Managing nurses and nursing: short courses as role development

This paper describes the development over a 3-year-period of short management courses for registered nurses offered as part of a professional development educational programme by Oxfordshire Health Authority (OHA) Clinical Education and Practice Team (OXCEPT). The courses were seen as role development for staff nurses, team leaders, sisters, charge nurses and senior sisters, and the content and length of courses were altered, extended and developed in response to evaluation of the courses by tutors and participants. The emphasis is on integrating participants' clinical, managerial and educational roles, as professional practitioners managing nurses and nursing.     

3H-1,2-二氢-1-吡里酮衍生物的合成

发现3 H-1,2-二氢-1-吡咯里嗪酮具有明显的抗炎镇痛作用。用Friedel-Crafts酰化和Dieckmann缩合等反应制备了该酮的一些衍生物,其中五个未见于文献报道。药理实验证明,这些化合物均有不同程度的抗炎镇痛作用。     

Pheochromocytoma and the normal adrenal medulla: improved visualization with I-123 MIBG scintigraphy

The radiopharmaceutical iodine 131 metaiodobenzylguanidine (I-131 MIBG) has been shown to locate pheochromocytomas scintigraphically with a false-negative rate of approximately 13%. To improve image quality and reduce the false-negative rate, I-123 was examined as a radioactive label for MIBG, as it has many advantages over I-131, including superior dosimetry and better detection efficiency. Diagnostic doses of 0.5 mCi (18.5 MBq) I-131 MIBG and 10.0 mCi (370.0 MBq) I-123 MIBG with nearly equivalent radiation dosimetries were compared in 18 patients with known or suspected pheochromocytomas. Images of superior quality were obtained with I-123 MIBG in 18 of 18 patients, and in eight cases lesions not visualized on I-131 MIBG scintigraphy were portrayed. A further advantage of I-123 MIBG is that it permits single photon emission computed tomography (SPECT). This was performed in six cases and provided additional information in three cases. The adrenal medullae were definitely visualized using I-123 scintigraphy in eight of 14 patients still possessing adrenal glands, whereas I-131 MIBG images portrayed the adrenal medulla in only one of 14 cases. Five remaining patients had multiple abdominal tumor deposits that were difficult to differentiate from normal adrenal medullae.     

Glomus tympanicum tumours: demonstration by high resolution C.T.

The situation and extent of small glomus tumours confined to the middle ear cavity have been reliably demonstrated by high resolution C.T. The distinctive clinical and radiological features of four cases are described. High resolution C.T. is now considered to be the definitive radiological investigation and angiography is regarded as an unnecessary procedure in most patients with this condition.     

Olfactory neuroblastoma: imaging by magnetic resonance,CT and conventional techniques

Twenty-four patients with the histological diagnosis of olfactory neuroblastoma have been treated at the Royal National Throat, Nose and Ear Hospital since 1975. The tumour showed a bimodal age distribution and 30% of the patients were under 30 years of age. The imaging characteristics on plain film, computed tomography and magnetic resonance combined with intravenous gadolinium DTPA are detailed. None of the changes described is wholly specific. However, a tumour in the ethmoids and upper part of the nasal cavity, which expands into the orbit and erodes the roof of the fronto-ethmoid complex or cribriform plate unilaterally in a young patient, is highly suggestive of olfactory neuroblastoma, particularly if this is combined with the magnetic resonance signal characteristics of a vascular tumour. The typical MR features are those of an intense signal on pre-contrast T2 weighted spin echo sequences and strong enhancement after gadolinium on Tl weighted sequences. A characteristic feature of the response to gadolinium is an enhancement of tumour higher than that of turbinate mucosa on inversion recovery and less than that of mucosa when Tl weighted spin echo sequences are employed. The extent of tumour in the paranasal sinuses and the anterior cranial fossa is best demonstrated after magnetic resonance with intravenous gadolinium and this is now regarded as the most accurate method of preoperative assessment of these patients prior to craniofacial surgery.