Assessing the competence of registered radiographers’ clinical work is of great importance because of the recent change in nursing focus and rapid technological development. Self-assessment assists radiographers to v...Assessing the competence of registered radiographers’ clinical work is of great importance because of the recent change in nursing focus and rapid technological development. Self-assessment assists radiographers to validate and improve clinical practice by identifying their strengths as well as areas that may need to be developed. The aim of the study was to develop and psychometrically test a specially designed instrument, the Radiographers Competence Scale (RCS). A cross sectional survey was conducted comprising 406 randomly selected radiographers all over Sweden. The study consisted of two phases;the development of the instrument and evaluation of its psychometric properties. The first phase included three steps: 1) construction of the RCS;2) pilot testing of face and content validity;and 3) creation of a web-based 54-item questionnaire for testing the instrument. The second phase comprised psychometric evaluation of construct validity, internal consistency reliability and item reduction. The analysis reduced the initial 54 items of the RCS to 28 items. A logical two-factor solution was identified explaining 53.8% of the total variance. The first factor labelled “Nurse initiated care” explained 31.7% of the total variance. Factor 2 labelled “Technical and radiographic processes” explained 22.1% of the total variance. The scale had good internal consistency reliability, with a Cronbach’s alpha of 0.87. The RCS is a short, easy to administer scale for capturing radiographers’ competence levels and the frequency of using their competence. The scale was found to be valid and reliable. The self-assessment RCS can be used in management, patient safety and quality improvement to enhance the radiographic process.展开更多
Objective: The work aims to determine the radiographers’ preference between primary and secondary radiation fields for imprinting anatomical markers on radiographs. Methodology: Processed radiographs from the darkroo...Objective: The work aims to determine the radiographers’ preference between primary and secondary radiation fields for imprinting anatomical markers on radiographs. Methodology: Processed radiographs from the darkroom with evidence of radiographic anatomical markings were selected randomly and reviewed using a viewing box, within a 4-week period. The radiation field in which markers were placed was noted for each radiograph. Faintly-appearing and partly coned- off markers were excluded. Simple statistical tools were used to derive central tendency. Result: 623 radiographs were assessed. 89.0% (n = 555) had markers in the primary radiation field while 11.0% (n = 68) were in the secondary radiation field. 98% (n = 611) of markers did not obstruct essential anatomy while 2% (n = 12) did, but the radiographs were neither repeated nor rejected because of the twin reason of reportability and the need to avoid additional radiation dose to patients. Conclusion: Radiographers in the centre preferred the primary radiation field for marker placement to avoid cone-off, cut-off and illegibility which leads to repeat. This, however, does not offer superior advantage to markers placed in secondary radiation field. It is recommended that marker placement preference should be guided by the need for legibility, aesthetics and avoidance of essential anatomy.展开更多
Background:Radiographers were at risk of x-ray radiation.Ministry of Heath of Indonesia made a regulation act no.33 year 2007 to secure radiographers on ionizing radiations by using radiation protection equipment(RPE)...Background:Radiographers were at risk of x-ray radiation.Ministry of Heath of Indonesia made a regulation act no.33 year 2007 to secure radiographers on ionizing radiations by using radiation protection equipment(RPE).Objective:This study identified the factors affecting compliance towards RPE among radiographers and determined the correlation between influencing factors and compliance towards RPEs.Methods:The study conducted a quantitative descriptive-correlational design in a cross sectional approach.A total of 103 radiographers answered the online self administered questionnaires from 9 government hospitals at Jakarta,Indonesia.Results:It was identified that personal factors were the knowledge and motivations while the availability of RPEs and standard operating procedures were environmental factors.The knowledge(p=0.001,r=0.321)and motivations(p=0.018,r=0.232),and availability of RPE(p=0.138,r=0.146)and standard operating procedures(p=0.023,r=0.224)were factors affecting a compliance to RPEs.It was however determined that gender(p=0.251,r=0.113),and place of work(p=0.479,r=0.070)were not correlated to both personal and environmental factors.On the contrary,age(p=0.031,r=0.212),highest educational attainment(p=0.039,r=0.203),years of experience(p=0.001,r=0.336),and training(p=0.001,r=0.341)influenced both personal and environmental factors affecting compliance of radiographers towards RPEs.Findings:It was found that Dr.Cipto Mangunkusumo(p=0.271),Persahabatan(p=0.133),Fatmawati(p=0.357),Otak Nasional(p=0.238),Pasar Rebo(p=0.356),Tarakan(0.255),and Koja(p=0.199)hospitals were not probable to comply towards RPEs.Only Infeksi Sulianti Suroso(p=0.21),and Budhi Asih(p=0.0002)hospitals were most probable to comply towards RPEs.展开更多
