Radiologic features compared to clinical findings in a prospective study of 153 patients with metastatic spinal cord compression treated by radiotherapy

Summary Plain radiography, myelography and post-myelographic CT-scan are described and related to clinical findings in a prospective study of 153 consecutive patients with myelographic signs of spinal cord compression. The majority of the metastatic tumours arise in the vertebral body or the pedicles. In 80% of the patients with total blockage to the contrast medium on myelography the post-myelographic-CT showed passage of the contrast medium. Ambulatory function at time of diagnosis was correlated to the degree and the localization of the epidural block. In 64 patients who underwent a second myelography, the post-treatment findings of sensory function were correlated to radiological regression.     

Brain stem tuberculoma in adult patients: Diagnosis and treatment

A consecutive series of six adult patients ranging in age from 29 to 53 years is presented. The clinical and radiological features in each patient are described. Attention is drawn to the features demonstrated on computed axial tomography. In only one patient, the first encountered, was surgical excision undertaken and histological verification obtained. One patient died before any form of treatment could be instituted. The remaining four patients were treated with antituberculous chemotherapy alone and their progress monitored by sequential computed tomography. The excellent response and good outcome in this conservatively treated group are documented.     

放射卫生机构在核辐射卫生应急体系作用探讨

分析和探讨放射卫生机构在核辐射卫生应急体系中发挥的作用。通过对比发现,核辐射紧急医学救援基地多由取得放射卫生技术服务（甲级）资质或放射性疾病诊断机构资质的单位承担建设任务。放射卫生机构在平时工作中积累的辐射监测、污染检测、剂量估算、健康效应评价等技术能力可在核辐射卫生应急处置中发挥重要作用,实现能力建设的“平急结合”。建议各级放射卫生机构继续发挥自身所长,通过参加放射卫生监测项目的机会提高自身能力,并积极参与放射卫生技术机构检测能力考核,为核辐射卫生应急工作做好人才和技术储备。     

肋骨肿瘤X线诊断(附50例报告)

目的：探讨肋骨肿瘤的X线诊断。方法：回顾性分析50例经病理证实的肋骨肿瘤的X线表现。结果：肋骨肿瘤基本X线征象是骨破坏,良性肋骨肿瘤呈膨胀性骨破坏,边界清楚,骨皮质完整、变薄。恶生骨肿瘤表现为侵蚀样骨破坏,边界不清,呈虫蚀状,溶骨性一扫光样改变或成骨样改变。结论：肋骨肿瘤可在肺野内形成异常影像,易误诊为肺及纵隔病变,阅胸片时需注意观察,分析肋内改变。     

预防性维修在放射设备维修中的探索

介绍我们对放射设备进行预防性维修的探索工作,总结在放射科实施预防性维修的意义。     

脑膜瘤复发的多因素研究

目的探讨诸多临床因素和影像学特征对脑膜瘤复发的影响。以便能有效地早期预防和控制脑膜瘤复发，改善其预后。方法回顾1993～1997年武汉大学中南医院神经外科经手术治疗脑膜瘤患者145例，对其临床诊治过程和影像学资料进行回顾性分析，发现其中资料齐全的有83例，分析其临床因素如性别、年龄、手术切除程度、组织学类型和影像学特征如瘤周水肿、肿瘤形状、肿瘤大小、骨质改变、肿瘤部位、钙化、瘤周边界、CT增强形态。应用SPSS11．07软件，进行单因素分析和多因素分析。多因素分析应用二值多元logic回归模型，以诸多临床因素和影像学特征作为自变量，复发与否作为因变量。结果经单因素分析显示：肿瘤形状、肿瘤大小、瘤周水肿、组织学类型，手术切除程度、肿瘤部位和CT增强形态与脑膜瘤复发有明显关系。多因素分析显示：肿瘤形状、肿瘤大小、肿瘤部位、瘤周水肿、组织学类型、手术切除程度、CT增强形态是影响恼膜瘤复发的主要因素。其它囟素在单因素分析及多因素分析中均显示对脑膜瘤复发无明显影响。结论脑膜瘤手术切除程度、组织学类型和CT扫描增强对脑膜瘤复发有明显影响。可作为预测脑膜瘤复发的显著危险因子和标准。     

