the ACR guidelines. The main indications were evaluation of tumor recurrence after surgical resection (in 25.9%); detection and staging of gynecologic neoplasms (in 23.3%); and evaluation of pelvic pain or of a mass (in 17.1%). Conclusion In the majority of the cases evaluated, magnetic resonance imaging was clearly indicated according to the ACR criteria. The main indication was local recurrence after surgical treatment of pelvic malignancies, which is consistent with the routine protocols at cancer centers. PMID:28298725

  3. Evaluation of the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer, according to the American College of Radiology criteria.

    Science.gov (United States)

    Boaventura, Camila Silva; Rodrigues, Daniel Padilha; Silva, Olimpio Antonio Cornehl; Beltrani, Fabrício Henrique; de Melo, Rayssa Araruna Bezerra; Bitencourt, Almir Galvão Vieira; Mendes, Gustavo Gomes; Chojniak, Rubens

    2017-01-01

    To evaluate the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer. This was a retrospective, single-center study, conducted by reviewing medical records and imaging reports. We included 1060 female patients who underwent magnetic resonance imaging of the pelvis at a cancer center between January 2013 and June 2014. The indications for performing the examination were classified according to the American College of Radiology (ACR) criteria. The mean age of the patients was 52.6 ± 14.8 years, and 49.8% were perimenopausal or postmenopausal. The majority (63.9%) had a history of cancer, which was gynecologic in 29.5% and nongynecologic in 34.4%. Of the patients evaluated, 44.0% had clinical complaints, the most common being pelvic pain (in 11.5%) and bleeding (in 9.8%), and 34.7% of patients had previously had abnormal findings on ultrasound. Most (76.7%) of the patients met the criteria for undergoing magnetic resonance imaging, according to the ACR guidelines. The main indications were evaluation of tumor recurrence after surgical resection (in 25.9%); detection and staging of gynecologic neoplasms (in 23.3%); and evaluation of pelvic pain or of a mass (in 17.1%). In the majority of the cases evaluated, magnetic resonance imaging was clearly indicated according to the ACR criteria. The main indication was local recurrence after surgical treatment of pelvic malignancies, which is consistent with the routine protocols at cancer centers.

  4. The evaluation of the clinical, laboratory and the radiological findings of the fifty-five cases diagnosed with tuberculous, Brucellar and pyogenic spondylodiscitis

    Directory of Open Access Journals (Sweden)

    Kadriye Yasar

    2012-01-01

    Full Text Available Objective: In this study, the evaluation of the clinical, laboratory and radiological findings belonging to 55 cases that were hospitalized in our clinic to be followed-up and were diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis (SD was aimed. Materials and Methods: The cases with SD were evaluated retrospectively. Hematological, serological, biochemical laboratory tests and imaging technics were used for diagnosis. Results: Of 55 cases aged ranging between 25 to 79, 33 (59% were female. The cases with tuberculous SD (TBSD, brucellar SD (BSD and pyogenic SD (PSD were found in 24 (43%, 12 (21% and in 19 (34% patients.Erytrocyte sedimentation rate, increased C-reactive protein, and leucocytosis were present in 51 (91%, 22 (39% and 8 (14% cases. The number of the cases with history of previous surgery or trauma was 14 (25%. Diagnosis of TBSD was established by acid fast bacilli positiveness and Löwenstein Jensen culture positiveness, in two and seven patients, respectively. While all 12 cases with BSD had positive standard tube aglutination test, only 3 (25% had hemoculture positivity. In PSDs, diagnosis was confirmed with culture positivity in 9 of 19 cases.Of the cases in our study, 89% responded to medical treatment while three required surgery and three died (5.5% and 5.5%, respectively. Conclusion: SD may develop secondary to infections or following spinal surgical procedures and traumas. Also, the importance of endemicity should be kept in mind, beside the helpful diagnostic findings while treatment regulation.

  5. Radiological survey and evaluation of the fallout area from the Trinity test: Chupadera Mesa and White Sands Missile Range, New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, W.R.; Rodgers, J.C.

    1985-06-01

    Current radiological conditions were evaluated for the site of the first nuclear weapons test, the Trinity test, and the associated fallout zone. The test, located on White Sands Missile Range, was conducted as part of the research with nuclear materials for the World War II Manhattan Engineer District atomic bomb project. Some residual radioactivity attributable to the test was found in the soils of Ground Zero on White Sands Missile Range and the areas that received fallout from the test. The study considered relevant information including historical records, environmental data extending back to the 1940s, and new data acquired by field sampling and measurements. Potential exposures to radiation were evaluated for current land uses. Maximum estimated doses on Chupadera Mesa and other uncontrolled areas are less than 3% of the DOE Radiation Protection Standards (RPSs). Radiation exposures during visits to the US Army-controlled Ground Zero area are less than 1 mrem per annual visit or less than 0.2% of the RPS for a member of the public. Detailed data and interpretations are provided in appendixes. 14 figs., 45 tabs.

  6. Evaluation of critical pathways, radionuclides, and remedial measures for reducing the radiological dose to returning populations at a former nuclear test site

    Energy Technology Data Exchange (ETDEWEB)

    Robison, W. L., LLNL

    1997-11-01

    Bikini Island, the major residence island at Bikini Atoll, was contaminated with radioactive fallout as a result of the BRAVO test conducted on March 1, 1954. We have identified the critical radionuclides and supplied radiological data needed to develop dose estimates for all possible exposure pathways. These estimates show that the major dose to returning populations would result from ingestion of cesium-137 (137 Cs) in locally grown terrestrial foods where the predicted population average effective dose exceeds current federal guidelines. Consequently, we designed several long-term field experiments to develop and evaluate methods to reduce the 137 Cs content in locally grown foods.This paper gives a general outline of the remediation experiments with a more detailed description of a preferred combined option. Our comparative evaluation on various remedial methods show that the combined option--potassium treatment of the entire islands with limited excavation of soil in village an d housing areas--will be effective in reducing the dose to about 10% of pretreatment levels, and offers very significant benefits with respect to adverse environmental impacts as well as savings in overall costs, time, and required expert resources.

