Advanced γ ray technology for scanning cargo containers

The shipping industry is striving to increase security for cargo containers without significantly impeding traffic. Three Science Applications International Corporation (SAIC) development programs are supporting this effort. SAIC's ICIS system combines SAIC's VACIS^® γ ray imaging, radiation scanning, OCR, elemental analysis and other technologies to scan containers for nuclear materials and other hazards in normal terminal traffic. SAIC's enhanced γ ray detector improves VACIS image resolution by a factor of three. And SAIC's EmptyView software analyzes VACIS images to automatically verify empty containers.     

A Proactive Approach to High Risk Delirium Patients Undergoing Total Joint Arthroplasty

Background

Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a “never-event.” The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA.

Monorail™ Piccolino catheter: A new rapid exchagne/ultralow profile coronary angioplasty system

The Monorail^TM Piccolino coronary angioplasty balloon catheter (MBC) was evaluated on 118 patients at two centers. Technical success was achieved in 110 patients (93%). Time for catheter exchange and total fluoroscopy time were significantly lower for the Monorail catheter than with standard equipment (exchange time 97 vs. 170 seconds P <.05 and fluoroscopy time 17 vs. 88 seconds P < 0.001). The advantages of rapid exchange and the ability of utilize 2 Monorail balloon catheters through one 9F guiding catheter for simultaneous inflations allowed for maximal flexibility in treating patients with bifurcation lesions. The double wire approach utilizing one Monorail balloon catheter with a 7F guiding catheter was also technically successful. The Monorail^TM Piccolino balloon catheter has unique features that allow for greater ease of operator use, rapid catheter exchange, and optimal angiographic visualization. It is felt that this catheter design provides distinct advantages over standard angioplasty equipment.     

Imaging of small bowel Crohn's disease: can abdominal CT replace barium radiography?

Objectives: To analyze imaging features and compare the diagnostic information provided by abdominal computed tomography (CT) and enteroclysis to see whether CT can replace barium examinations in the assessment of patients with small bowel Crohn's disease. Methods: The abdominal CT studies and enteroclysis of 33 patients with small bowel Crohn's disease who underwent both examinations within a 2-week time period were retrospectively reviewed and scored for the presence and severity of the following features: mural edema, ulceration, small bowel obstruction, stricture, sinus tract formation, fistula, abscess, extraintestinal manifestations, and total number of intestinal sites involved. The statistical significance of the differences for each variable was calculated. Results: A total of 37 case sets were reviewed. CT demonstrated 10 (27 %) abscesses compared to 7 (19 %) shown by enteroclysis. Three extraintestinal sites shown by CT were not demonstrated by enteroclysis. Enteroclysis detected a larger number of intestinal sites of involvement (54 vs. 47) and more cases of ulceration (78 % vs. 19 %), small bowel obstruction (46 % vs. 16 %), stricture (38 % vs. 11 %), fistula formation (24 % vs. 8 %), and sinus tract formation (27 % vs. 5 %). The two modalities were similar in characterizing and grading the severity of mural thickening (CT showed 41 %, enteroclysis 46 %). Conclusion: Abdominal CT and enteroclysis provide unique and complementary diagnostic information in patients with Crohn's disease of the small bowel. Both methods may be required for the accurate assessment of the severity and extent of Crohn's disease of the small bowel. The choice of initial examination will depend on the clinical issue in question.     

The clinical evaluation of soft tissue tumors

Soft tissue tumors range from benign subcutaneous lipomas to malignant deep high-grade sarcomas. Patients are evaluated with a thorough history and physical examination followed by imaging studies. Magnetic resonance imaging is the modality of choice, although radiographs, computed tomography, and other modalities may be of value. Open or closed biopsy can be performed to establish a diagnosis. Treatment depends on the diagnosis and includes observation or marginal excision for benign lesions and wide resection for malignant masses, with radiation therapy or chemotherapy for large, high-grade tumors. An algorithm for the evaluation, diagnosis, and treatment of soft tissue tumors is presented.     

Outcome expectancy as a moderator of mental fatigue influence on cardiovascular response

Female undergraduates performed an easy (fatigue low) or difficult (fatigue high) scanning task and then were presented mental arithmetic problems with instructions that they would earn a high or low chance of winning a prize if they did as well as or better than 50% of those who had performed previously. As expected, blood pressure responses in the second work period rose or tended to rise with fatigue where the chance of winning was high. By contrast, the responses tended weakly to decline with fatigue where the chance of winning was low. The pressure findings support the suggestion of a recent fatigue analysis that success importance should moderate fatigue influence on CV responses to a challenge so long as fatigued performers view success as possible. They also conceptually replicate previous fatigue results and provide a special class of evidence that fatigue influence on CV response is mediated by effort.