Objective:To assess the radiation protection practices and knowledge among radiographers in the central region of Ghana.Methods:A cross-sectional study was carried out among practicing radiographers in three selected ...Objective:To assess the radiation protection practices and knowledge among radiographers in the central region of Ghana.Methods:A cross-sectional study was carried out among practicing radiographers in three selected hospitals.The study was carried out from January to October 2021.A self-administered questionnaire comprising three sections was given out to 20 participants to answer.Data were analyzed statistically using the Statistical Package for Social Sciences(SPSS)version 25.0 and logistic regression analysis.Results:The study revealed that over ninety percent of the radiographers had dosimeters but only 25%wear them always.Adherence to radiation protection measures and practices was found to be generally fairly satisfactory,but was high in the age group 35-45.However,Knowledge of radiation protection practices amongst the radi-ographers was generally high.Working experience of fewer than 5 years(P=0.035)gave a high odds ratio(OR)and was of a significant value in determining the radiation training and courses undertaken by these radiographers.Conclusions:The adherence to radiation protection practices was fairly satisfactory,and the knowledge of radi-ation protection practices was generally high,but that is not enough.There is more room for improvement to ensure knowledge is put into practice to enhance proper safety measures,ensure effective work,and overall reduce the negative effects of ionizing radiation.展开更多
Intertrochanteric fractures,prevalent among older adults,pose significant clinical challenges due to high morbidity,mortality,and complication rates.Despite advancements in surgical methods and implant technology,one-...Intertrochanteric fractures,prevalent among older adults,pose significant clinical challenges due to high morbidity,mortality,and complication rates.Despite advancements in surgical methods and implant technology,one-year mortality remains between 20%and 30%,with up to 20%of survivors requiring revision surgery due to mechanical complications.Accurate fracture reduction and precise implant positioning are critical determinants of successful outcomes.This review synthesizes current literature on key radiographic parameters essential for evaluating fracture reduction quality and implant placement in intertrochanteric fracture fixation.Standardized intraoperative imaging techniques,such as correct anteroposterior and lateral fluoroscopic views,are fundamental for identifying malalignment.Important radiographic measures include the neck shaft angle,greater trochanter orthogonal line,anterior cortical line,and calcar displacement assessment.Reduction quality indices,notably the Baumgaertner and Chang Reduction Quality Criteria,provide reliable frameworks for predicting mechanical complications.Additionally,implant positioning parameters—including tip-apex distance,Calcar-referenced tip-apex distance,Cleveland zones,and Parker’s ratio index—are discussed as predictors of mechanical complications.Enhanced understanding and application of these radiographic criteria can improve surgical precision,reduce complications,and ultimately optimize patient outcomes in intertrochanteric fracture management.展开更多
Mucopolysaccharidoses(MPS)encompass a spectrum of inherited lysosomal storage disorders caused by deficiencies in enzymes required for glycosami-noglycan(GAG)degradation.These enzymatic deficits lead to GAG accumulati...Mucopolysaccharidoses(MPS)encompass a spectrum of inherited lysosomal storage disorders caused by deficiencies in enzymes required for glycosami-noglycan(GAG)degradation.These enzymatic deficits lead to GAG accumulation within lysosomes,resulting in progressive multiorgan damage,with skeletal ab-normalities prominently affecting diagnostic imaging.Radiologists play a crucial role in identifying characteristic skeletal changes,including skull defor-mities like J-shaped sella turcica,cranial thickening,spinal abnormalities such as odontoid hypoplasia and kyphosis,and unique thoracic and pelvic malformations.This review synthesizes radiographic findings across MPS subtypes,underscoring the importance of early diagnosis and continual imaging to monitor disease progre-ssion,particularly in the context of enzyme replacement therapy(ERT).While ERT offers symptom stabilization,it provides limited reversal of established structural abnormalities.Comprehensive radiographic assessment remains in-dispensable for guiding both symptomatic management and potential surgical intervention,thereby enhancing clinical outcomes for MPS patients.展开更多