  7. Machine Learning and Radiology

    Science.gov (United States)

    Wang, Shijun; Summers, Ronald M.

    2012-01-01

    In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. PMID:22465077

  8. Radiological Emergency Response Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — Quality Data Asset includes all current and historical emergency radiological response event and incident of national significance data and surveillance, monitoring,...

  9. Avaliação de um sistema de segunda opinião em radiologia Evaluation of a second opinion system in radiology

    Directory of Open Access Journals (Sweden)

    Ricardo Alfredo Quintano Neira

    2010-06-01

    Full Text Available OBJETIVO: A segunda opinião médica pode auxiliar no processo de investigação do problema de saúde de um paciente e na definição da conduta terapêutica. Este trabalho tem por objetivo demonstrar um processo de segunda opinião médica por meio de um sistema web multiespecialidades adaptado para a radiologia. MATERIAIS E MÉTODOS: O sistema foi utilizado por 49 médicos residentes da Universidade Federal de São Paulo, os quais responderam a 52 solicitações de segunda opinião. Como instrumentos de avaliação foram utilizados questionários. RESULTADOS: Foram avaliadas 1.704 respostas de segunda opinião. Deste total, 514 (29,1% foram definidas como satisfatórias. Em 64,4% as respostas dos questionários indicaram que a qualidade das imagens não comprometeu o diagnóstico. O tempo médio para emitir a segunda opinião remota foi de 6 minutos e 26 segundos. CONCLUSÃO: O processo de segunda opinião médica realizado por intermédio de um sistema web multiespecialidades ajustado para a radiologia pode ser uma excelente ferramenta para o manejo das condutas médicas.OBJECTIVE: A second medical opinion can aid in the investigation of a health problem as well as in the definition of the therapeutic approach. The present study is aimed at demonstrating a process of second medical opinion by means of a web-based multispecialty system adapted for radiology. MATERIALS AND METHODS: The system was utilized by 49 residents at Universidade Federal de São Paulo, Brazil, who gave their medical opinion on 52 second opinion requests. Questionnaires were utilized as an evaluation tool. RESULTS: A total of 1704 medical second opinions were evaluated and 514 (29.1% of them were defined as satisfactory. In 64.4% of cases, the answers of the questionnaires indicated that the images quality did not affect the diagnosis. On average, 6 minutes and 26 seconds was the time required to issue a remote second medical opinion. CONCLUSION: A process of second

  10. The role of anxiolytic premedication in reducing preoperative anxiety.

    LENUS (Irish Health Repository)

    Carroll, Jennifer K

    2012-01-01

    Prevention of preoperative anxiety with anxiolytic premedication is associated with improved preoperative outcomes in surgical patients. The objective of the authors\\' study was to evaluate the percentage of surgical patients that are prescribed premedication for preoperative anxiety before their anticipated surgical procedure. A prospective study was carried out by theatre nursing staff in the theatre reception bay of a university teaching hospital. A questionnaire was designed to record the number of patients that described symptoms consistent with preoperative anxiety. The number of patients that had been offered anxiolytic premedication for preoperative anxiety was also recorded. Consent was obtained from 115 consecutive surgical patients (male, n=52; female, n=63). Of these, 66% (n=76) reported anxiety before their surgical procedure (male: n=27, female: n=49). Premedication with a low-dose benzodiazepine was prescribed by an anaesthetist in 4% of cases (n=5). Patients that received premedication preoperatively reported effective relief of their anxiety symptoms This study demonstrates that preoperative patient anxiety is highly prevalent. The authors\\' findings suggest that premedication with anxiolytic pharmacological therapy may be an underused therapeutic resource for managing preoperative patient anxiety.

  11. High-resolution CT: pre-operative assessment of chronic and recurrent rhinosinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Ferrie, J.C. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Vandermarcq, P. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Azais, O. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Klossek, J.M. [Dept. of Oto-Rhino-Laryngology, University Hospital, 86 Poitiers (France); Drouineau, J. [Dept. of Radiology A, University Hospital, 86 Poitiers (France)

    1993-04-01

    The better understanding of chronic and recurrent rhinosinusitis and the advance in endoscopic endonasal surgery have modified the radiological pre-operative investigation of this condition. The ethmoid labyrinth, not accessible to the endoscope, may be explored by axial and coronal high-resolution thin section (2 mm) CT. We have reviewed 100 CT scans with endoscopic correlation in order to assess the accuracy of this pre-operative method. This anatomical study reveals the presence and extent of parasinus diseases which are usually concentrated in the area of the ostiomeatal unit. The anatomic variations of the lateral nasal wall that have been reporded as predisposing to sinusitis and the morphologic variations altering the relationships of the ethmoid with the orbits and the brain were also studied. This pre-operative radiological assessment is currently necessary for functional and safe surgery. (orig.)

