Digital chest radiography: effect on diagnostic accuracy of hard copy, conventional video, and reversed gray scale video display formats

Observer performance tests were conducted to compare the effects on diagnostic accuracy of hard copy (film) versus video display and to determine the diagnostic merits of conventional negative ("white bone") versus positive ("black bone") video displays. Subjective preferences were elicited from each observer for each display modality, and diagnostic accuracy was determined with receiver operating characteristic analysis. Digitized chest radiographs were used, including normal and abnormal cases with a variety of subtle abnormalities. The hard copy was printed with a 1,024 X 1,024-matrix by a high-quality drum scanner in conventional white bone format only. The video images were displayed on a 1,023-line monitor (30 Hz, interlaced) in both white bone and black bone formats with fixed window and brightness settings. Most observers preferred hard copy to video, but preferences were sharply divided between white bone and black bone video. Diagnostic accuracy was significantly greater with hard copy than with video display, and the conventional white bone format was significantly superior in accuracy to the black bone display.     

Digital radiography for clinical applications

LANGUAGE="EN">Summary. In the field of radiological research methods, digital imaging is becoming increasingly prevalent. Apart from computerised tomography, magnetic resonance tomography and angiography, also in projection radiography, traditional film/screen imaging is more and more being replaced by digital imaging using digital image-intensifier and storage phosphor technology. Digital imaging offers various new possibilities in image processing, storage and transmission. This may yield additional diagnostic information, dose reduction and fast availability of images. However, an inappropriate parameter selection for imaging and post-processing as well as a lack of integration in the entire organisation may lead to a rejection of this innovative technology.     

Metastatic Crohn's disease: a review

Metastatic Crohn's disease (MCD) indicates the presence of non-caseating granuloma of the skin at sites separated from the gastrointestinal tract by normal tissue and is the least common dermatologic manifestation of CD. In adults, MCD usually appears after the initial diagnosis of CD in 70% of cases, whereas in children, it appears at the same time as CD in almost half of the cases. The most frequent skin lesions in adults are nodules, plaques with or without ulceration on the extremities and ulcers on the genitals. In children, genital swelling with or without erythema is the most frequent presentation of MCD. Simultaneous presence of perianal CD affects more females (60%) and particularly children. Associated gastrointestinal symptoms are present in one third of the cases in adults and in half of the cases in children. Treatment is often unsatisfactory. Randomised controlled trials are lacking. Various chemotherapeutic agents have been used such as oral metronidazole, topical and/or oral steroids, azathioprine, cyclosporine, sulfasalazine, tetracyclines, topical or systemic tacrolimus, infliximab alone or with methotrexate, and surgical treatment with oral zinc sulphate. MCD represents another 'great imitator'. This reviews the most relevant characteristics of this disease, in order to increase awareness and to avoid delay in diagnosis and improve management of the whole CD complex.     

Clinimetric evaluation of methods to measure muscle functioning in patients with non-specific neck pain: a systematic review

Background  

Neck pain is a significant health problem in modern society. There is evidence to suggest that neck muscle strength is reduced in patients with neck pain. This article provides a critical analysis of the research literature on the clinimetric properties of tests to measure neck muscle strength or endurance in patients with non-specific neck pain, which can be used in daily practice.     

Influence of intense light stimulation on trigeminal and cervical pain perception thresholds

Thirty-three migraineurs and 23 healthy controls were submitted to pressure algometry before and after light-induced discomfort was elicited by progressive light stimulation in a monoblind fashion. Pressure algometries were performed on the emergence of the supraorbital, infraorbital, mental and greater occipital nerves, and over the temporal muscles, always throughout the same sequence and from right to left. Measurements were carried out before and immediately after light stimulation and after 10 min of the second algometry. The final result for each site measured at each time-point was the mean of the three measurements. Light stimulation was carried out progressively until light-induced discomfort was reported, to a maximum of 20,000 lux. A heat-blocking glass protected patients' eyes. Migraineurs presented significant and persistent drops in pain perception thresholds after light stimulation, at all sites tested (P = 0.002 to < 0.0001). These drops were not seen in controls, in whom, conversely, a less significant increase was seen on right infraorbital and left temporal muscle sites. Our results indicate that in migraineurs, light may have a relevant role in trigeminal and cervical pain perception thresholds.     

胸腰椎骨折椎体次全切除内固定16例

1 临床资料 2000-05/2004-04收治胸腰椎爆裂骨折(TLBF)患者16(男14,女2)例,年龄19～48(平均33)岁,骨折部位,T12 6例,L1 7例,L2 2例,L3 1例,新鲜骨折15例,陈旧性骨折1例,手术时间: 外伤后1 wk内3例;2～3 wk 12例,6 mo 1例. ASIA脊髓功能A级1例,B级2例,C级4例,D级7例,E级2例. 合并肢体骨折2例,肋骨骨折5例,脑外伤2例,血气胸1例.