Late ultrastructural changes in the retina of the rat following low-dose X-irradiation

This study describes ultrastructural changes in the pigmented hooded Lister rat retina, 3–12 months following X-irradiation with single doses of between 200 and 2000 cGy. The extreme radiosensitivity of the photoreceptor cells was underlined by the continued manifestation of fine structural changes and cell death up to 6 months post-radiation in animals receiving doses above 500 cGy. The retinal pigment epithelial (RPE) cells were more radioresistant than photoreceptors and RPE cell loss was only observed at doses of more than 1500 cGy. One year after irradiation with 1500 cGy the retinal vasculature showed capillary occlusion with some evidence of recanalisation. Telangiectasia was observed in the large retinal veins. Although the inner retinal neurones and glia1 cells showed no evidence of direct radiation damage, the nerve fibre layer adjacent to occluded retinal vessels demonstrated ultrastructural evidence of ischaemic neuropathy and retinal oedema. At doses above 1500 cGy the choriocapillaris showed platelet aggregation and capillary loss.     

Patterns of primary care and survival in 336 consecutive unselected Norwegian patients with bladder cancer.

The outcome of 336 unselected patients diagnosed as having bladder cancer in 1985 in a southern health region of Norway was studied. Two hundred and forty patients had superficial bladder cancer (Tis, Ta and T1). Seventy-four had T2-3 and 17 had T4 bladder tumours at the time of diagnosis (the T-category was unknown in five cases). In 46 of 248 evaluable cases (19%) 12 or more months had elapsed between the onset of symptoms and the histological confirmation of the diagnosis. The information received from the initial routine histology report was inadequate in 51 of 240 (21%) of the patients with superficial bladder cancer. Among the 91 patients with muscle-infiltrating tumours the primary treatment varied considerably, and only 15 patients underwent total cystectomy as the initial treatment. Only 46 in whom muscle-infiltrating tumours were diagnosed initially were referred to the regional uro-oncological unit during the course of the disease. The cancer-corrected, four-year survival was 86% and 42% for superficial and muscle infiltrating bladder cancer, respectively. The comparable figures for crude survival were 64% and 34%, respectively. The lack of optimal standard treatment of muscle-infiltrating bladder cancer warrants the introduction of clinical trials to assess both curative and palliative regimens as well as to study prognostic factors such as proliferation and immunohistochemical parameters by uro-oncological units. Scandinavian Cancer Registries should consider the optional recording of the T category on the case record forms for newly diagnosed cases of bladder cancer.     

An online clinical governance learning package for student radiographers

PurposeClinical governance is a key element of the Government's plan for reform in the National Health Service. As such, it is an essential element for final year undergraduate radiography studies. With Ciris becoming a standard web-based solution for clinical governance within the NHS, a need has been identified for it to be introduced at university to undergraduate radiographers.MethodsA distance learning package for Ciris has therefore been developed that was trialed by third year radiography students whilst on their final clinical placement. The package includes a specifically designed online virtual hospital which the students engaged with interactively using a workbook. The students undertook detailed individual and group exercises aimed at delivering practical experience of the Ciris program and its role in clinical governance.ResultsThe package was evaluated by the students in terms of their experiential learning and their perceived learning needs for clinical governance. Technical and support issues associated with the delivery of this package online were identified.ConclusionThe combination of a distance online learning environment, supported by a workbook, is an effective method of engaging students and is beneficial in terms of helping achieve learning outcomes in clinical governance for final year radiography studies.