  12. Evaluation of personal protective devices used in diagnostic radiology; Avaliacao de dispositivos de protecao individual utilizados em radiologia diagnostica

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Fernanda Cristina Salvador

    2006-07-01

    In this work protective devices of five manufacturers were evaluated according to the NBR/IEC 61331-1 and NBR/IEC 61331-3 standards. Three different methodologies (linear interpolation, Archer model and sum of exponentials) were applied for the determination of the attenuation equivalent, since the standard does not indicate how it must be determined. Moreover, the uncertainties associated to each method, and the influence of the number of measurements in the combined uncertainty were estimated. The evaluated manufacture characteristics were: accompanying document, design, materials, dimensions and label marking. For this evaluation a check list about the requirements of the NBR/IEC 61331-3 standard was elaborated. The results showed a great difference between nominal and measured attenuation equivalent values. The comparison of the results using the three methodologies showed small variations among the obtained values and among the associated uncertainties in the different methodologies. It was possible to observe that the number of measurements does not contribute significantly for the increase of the uncertainty in all three methodologies. The best methodology for the laboratory routine is the linear interpolation methodology, with five measurements for each air kerma rate value. The discrepancy between the results obtained in this work and the requirements of the applied standards show the need to adopt a compulsory certification process for protective devices, thus contributing for the increase of the radiation protection of the users. (author)

  13. American College of Radiology

    Science.gov (United States)

    American College of Radiology Login About Us Media Center Contact Us Follow us Shopping Cart (0) ACR Catalog Donate My ACR Join ACR ... ACR Catalog Education Center eLearning Exams & Assessments AIRP™ Radiology Leadership Institute ® Quality & Safety Accreditation Appropriateness Criteria ® Practice ...

  14. Physics of Radiology

    CERN Document Server

    Johns, Harold Elford

    1983-01-01

    Authority, comprehensivity and a consummate manner of presentation have been hallmarks of The Physics of Radiology since it first saw publication some three decades past. This Fourth Edition adheres to that tradition but again updates the context. It thoroughly integrates ideas recently advanced and practices lately effected. Students and professionals alike will continue to view it, in essence, as the bible of radiological physics.

  15. Radiological diagnosis of aggressive fibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmann, W.; Galanski, M.; Peters, P.E.; Timm, C.

    1986-11-01

    Aggressive fibromatosis (desmoid, desmoid tumour) resembles, in its infiltrating and destructive growth, a fibrosarcoma, but does not metastasise. Because of its high recurrence rate, the tumour remains a surgical problem. Various imaging methods were evaluated retrospectively in 23 patients with histologically confirmed aggressive fibromatosis. Conventional radiological procedures are poor at demonstrating the extent and type of tumour. Modern tomographic methods are more able to determine the size of the lesion and a combination of angiography and CT can frequently provide a definite diagnosis.

  16. Evaluation of radiologic findings in neonates with hirschprung's disease, referred to Boo-Ali Sina Hospital in Sari between 2008 and 2009

    Directory of Open Access Journals (Sweden)

    Abdolrasoul Alaee

    2009-01-01

    Full Text Available (Received 9 September, 2009 ; Accepted 9 November, 2009AbstractBackground and purpose: Diagnosis of Hirschprung's disease is one of the most important problems of pediatric surgeons and leaving it without treatment has its own complications. Early diagnosis in younger age with special attention to clinical and radiological findings can reduce these complications. The aim of this study was to compare the findings of plain abdominal radiography and contrast enema in neonates with Hirschprung's disease.Materials and methods: Twenty seven neonates referred to Boo-Ali Sina Hospital, in Sari (2007-2009 for Hirschprung's disease underwent abdominal X-ray and barium enema, and the findings were evaluated followed by rectal biopsy was. In all cases, radiological and barium enema findings were seen by a radiologist, and in each view presence of serration in colon, distention of colon, absence of gas in colon, small intestinal distention, soap bubble and mottling in RLQ of abdomen, delay on barium transit, recto-sigmoid index, absence or present of TZ (Transitional Zone were assessed. Data were analyzed using SPSS 16 software. Chi-Square test and descriptive statistical methods were used for comparing abdominal X-ray and barium enema effectiveness for differentiating patients with Hirschprung's disease.Results: The findings in plain abdominal radiography were: colonic distention and TZ (82.59%, absence of gas in rectum (48.15%, small bowel distention (7.41%, soap bubble pattern (3.7% and mottling in RLQ (3.7%. In contrast the findings of enema of neonates were: distention (70.3%, delayed barium transition (59.2%, transitional zone (55.5%, barium-fecal mixing (22.2%, micro colon (7.4% and serration (3.7%.Conclusion: A plain abdominal radiography is reliable and useful in diagnosis of the disease in patients with failed contrast enema. Key words: Hirschprung's disease, neonate, plain abdominal radiography and contrast enema J Mazand Univ Med Sci 2009; 20

  17. Evaluation of the nuclear and radiological emergency response system in Brazil; Visao critica do sistema de atendimento a emergencia radiologica e nuclear no Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Estrada, Julio J.S.; Azevedo, Eduardo M.; Knoefel, Tom M.J. [Instituto de Radioprotecao e Dosimetria (IRD), Rio de Janeiro, RJ (Brazil)

    1997-12-31

    Brazilian Nuclear Energy Commission (CNEN) has made outstanding efforts to improve its nuclear and radiological accident response system since the tragic accident in Goiania, Brazil. Most of these efforts are related to nuclear emergency although radiological accidents are also considered. Several topics are discussed involving those related to planning and preparedness. Some deficiencies that need to be corrected or improved are pointed out 8 refs.

  18. The potential use of Chernobyl fallout data to test and evaluate the predictions of environmental radiological assessment models

    Energy Technology Data Exchange (ETDEWEB)

    Richmond, C.R.; Hoffman, F.O.; Blaylock, B.G.; Eckerman, K.F.; Lesslie, P.A.; Miller, C.W.; Ng, Y.C.; Till, J.E.

    1988-06-01

    The objectives of the Model Validation Committee were to collaborate with US and foreign scientists to collect, manage, and evaluate data for identifying critical research issues and data needs to support an integrated assessment of the Chernobyl nuclear accident; test environmental transport, human dosimetric, and health effects models against measured data to determine their efficacy in guiding decisions on protective actions and in estimating exposures to populations and individuals following a nuclear accident; and apply Chernobyl data to quantifications of key processes governing the environmental transport, fate and effects of radionuclides and other trace substances. 55 refs.

