Quality assessment and assurance in diagnostic imaging. Theoretical and practical considerations and a quality audit of the excretory urogram

Concepts necessary to an understanding of the basics of quality assurance audits are presented. Included are specific examples that bridged theory and practice by applying the protocol to a real-life diagnostic imaging situation. This method meets the present requirements of the Joint Commission of the Accrediation of Hospitals.     

Patient and partner satisfaction with the Mentor Alpha-1 inflatable penile prosthesis

OBJECTIVE: To evaluate the satisfaction level of patients and partners after implantation of a Mentor Alpha-1 inflatable penile prosthesis (IPP) for the treatment of erectile dysfunction (ED). MATERIAL AND METHODS: A questionnaire was sent to 46 patients who had been operated on for ED with implantation of a Mentor Alpha-1 IPP. The investigation was designed to evaluate patient and partner satisfaction. RESULTS: Eighty-five percent of the questionnaires were returned. Sexual desire had not changed but the quality of sexual activity had significantly improved. Acceptance by the partner was good. Overall satisfaction among both patients and partners was high. In total, 95% of patients said that they would recommend the procedure to other patients in the same situation. CONCLUSIONS: Patient and partner satisfaction with the Mentor Alpha-1 IPP was high, with the exception of the minority of patients who experienced unacceptable complications. Infection and mechanical failure are important risks which patients should be informed of before agreeing to implantation surgery.     

Colon perforation following percutaneous nephrostomy and renal calculus removal

Two patients had colonic perforation as a result of percutaneous nephrostomy placement followed by track dilatation and renal calculus removal. We present the technical aspects of nephrostomy placement and stone removal, as well as the clinical diagnosis and management of these cases. Both patients recovered well with conservative therapy and required no surgical intervention. This report reviews the anatomic considerations for percutaneous nephrostomy in patients undergoing renal stone removal.     

Comparison of the binding properties of the mushroom Marasmius oreades lectin and Griffonia simplicifolia I-B isolectin to alphagalactosyl carbohydrate antigens in the surface phase

The binding of two alpha-galactophilic lectins, Marasmius oreades agglutinin (MOA), and Griffonia simplicifolia I isolectin B(4) (GS I-B(4)) to neoglycoproteins and natural glycoproteins were compared in a surface phase assay. Neoglycoproteins carrying various alpha-galactosylated glycans and laminin from basement membrane of mouse sarcoma that contains the xenogenic Galalpha1-3Gal1-4GlcNAc epitope were immobilized in microtiter plate wells and lectin binding determined with an enzyme-linked assay. After 24 h of incubation, MOA had higher affinity for the xenogenic pentasaccharide (Galalpha1-3Gal1-4GlcNAcbeta1-3Galbeta1-4Glc) than for the Galalpha-monosaccharide. The binding properties of MOA and GS I-B(4) to the xenogenic disaccharide (Galalpha1-3Galbeta1) were comparable while the binding of MOA to the xenogenic pentasaccharide was much stronger than the binding of GS I-B(4) to the same epitope. Non-xenogenic disaccharide-coupled neoglycoproteins having galactose end groups linked alpha1-2 or alpha1-4 to Gal or linked alpha1-3 to GalNAc bound very weakly to MOA, whereas GS I-B(4) recognized all of these disaccharides with similarly high affinity. MOA also showed high affinity for laminin. The results indicate that the Marasmius oreades lectin has nearly the same affinities as does GS I-B(4) for the simple xenogenic carbohydrate antigens, but MOA has greater affinity for the pentasaccharide and is far more specific in its binding preferences than the Griffonia lectin.     

肾康片质量标准的研究

目的：研究肾康片的质量标准并控制该制剂的质量。方法：用薄层色谱法鉴别了肾康片中的黄芪,山茱萸,桑寄生及丹参,用薄层色谱法限量检查屯该制剂中的乌头碱,用双波长薄层扫描法测定了该制剂中黄芪甲苷的含量。结果：乌头碱限量符合中国药典测定,黄芪甲苷的平均回收率为９７．５％,其ＲＳＤ为１．４３％。结论：本文的结果显示出这些方法可用于控制该制剂的质量,方法灵敏,简便,专属,准确。     

Cervical myelography: survey of modes of practice and major complications

A total of 68 major complications of cervical myelography were reported by 220 neuroradiologists in a mail survey. Two-thirds of the complications were attributed to cervical spine hyperextension and one-third to lateral C1-2 puncture. Narrow sagittal diameter of the spinal canal and severe cervical spondylosis were frequent contributing factors to hyperextension injury of the cervical spinal cord. Clinical and radiographic premyelography screening is suggested, with magnetic resonance imaging performed first in patients with spinal canal stenosis, severe spondylosis, and/or myelopathy of any cause. Neck extension should be minimal during myelography. All C1-2 punctures should be monitored with lateral fluoroscopy for accurate needle positioning and prevention of contrast medium injection into the spinal cord.