Radiation dose reduction during hysterosalpingography: an application of scanning-beam digital radiography

Hysterosalpingography was performed in 31 patients by means of a low-dose scanning-beam digital radiographic system. The technique permits adequate evaluation of gynecologic abnormalities while allowing significant reduction in radiation: 2.4-mR (6.1 X 10(-7) C/kg) exposure to the skin and 0.7-mrad (7 X 10(-6) Gy) mean dose to the ovaries per image obtained. Sixteen patients demonstrated readily recognizable and documented abnormalities, corroborated by laparoscopy, laparotomy, or other supportive evidence.     

A final adjustment for staff allocation under environmental uncertainty

Through understanding the relationships between the previous day's (Sunday) demand and the remaining days' demand, a prediction model can be constructed. The staff level can be determined based on this prediction model. This model can also be applied in different hospital units or a staff environment other than hospitals.     

Scalp electrical recording during paralysis: quantitative evidence that EEG frequencies above 20 Hz are contaminated by EMG.

OBJECTIVE: To identify the possible contribution of electromyogram (EMG) to scalp electroencephalogram (EEG) rhythms at rest and induced or evoked by cognitive tasks. METHODS: Scalp EEG recordings were made on two subjects in presence and absence of complete neuromuscular blockade, sparing the dominant arm. The subjects undertook cognitive tasks in both states to allow direct comparison of electrical recordings. RESULTS: EEG rhythms in the paralysed state differed significantly compared with the unparalysed state, with 10- to 200-fold differences in the power of frequencies above 20 Hz during paralysis. CONCLUSIONS: Most of the scalp EEG recording above 20 Hz is of EMG origin. Previous studies measuring gamma EEG need to be re-evaluated. SIGNIFICANCE: This has a significant impact on measurements of gamma rhythms from the scalp EEG in unparalysed humans. It is to be hoped that signal separation methods will be able to rectify this situation.     

A stochastic model for determining the necessary staff level in a service industry

Determining sufficient staff levels and providing quality, economical and efficient service is a problem that is difficult for some staffing managers to solve. The objectives in this paper are to derive a stochastic model for determining the necessary staff levels in various service environments such as hospitals, banks, or in manufacturing settings where the demand for a good staff is erratic. In order to assess the proper staff levels, an equation must be used which involves previous service demand hours that are considered as a distribution integrated within the statistical capability scale distribution. The most important property of this staffing model is that the results are independent of the mix of the jobs, the variation of the in-service time for jobs, and the stationary or nonstationary job arrival rate.     

Merkel Cell Carcinoma Arising from the Subcutaneous Fat of the Arm with Intact Skin

BACKGROUND: Merkel cell carcinoma is a rare malignant neuroendocrine neoplasm characteristically arising from the dermis of sunlight-exposed skin. It rarely arises outside the skin. OBJECTIVE: We present a patient with primary Merkel cell carcinoma arising from subcutaneous fat, with no involvement of the overlying skin. We describe the clinical manifestations and magnetic resonance imaging (MRI) findings. METHODS: We report a 63-year-old woman with a primary lesion of Merkel cell carcinoma that arose from the subcutaneous fat layer of the left arm. The lesion presented as a subcutaneous nodule with intact overlying skin. MRI showed that the nodular lesion was located entirely in the subcutaneous fat layer, with no involvement of the dermis. Peritumoral infiltration around the lesion and enlarged lymph nodes deep to the lesion were noted. The patient received wide excision of the lesion with dissection of the regional lymph nodes and adjuvant radiotherapy and chemotherapy. RESULTS: Histopathologic examination confirmed the diagnosis of Merkel cell carcinoma with local lymphatic metastasis, and the lesion was completely located in the subcutaneous fat, with no involvement of the dermis. These findings were well correlated with MRI findings. CONCLUSION: Primary Merkel cell carcinoma may arise from the subcutaneous fat and present as an entirely subcutaneous lesion with intact skin. MRI is helpful to evaluate the local extension of the lesion and regional lymphatic metastasis.     

表小檗碱对α受体的作用

表小檗碱(epiberberine,EB)是从湖北产黄连(Coptis chinensis Franch)中提取的一种生物碱,属苯喹嗪类原小檗碱,对其药理作用的研究资料甚少,未见其对α肾上腺素体作用的报道。资料表明,许多原小檗碱类化合物有α受体阻滞作用,为从该类化合物中选择     

Pain and faulty breathing: a pilot study

The purpose of this pilot study was to observe both relaxed and deep breathing patterns in a convenience sample to determine the incidence of normal versus faulty patterns of respiration. These observations were then combined with respondent answers to a survey on pain history to determine if there is any correlation between faulty breathing and musculo-skeletal pain patterns. If such a correlation can be made, then we propose that clinicians working with chronic pain patients may have improved outcomes if they address and correct faulty breathing patterns. Based on this study, it is suggested to include the evaluation and treatment of faulty respiration in the rehabilitation of chronic musculo-skeletal conditions, most notably cervical pain.     

Prostate cancer: Prevalence and treatment in African men

Epidemiological data from the United States of America (USA) indicate that the incidence and mortality of prostate cancer is higher among Black African-American men (AAM) than among White (Caucasian) American men (CAM). Earlier studies suggesting that prostate cancer is relatively rare among indigenous Black men in Africa are probably flawed by underreporting because recent studies indicate that the incidence rates among Black men are similar to those of White men living in Africa. The higher incidence of prostate cancer among AAM has been ascribed to racial differences in genetic susceptibility, dietary factors, or androgen metabolism. However, it may also be due to registration artefacts because in Africa the reported incidence rates of prostate cancer in different countries correlate directly with the per capita gross national product, suggesting improved access to medical facilities is responsible for higher reported incidence rates.

The greater prostate cancer mortality among AAM may result from higher tumour grade and stage and higher serum PSA at presentation, but it has also been suggested that prostate cancer is biologically more aggressive in AAM than in CAM. However, recent studies indicate that tumour grade and stage and serum PSA at presentation are similar in the races, with no difference in survival after multivariate analysis controlling for pretreatment cancer severity. This suggests that the higher prostate cancer mortality among AAM results from socio-economic factors and limited access to healthcare. Black men living inside as well as outside of Africa still tend to present with locally advanced or metastatic prostate cancer due to lack of early detection programmes.