  19. Evaluation and significance of preoperative pulmonary function in patients with lung cancer%肺癌患者手术前肺功能的综合评判及其临床意义

    Institute of Scientific and Technical Information of China (English)

    张敬强

    2013-01-01

    目的 探讨术前肺功能评价对老年肺癌手术的临床意义.方法 回顾分析50例50岁以上肺癌患者的手术情况,统计和分析患者术前肺功能对手术治疗的影响.结果 术后并发症12例(24%),肺功能正常的33例患者中,心电图异常1例,术后出血1例.肺功能轻度异常者8例,并发肺炎3例;肺功能中度异常者7例,并发症5例,为肺炎合并Ⅱ型呼吸衰竭;肺功能重度异常2例,并发症2例,为肺炎合并呼吸衰竭而死亡.术前肺功能越差,术后危险性越高.并发症的发生率与术前肺功能指标相比,差异有统计学意义(P<0.05).结论 肺功能检查已成为心胸外科必要的一种检查手段,老年肺癌手术前应行综合评估肺功能情况.术前肺功能指标评估对于估计术后并发症、决定手术切除范围、病死率和生活质量等均有临床指导意义.%Objective To investigate the clinical significance of preoperative pulmonary function evaluation in elderly patients with lung cancer.Methods Retrospectively analysis of 50 cases of surgical treatment for lung cancer patients over 50 years old was made,and the effects of preoperative pulmonary function in patients with lung cancer was analyzed.Results The postoperative complications occured in 12 cases(24%).Among the 33 patients with normal lung functions,abnormal electrocardiogram in 1 case,postoperative hemorrhage in 1 case.There were 8 cases of mild abnormal pulmonary function,3 cases complicated with pneumonia complication.Moderately abnormal pulmonary function in 7 cases,complicated with type Ⅱ respiratory failure in 5 cases.Severe abnormal pulmonary function in 2 cases,complications of pneumonia with respiratory failure in 2 cases,all died.With preoperative pulmonary function more worse,the postoperative risk was more higher.The incidence of complications compared with preoperative pulmonary function index,the difference was statistically significant (P < 0.05).Conclusions

  20. Desperdício de exames complementares na avaliação pré-operatória em cirurgias de catarata Waste of medical tests in preoperative evaluation for cataract surgery

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Leite Arieta

    2004-02-01

    Full Text Available O objetivo deste experimento clínico foi determinar a freqüência dos exames considerados dispensáveis numa rotina pré-operatória de facectomias e avaliar os gastos com eles. Se o paciente foi sorteado para testes-seletivos, solicitou-se que nenhum teste fosse executado, a menos que o paciente apresentasse um novo problema médico, ou piora de uma doença preexistente, a qual requeresse os testes independentemente da realização da cirurgia. Para pacientes sorteados para testes-rotineiros, foram solicitados: eletrocardiograma, dosagem de hemoglobina e glicemia de jejum. Foram calculados os gastos com exames considerados desnecessários. A amostra de 1.025 pacientes incluiu 513 sorteados para testes seletivos e 512 para testes rotineiros. A freqüência de eventos adversos intra-operatórios foi semelhante nos dois grupos (p = 0,923. O grupo de testes seletivos realizou de 60,7% menos exames que o de testes rotineiros. Os resultados sugerem que a requisição seletiva de exames pré-operatórios em facectomias, além de não prejudicar o paciente do ponto de vista de complicações clínicas intra-operatórias, possibilita expressiva economia de recursos quando comparada à atual rotina.The objective of this clinical trial was to determine the frequency of medical tests considered unnecessary in routine preoperative evaluation for cataract surgery. Unnecessary costs with these tests were also evaluated. For patients assigned to the selective testing group, it was requested that no preoperative testing be performed unless the patient presented a new or worsening medical problem warranting medical evaluation with testing. For patients assigned to the routine testing group, three tests were requested: a 12-lead electrocardiogram, complete blood count, and serum glucose level. The costs of tests considered unnecessary were calculated. The sample of 1,025 patients consisted of 512 assigned to the routine testing group and 513 to the selective

  1. An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy.

    Science.gov (United States)

    Leung, Ann N; Bull, Todd M; Jaeschke, Roman; Lockwood, Charles J; Boiselle, Phillip M; Hurwitz, Lynne M; James, Andra H; McCullough, Laurence B; Menda, Yusuf; Paidas, Michael J; Royal, Henry D; Tapson, Victor F; Winer-Muram, Helen T; Chervenak, Frank A; Cody, Dianna D; McNitt-Gray, Michael F; Stave, Christopher D; Tuttle, Brandi D

    2011-11-15

    Pulmonary embolism (PE) is a leading cause of maternal mortality in the developed world. Along with appropriate prophylaxis and therapy, prevention of death from PE in pregnancy requires a high index of clinical suspicion followed by a timely and accurate diagnostic approach. To provide guidance on this important health issue, a multidisciplinary panel of major medical stakeholders was convened to develop evidence-based guidelines for evaluation of suspected pulmonary embolism in pregnancy using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system. In formulation of the recommended diagnostic algorithm, the important outcomes were defined to be diagnostic accuracy and diagnostic yield; the panel placed a high value on minimizing cumulative radiation dose when determining the recommended sequence of tests. Overall, the quality of the underlying evidence for all recommendations was rated as very low or low, with some of the evidence considered for recommendations extrapolated from studies of the general population. Despite the low-quality evidence, strong recommendations were made for three specific scenarios: performance of chest radiography (CXR) as the first radiation-associated procedure; use of lung scintigraphy as the preferred test in the setting of a normal CXR; and performance of computed-tomographic pulmonary angiography (CTPA) rather than digital subtraction angiography (DSA) in a pregnant woman with a nondiagnostic ventilation-perfusion (V/Q) result. The recommendations presented in this guideline are based upon the currently available evidence; availability of new clinical research data and development and dissemination of new technologies will necessitate a revision and update.

