Surface shield: device to reduce personnel radiation exposure

A simple device is described that can reduce personnel exposure from scatter radiation by up to 75%. The device consists of an oblong piece of shielding (0.75-mm lead equivalent) that is taped to the side of the patient during percutaneous renal stone removal and other interventional procedures. Contrary to other shields and barriers, this does not interfere with access to the patient. Scatter exposure data from phantom studies are presented and the rationale for surface shielding discussed.     

Fibrosing alveolitis: CT-pathologic correlation

Computed tomography (CT) was performed within 10 days of open lung biopsy in nine patients with fibrosing alveolitis. One-centimeter collimation contiguous scans through the chest were obtained in all patients. Additional 1.5-mm collimation scans were obtained in the area in which lung biopsy was later performed in six patients. In seven patients, CT demonstrated patchy involvement of the lung parenchyma, areas with a reticular pattern being intermingled with areas of normal lung. The reticular pattern was associated with cystic spaces 2-4 mm in diameter and was more severe in the lung periphery. Histologically, the reticular pattern corresponded to areas of irregular fibrosis. One patient had diffuse honeycombing (2-20-mm cysts), and one had honeycombing only in the lung periphery. In all patients, CT clearly defined the architectural changes seen on open lung biopsy. These changes were much better seen on the 1.5-mm than on the 10-mm collimation scans. CT may be helpful in determining the pattern and distribution of lung involvement in patients with fibrosing alveolitis and in guiding the surgeon to the most appropriate area(s) for biopsy.     

Urine-compatible polymer for long-term ureteral stenting

Internal double-J ureteral stents were designed from a urine-compatible polymer (C-Flex), and 35 stents were placed in patients. The overall patency rate for the stents was 80%, with most stent failures occurring before 2 months; the follow-up period ranged from 2 to 16 months, with a mean follow-up for all stents of 5.0 months. Stents were considered patent at last follow-up only if they had been in place for at least 2 months. No migration or fracture of the stents occurred. Physical properties of urine-exposed stents were compared with those of virgin tubing and tubing exposed for 1 year to shelf conditions. Stent patency was optimized by increasing urine flow by increasing the patient's voluntary oral intake, administering prophylactic oral antibiotics, and avoiding placement of stents into grossly bloody or infected collecting systems.