CBRN considerations in a major incident

Chemical, biological, radiological and nuclear (CBRN) hazards may be encountered during any major incident. General considerations include modifications to triage, managing contaminated or contagious casualties, and the identification and appropriate management of intoxicated/infected/irradiated/injured casualties. In dealing with chemical incidents, characteristics such as toxicity, latency and persistency need to be understood in order to manage casualties appropriately in terms of triage category, life-saving interventions and assessment of contamination risk to responders. Biological agents can be differentiated into live agents (bacteria, viruses and fungi) and toxins. Live agent characteristics and management depend on pathogenicity, virulence, lethality, infectivity and transmissibility, whereas toxins are treated similarly to chemical agents. Radiological and nuclear hazards are managed similarly and may cause irradiation, contamination (external and internal) or a combination with or without trauma. A generic and structured approach is advised to deal with all major incidents including those with a suspected of confirmed CBRN hazard. All healthcare professionals that may be involved in the response to such an incident need to be familiar with the principles of CBRN incident management and of CBRN casualty management as described in this article.     

Efficacy of antibiotic‐impregnated cement in total hip replacement

Background and purpose?Antibiotic‐impregnated cement is used as a spacer or during re‐implantation surgery for the treatment of infected total hip arthroplasties. The routine use of antibiotic‐impregnated cement during primary or uninfected revision total hip arthroplasty remains controversial. With this meta‐analysis of the published literature, we intended to assess efficacy and safety in the use of antibiotic‐impregnated cement for uninfected arthroplasty.

Methods?Following a detailed literature search, only studies reporting on the outcome of total hip replacement performed with antibiotic cement were included. Strict inclusion criteria were used and studies lacking sufficient sample size or critical data were excluded. 19 studies reporting on 36,033 hip replacements in 35,659 patients met the initial inclusion criteria. The main aim of the meta‐analysis was to determine the rate of deep infection with and without the use of antibiotic cement, and to assess the revision rate and the ultimate survivorship of arthroplasty using antibiotic cement.

Results?The rate of deep infection following primary total hip arthroplasty, at 1.2%, was significantly lower when antibiotic cement was used than when cement without antibiotics was used (2.3%). Similarly, the rate of deep infection following revision total hip arthroplasty when a standard combination of cement and antibiotic—or a custom‐made combination of cement and antibiotic, depending on the results of culture—was used, was almost half of the rate of deep infection when no antibiotics were present in the cement. Overall, the survivorship was 98% (101 failures in 5,178 hips) for primary arthroplasty and 88% (100 failures in 855 hips) for revision arthroplasty. There were no reported adverse events or complications associated with the use of antibiotic‐impregnated cement.

Interpretation?The use of antibiotic‐impregnated cement lowered the infection rate by approximately 50% in primary hip arthroplasty. For revisions of previously infected hips, combinations or culture‐dependent antibiotics lowered infection rates by approximately 40%.     

Radiological impact assessment to the environment due to waste from disposal of porcelain

The present study aimed to assess the radiological parameters from gamma rays due to the uncontrolled disposal of porcelain waste to the environment. Qualitative and quantitative identification of radionuclides in the investigated samples was carried out by means of a high-purity germanium (HPGe) detector. The average activity concentrations of the local porcelain samples were measured as 208.28?Bq/kg for ²²⁶Ra, 125.73?Bq/kg for ²³⁸U, 84.94?Bq/kg for ²³²Th and 1033.61?Bq/kg for ⁴⁰K, respectively. The imported samples had an average activity of 240.57?Bq/kg for ²²⁶Ra, 135.56?Bq/kg for ²³⁸U, 115.74?Bq/kg for ²³²Th and 1312.49?Bq/kg for ⁴⁰K, respectively. Radiological parameters and the radium equivalent Ra_eq for the investigated samples were calculated. The external and internal hazard indices, representative level index (I_γ), alpha index (I_α), and the exemption level (I_x), were estimated to be higher than the recommended value (unity), while the average activity concentrations for the studied samples were higher than recommended levels. In conclusion, we are concerned that disposal of porcelain in the environment might be a significant hazard.