  2. Comparative study between radiology and ultrasound in the evaluation of extracardiac thoracic diseases in dogs and cats

    Directory of Open Access Journals (Sweden)

    Sâmara Turbay Pires

    2015-12-01

    Full Text Available ABSTRACT: This study compared radiographic and B-mode and Doppler ultrasound exams of the thoracic cavity, excluding the heart, in canine and feline species, in which the radiographs revealed the formation of a potential acoustic window. The objectives were to demonstrate the advantages and limitations of each technique and to determine whether the additional information influenced the differential diagnosis as well as the outcome of each case. The advantages of B-mode ultrasonography included: better qualitative and quantitative evaluation of pleural effusions, an improved ability to determine whether a nodule was solid or cystic and easier determination of the location in the pulmonary parenchyma. The Power Doppler ultrasound evaluated the blood supply pattern of the nodules and masses and differentiated between vessels and fluid bronchogram. A limitation of the ultrasound examination was the need to be guided by the previous radiography. The advantages of the radiographic examination included the possibility of localizing pulmonary lesions at any depth in the absence of a pleural effusion and providing a panoramic view of the extent of the thoracic disease. The ultrasound examination influenced the differential diagnosis in 18 (62.06% cases and influenced the outcome of 8 (27.58% cases.

  3. 多层螺旋CT血管造影在胃癌规范性根治术术前评估中的价值%Preoperative Evaluation Value of Multislice Spiral Computed Tomography Angiography for Normative Radical Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    刘超; 黄源; 林进令

    2011-01-01

    Objective To explore the evaluation value of preoperative multislice spiral computed tomography angiography (MSCTA) for normative radical gastrectomy. Methods The anatomic distributions of celiac trunk and its three branches and their tributaries (common hepatic artery, right hepatic artery, left hepatic artery, splenic artery, and left gastric artery) of 86 patients with gastric cancer were comprehended by preoperative MSCTA, which were verified during the surgery. Simultaneously preoperative TNM staging was evaluated by MSCTA, which compared with postoperative pathological results. Results The accuracy rate of preoperative MSCTA evaluating the distribution of celiac trunk and its three branches and their tributaries was 100%. Abnormal hepatic arteries were found in 22 cases by MSCTA, the mutation rate was 25.58%. Abnormal right hepatic arteries were found in 11 cases (12.79%), abnormal left hepatic arteries in 7 cases (8.14%), both abnormal right and left hepatic arteries in 1 case (1.16%), and abnormal common hepatic arteries in 3 cases (3.49%). Straight splenic arteries were found in 24 cases (27.91% ), slightly curved splenic arteries in 44 cases (51.16 % ), and significantly curved splenic arteries in 18 cases (20. 93 % ). Compared with postoperative pathological results, the accuracy rates of preoperative MSCTA evaluating gastric cancer T, N, and M staging were 75.58% (65/86), 74.42% (64/86), and 91.86% (79/86), respectively. Conclusions Preoperative MSCTA is an objective way to assess the distributions of celiac artery trunk and related tributaries of patients with gastric cancer. Also, it is an accurate method to evaluate the preoperative TNM stage of gastric cancer, which can help to make an individual operative plan and avoid the intraoperative injury of the artery.%目的 探讨多层螺旋CT血管造影(multislice spiral computed tomography angiography,MSCTA)在胃癌规范性根治术术前评估中的价值.方法

  4. Evaluation of radiological prognostic factors of hepatic metastases in patients with non-functional pancreatic neuroendocrine tumors

    Energy Technology Data Exchange (ETDEWEB)

    Denecke, Timm [Klinik für Radiologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin (Germany); Baur, Alexander D.J., E-mail: alexander.baur@charite.de [Klinik für Radiologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin (Germany); Ihm, Claudia; Steffen, Ingo G. [Klinik für Radiologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin (Germany); Tischer, Elisabeth [Medizinische Klinik m.S. Hepatologie Gastroenterologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin (Germany); Arsenic, Ruza [Institut für Pathologie, Campus Charité Mitte, Charité - Universitätsmedizin Berlin (Germany); Pascher, Andreas [Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin (Germany); Wiedenmann, Bertram; Pavel, Marianne [Medizinische Klinik m.S. Hepatologie Gastroenterologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin (Germany)

    2013-10-01

    Purpose: There are different therapeutic options in non-functional well to moderately differentiated (G1 and G2) pancreatic neuroendocrine tumors (pNET) with unresectable hepatic metastases including systemic chemotherapy and novel molecular targeted therapies. Treatment with somatostatin analogs (SSA) as antiproliferative agents is optional. At initial diagnosis watchful waiting until tumor progression is a well-established approach. Goal of this study was to evaluate imaging features as potential prognostic factors predicting early tumor progression in order to select patients that might benefit from an earlier initiation of medical treatment. Patients and methods: In 44 patients we correlated tumor grade, chromogranin A (CgA) levels, treatment with SSA and imaging features of hepatic metastases on contrast-enhanced multiphase CT and MR imaging with time to tumor progression (TTP) according to RECIST 1.0. Results: In the total patient cohort none of the tested imaging features was found to be a statistically significant prognostic factor for TTP. Since treatment with SSA was associated with an increased TTP we also analyzed a subgroup of 30 patients not treated with SSA. In this subgroup of patients hypoenhancement of hepatic metastases during early contrast phases was found to be a negative prognostic factor for early tumor progression within 12 months (p = 0.039). The other evaluated parameters including hepatic tumor load, number of metastases, and presence of regressive morphological changes did not reveal significant results. Conclusion: Hypovascularization of liver metastases from G1 and G2 pNET reflected by hypoenhancement during the early contrast phases seems to be associated with early tumor progression. In patients with hypoenhancing metastases repeated biopsy for reassessment of grading of these metastases, and early initiation of therapy should be considered.

  5. Evaluation of Final Radiological Conditions at Areas of the Niagara Falls Storage Site Remediated under the Formerly Utilized Sites Remedial Action Program -12184

    Energy Technology Data Exchange (ETDEWEB)

    Clayton, Christopher [U.S Department of Energy Office of Legacy Management, Washington, DC; Kothari, Vijendra [U.S Department of Energy Office of Legacy Management, Morgantown, West Virginia; Starr, Ken [U.S Department of Energy Office of Legacy Management, Westminster, Colorado; Widdop, Michael; Gillespie, Joey [SM Stoller Corporation, Grand Junction, Colorado

    2012-02-26

    The U. S. Department of Energy (DOE) methods and protocols allow evaluation of remediation and final site conditions to determine if remediated sites remain protective. Two case studies are presented that involve the Niagara Falls Storage Site (NFSS) and associated vicinity properties (VPs), which are being remediated under the Formerly Utilized Sites Remedial Action Program (FUSRAP). These properties are a part of the former Lake Ontario Ordnance Works (LOOW). In response to stakeholders concerns about whether certain remediated NFSS VPs were putting them at risk, DOE met with stakeholders and agreed to evaluate protectiveness. Documentation in the DOE records collection adequately described assessed and final radiological conditions at the completed VPs. All FUSRAP wastes at the completed sites were cleaned up to meet DOE guidelines for unrestricted use. DOE compiled the results of the investigation in a report that was released for public comment. In conducting the review of site conditions, DOE found that stakeholders were also concerned about waste from the Separations Process Research Unit (SPRU) at the Knolls Atomic Power Laboratory (KAPL) that was handled at LOOW. DOE agreed to determine if SPRU waste remained at that needed to be remediated. DOE reviewed records of waste characterization, historical handling locations and methods, and assessment and remediation data. DOE concluded that the SPRU waste was remediated on the LOOW to levels that pose no unacceptable risk and allow unrestricted use and unlimited exposure. This work confirms the following points as tenets of an effective long-term surveillance and maintenance (LTS&M) program: Stakeholder interaction must be open and transparent, and DOE must respond promptly to stakeholder concerns. DOE, as the long-term custodian, must collect and preserve site records in order to demonstrate that remediated sites pose no unacceptable risk. DOE must continue to maintain constructive relationships with the U

  6. Granulomatous mastitis: radiological findings

    Energy Technology Data Exchange (ETDEWEB)

    Ozturk, M.; Mavili, E.; Kahriman, G.; Akcan, A.C.; Ozturk, F. [Depts. of Radiology, Surgery, and Pathology, Erciyes Univ. Medical Faculty, Kayseri (Turkey)

    2007-02-15

    Purpose: To evaluate the radiological, ultrasonographic, and magnetic resonance imaging (MRI) findings of idiopathic granulomatous mastitis. Material and Methods: Between April 2002 and June 2005, the mammography, ultrasound, color Doppler ultrasound, non enhanced MR, and dynamic MR findings of nine patients with the preliminary clinical diagnosis of malignancy and the final diagnosis of granulomatous mastitis were evaluated. Results: On mammography, asymmetrical focal densities with no distinct margins, ill-defined masses with spiculated contours, and bilateral multiple ill-defined nodules were seen. On ultrasound, in four patients a discrete, heterogenous hypoechoic mass, in two patients multiple abscesses, in one patient bilateral multiple central hypo peripheral hyperechoic lesions, in two patients heterogeneous hypo- and hyperechoic areas together with parenchymal distortion, and in one patient irregular hypoechoic masses with tubular extensions and abscess cavities were seen. Five of the lesions were vascular on color Doppler ultrasound. On MR mammography, the most frequent finding was focal or diffuse asymmetrical signal intensity changes that were hypointense on T1W images and hyperintense on T2W images, without significant mass effect. Nodular lesions were also seen. On dynamic contrast-enhanced mammography, mass-like enhancement, ring-like enhancement, and nodular enhancement were seen. The time-intensity curves differed from patient to patient and from lesion to lesion. Conclusion: The imaging findings of idiopathic granulomatous mastitis have a wide spectrum, and they are inconclusive for differentiating malignant and benign lesions.

  7. Colour Doppler evaluation of extracranial carotid artery in patients presenting with features of cerebrovascular disease: A clinical and radiological correlation

    Directory of Open Access Journals (Sweden)

    Sanjeev Sehrawat

    2012-01-01

    Full Text Available Aim: To evaluate the morphological and hemodynamic changes that take place in carotid arteries by colour Doppler in patients presenting with features of stroke. Background and Objectives: Cerebrovascular accidents constitute a major cause of adult mortality. The principal indication for cerebrovascular Doppler examination is stroke prevention. Colour Doppler sonography is a sensitive method for detection of atherosclerotic plaque and provides considerable information about the extent and severity of plaque as well as the resulting diminution of arterial lumen. The main strengths of sonography of carotid arteries are patient comfort, lack of risk and accuracy in detecting carotid stenosis. Material and Methods: A prospective study of Colour Doppler in carotid arteries was carried out for 12 months from 1 st July 2009 to 1 st July 2010. The study was carried out on 40 individuals, suspected of cerebrovascular insufficiency and having one or the other risk factors for cerebrovascular disease. A detailed clinical history, CNS examination findings and evidence of hypertension, diabetes mellitus, hyperlipidemia and ischemic heart disease were noted. Carotid Doppler evaluation was done by using Siemens Antares Ultrasound system. The data gathered were grey scale and Doppler findings of common carotid artery, internal carotid artery and external carotid arteries. Doppler findings were correlated with clinical features and risk factors. Results: In our study of 40 patients, the commonest lesion found was the atherosclerotic plaque. Highest incidence of plaque was seen in males 41% in the age group of 60-70 years and in females 37% in age group of 70-80 years. Cigarette smoking was the most common risk factor (60% associated with stroke/ Transient Ischaemic Attacks (TIA. Hemiparesis was the most common presenting symptom (35% among the symptomatic cases. Atheromatous plaque was most commonly found in the right carotid system (60%. Most common site for

  8. Radiologic evaluation of bone loss at implants with biocide coated titanium abutments: a study in the dog.

    Directory of Open Access Journals (Sweden)

    Roberto López-Píriz

    Full Text Available The objective of the present study is to evaluate bone loss at implant abutments coated with a soda-lime glass containing silver nanoparticles subjected to experimental peri-implantitis. Five beagle dogs were used in the experiments, 3 implants were installed in each quadrant of the mandibles. Glass/n-Ag coted abutments were connected to implant platform. Cotton floss ligatures were placed in a submarginal position around the abutment necks and the animals were subject to a diet which allowed plaque accumulation, and after 15 weeks the dogs were sacrificed. Radiographs of all implant sites were obtained at the beginning and at the end of the experimentally induced peri-implantitis. The radiographic examination indicated that significant amounts of additional bone loss occurred in implants without biocide coating, considering both absolute and relative values of bone loss. Percentages of additional bone loss observed in implants dressed with a biocide coated abutment were about 3 times lower (p<0.006 distal aspect; and p<0.031 at mesial aspect than the control ones. Within the limits of the present study it seems promising the use of soda-lime glass/nAg coatings on abutments to prevent peri-implant diseases.

  9. Radiologic evaluation of bone loss at implants with biocide coated titanium abutments: a study in the dog.

    Science.gov (United States)

    López-Píriz, Roberto; Solá-Linares, Eva; Granizo, Juan J; Díaz-Güemes, Idohia; Enciso, Silvia; Bartolomé, José F; Cabal, Belén; Esteban-Tejeda, Leticia; Torrecillas, Ramón; Moya, José S

    2012-01-01

    The objective of the present study is to evaluate bone loss at implant abutments coated with a soda-lime glass containing silver nanoparticles subjected to experimental peri-implantitis. Five beagle dogs were used in the experiments, 3 implants were installed in each quadrant of the mandibles. Glass/n-Ag coted abutments were connected to implant platform. Cotton floss ligatures were placed in a submarginal position around the abutment necks and the animals were subject to a diet which allowed plaque accumulation, and after 15 weeks the dogs were sacrificed. Radiographs of all implant sites were obtained at the beginning and at the end of the experimentally induced peri-implantitis. The radiographic examination indicated that significant amounts of additional bone loss occurred in implants without biocide coating, considering both absolute and relative values of bone loss. Percentages of additional bone loss observed in implants dressed with a biocide coated abutment were about 3 times lower (p<0.006 distal aspect; and p<0.031 at mesial aspect) than the control ones. Within the limits of the present study it seems promising the use of soda-lime glass/nAg coatings on abutments to prevent peri-implant diseases.

  10. Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Veneziani, G. R.; Matsushima, L. C.; Campos, L. L. [Instituto de Pesquisas Energeticas e Nucleares, Gerencia de Metrologia das Radiacoes / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Filho, A. M., E-mail: venezianigr@gmail.com [Centro Universitario de Rio Petro - UNIRP, Rodovia Br 153 (Transbrasiliana), Km. 69 Sao Jose do Rio Preto, Sao Paulo (Brazil)

    2014-08-15

    The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

  11. Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase

    Directory of Open Access Journals (Sweden)

    Guerrero-Orriach JL

    2016-04-01

    Full Text Available José Luis Guerrero-Orriach,1 Daniel Ariza-Villanueva,1 Ana Florez-Vela,1 Lourdes Garrido-Sánchez,2,3 María Isabel Moreno-Cortés,1 Manuel Galán-Ortega,1 Alicia Ramírez-Fernández,1 Juan Alcaide Torres,3 Concepción Santiago Fernandez,3 Isabel Navarro Arce,1 José María Melero-Tejedor,4 Manuel Rubio-Navarro,1 José Cruz-Mañas1 1Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain; 2CIBER Fisiología de la Obesidad y Nutrición (CIBEROBN, Instituto de Salud Carlos III, Málaga, Spain; 3Department of Nutrition and Endocrinology, Instituto de Investigaciones Biomédicas de Málaga (IBIMA, University Hospital Virgen de la Victoria, Málaga, Spain; 4Department of Cardiovascular Surgery, University Hospital Virgen de la Victoria, Málaga, Spain Purpose: To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL and neuronal enolase. Methods: This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan. Levosimendan was administered preoperatively on the day before surgery. All patients were considered high risk of cardiac and perioperative renal complications. Cardiac function was assessed by echocardiography, renal function by urinary N-GAL levels, and the acute kidney injury scale. Neuronal damage was assessed by neuron-specific enolase levels. Results: After surgery, no significant variations were found in mean and SE levels of N-GAL (14.31 [28.34] ng/mL vs 13.41 [38.24] ng/mL, neuron-specific enolase (5.40 [0.41] ng/mL vs 4.32 [0.61] ng

  12. Preoperative assessment and optimization in periampullary and pancreatic cancer

    Directory of Open Access Journals (Sweden)

    S Myatra

    2011-01-01

    Full Text Available Perioperative management of pancreatic and periampullary cancer poses a considerable challenge to the pancreatic surgeon, anesthesiologist, and the intensive care team. The preoperative surgical evaluation of a pancreatic lesion aims to define the nature of the lesion (malignant or benign, stage the tumor, and to determine resectability or other non-surgical treatment options. Patients are often elderly and may have significant comorbidities and malnutrition. Obstructive jaundice may lead to coagulopathy, infection, renal dysfunction, and adverse outcomes. Routine preoperative biliary drainage can result in higher complication rates, and metal stents may be preferred over plastic stents in selected patients with resectable disease. Judicious use of antibiotics and maintaining fluid volume preoperatively can reduce the incidence of infection and renal dysfunction, respectively. Perioperative fluid therapy with hemodynamic optimization using minimally invasive monitoring may help improve outcomes. Careful patient selection, appropriate preoperative evaluation and optimization can greatly contribute to a favorable outcome after major pancreatic resections.

  13. Evaluation of Final Radiological Conditions at Areas of the Niagara Falls Storage Site Remediated under the Formerly Utilized Sites Remedial Action Program - 12184

    Energy Technology Data Exchange (ETDEWEB)

    Clayton, Christopher [U.S Department of Energy Office of Legacy Management, Washington, DC (United States); Kothari, Vijendra [U.S Department of Energy Office of Legacy Management, Morgantown, West Virginia (United States); Starr, Ken [U.S Department of Energy Office of Legacy Management, Westminster, Colorado (United States); Widdop, Michael; Gillespie, Joey [SM Stoller Corporation, Grand Junction, Colorado (United States)

    2012-07-01

    The U.S. Department of Energy (DOE) methods and protocols allow evaluation of remediation and final site conditions to determine if remediated sites remain protective. Two case studies are presented that involve the Niagara Falls Storage Site (NFSS) and associated vicinity properties (VPs), which are being remediated under the Formerly Utilized Sites Remedial Action Program (FUSRAP). These properties are a part of the former Lake Ontario Ordnance Works (LOOW). In response to stakeholders concerns about whether certain remediated NFSS VPs were putting them at risk, DOE met with stakeholders and agreed to evaluate protectiveness. Documentation in the DOE records collection adequately described assessed and final radiological conditions at the completed VPs. All FUSRAP wastes at the completed sites were cleaned up to meet DOE guidelines for unrestricted use. DOE compiled the results of the investigation in a report that was released for public comment. In conducting the review of site conditions, DOE found that stakeholders were also concerned about waste from the Separations Process Research Unit (SPRU) at the Knolls Atomic Power Laboratory (KAPL) that was handled at LOOW. DOE agreed to determine if SPRU waste remained at that needed to be remediated. DOE reviewed records of waste characterization, historical handling locations and methods, and assessment and remediation data. DOE concluded that the SPRU waste was remediated on the LOOW to levels that pose no unacceptable risk and allow unrestricted use and unlimited exposure. This work confirms the following points as tenets of an effective long-term surveillance and maintenance (LTS and M) program: - Stakeholder interaction must be open and transparent, and DOE must respond promptly to stakeholder concerns. - DOE, as the long-term custodian, must collect and preserve site records in order to demonstrate that remediated sites pose no unacceptable risk. - DOE must continue to maintain constructive relationships with

  14. Clinical Relevance of Classifying Massive Rotator Cuff Tears: Results Based on Functional and Radiological Findings After Arthroscopic Repair.

    Science.gov (United States)

    Ok, Hyun Soo; Kim, Byung Guk; Choi, Won Chul; Hong, Chul Gie; Kim, Jee Woong; Kim, Jae Hwa

    2017-01-01

    Studies on the results of arthroscopic repair of massive rotator cuff tears have reported widely varied prognoses. Among other factors, the sizable discrepancy can be attributable to the fact that the current definition of massive rotator cuff tears covers an extensive area of tendons. Functional and radiological results according to subgroups would show significant inter-subgroup differences preoperatively and postoperatively. Cohort study; Level of evidence, 2. A total of 104 patients who required arthroscopic repair for massive rotator cuff tears were prospectively evaluated. The patients were allocated into 3 groups according to tendon involvement as diagnosed by preoperative magnetic resonance imaging: group 1 (anterosuperior type involving the subscapularis and supraspinatus), group 2 (posterosuperior type involving the infraspinatus and supraspinatus), and group 3 (anteroposterior type involving the subscapularis, supraspinatus, and infraspinatus). We compared functional results (at 2 years postoperatively) and radiological findings (at 1 year postoperatively) for each group. There were 34 patients in group 1, 54 in group 2, and 16 in group 3. In all 3 groups, functional results significantly improved after surgery. There were no statistically significant intergroup differences in functional results among the 3 groups. On the radiological evaluations, each group (groups 1, 2, and 3) showed a significantly different result in the preoperative acromiohumeral distance (AHD) (7.19, 5.44, and 5.22 mm, respectively), tear size (38.8, 39.3, and 46.4 mm, respectively), extent of retraction (33.9, 40.0, and 41.4 mm, respectively), postoperative AHD (8.92, 7.37, and 6.71 mm, respectively), and retear rate (23.5%, 51.9%, and 56.2%, respectively) ( P rotator cuff tears can be divided into 3 types: anterosuperior (group 1), posterosuperior (group 2), and anteroposterior (group 3). Each group has distinctive characteristics and shows different results in the preoperative

  15. [Controlling instruments in radiology].

    Science.gov (United States)

    Maurer, M

    2013-10-01

    Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

  16. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, Linda

    1999-01-01

    BACKGROUND: After cholecystectomy for symptomatic gallstone disease 20%-30% of the patients co