Objective:Deep learning(DL)has become the prevailing method in chest radiograph analysis,yet its performance heavily depends on large quantities of annotated images.To mitigate the cost,cold-start active learning(AL),...Objective:Deep learning(DL)has become the prevailing method in chest radiograph analysis,yet its performance heavily depends on large quantities of annotated images.To mitigate the cost,cold-start active learning(AL),comprising an initialization followed by subsequent learning,selects a small subset of informative data points for labeling.Recent advancements in pretrained models by supervised or self-supervised learning tailored to chest radiograph have shown broad applicability to diverse downstream tasks.However,their potential in cold-start AL remains unexplored.Methods:To validate the efficacy of domain-specific pretraining,we compared two foundation models:supervised TXRV and self-supervised REMEDIS with their general domain counterparts pretrained on ImageNet.Model performance was evaluated at both initialization and subsequent learning stages on two diagnostic tasks:psychiatric pneumonia and COVID-19.For initialization,we assessed their integration with three strategies:diversity,uncertainty,and hybrid sampling.For subsequent learning,we focused on uncertainty sampling powered by different pretrained models.We also conducted statistical tests to compare the foundation models with ImageNet counterparts,investigate the relationship between initialization and subsequent learning,examine the performance of one-shot initialization against the full AL process,and investigate the influence of class balance in initialization samples on initialization and subsequent learning.Results:First,domain-specific foundation models failed to outperform ImageNet counterparts in six out of eight experiments on informative sample selection.Both domain-specific and general pretrained models were unable to generate representations that could substitute for the original images as model inputs in seven of the eight scenarios.However,pretrained model-based initialization surpassed random sampling,the default approach in cold-start AL.Second,initialization performance was positively correlated with subsequent learning performance,highlighting the importance of initialization strategies.Third,one-shot initialization performed comparably to the full AL process,demonstrating the potential of reducing experts'repeated waiting during AL iterations.Last,a U-shaped correlation was observed between the class balance of initialization samples and model performance,suggesting that the class balance is more strongly associated with performance at middle budget levels than at low or high budgets.Conclusions:In this study,we highlighted the limitations of medical pretraining compared to general pretraining in the context of cold-start AL.We also identified promising outcomes related to cold-start AL,including initialization based on pretrained models,the positive influence of initialization on subsequent learning,the potential for one-shot initialization,and the influence of class balance on middle-budget AL.Researchers are encouraged to improve medical pretraining for versatile DL foundations and explore novel AL methods.展开更多
Routine postoperative radiographs after surgical fixation of pediatric distal-radius fractures have long been part of standard care.Yet growing evidence shows that these images rarely change management in stable cases...Routine postoperative radiographs after surgical fixation of pediatric distal-radius fractures have long been part of standard care.Yet growing evidence shows that these images rarely change management in stable cases,adding unnecessary cost,radiation exposure,and clinical burden.A recent study highlights this issue and questions whether routine imaging truly benefits patient outcomes.As orthopedic care shifts toward more patient-centered and value-driven models,there is increasing support for the judicious use of radiographs,reserving imaging for cases where clinical examination or patient symptoms suggest a potential problem.This shift would reflect a broader movement within orthopedic practice:Aligning tradition with necessity,and optimizing care based on evidence rather than habit.展开更多
Badk ground:The role of cardiothoracic ratio(CTR)from the chest radiograph for assessmentof ventricular enlargement and function in rpaired tetralogy of Fallot(TOF)is conflicting.This study aimnedto determnine the ass...Badk ground:The role of cardiothoracic ratio(CTR)from the chest radiograph for assessmentof ventricular enlargement and function in rpaired tetralogy of Fallot(TOF)is conflicting.This study aimnedto determnine the associations between CTR and cardiac magnetic resonance(CMR)-derived ventricularvolumes and indices of ventricular function in adolescents and young adults with repaired TOF.Methods:The CTR and CMR findings,performed within 12 months of each other,were reviewed in 76 patients aged22.1±6.4 years.Associations between CTR and CMR parameters including right(RV)and left ventricular(LV)volumes and ejecticn fraction were determined.Diagnostic accuracies of CTR in identify ing moderateto severe RV or LV dilation were assessed by calculation of area under the receiver operator characteristiccurves(AUC),Results:Patients with normal CTR and those with increased CTR>0.5 had simnilar right andleft ventricular volumes,ejection fraction,and pulmonary regurgitant fraction(all p>0.05),There wereno significant oorrelations between CTR and RV end-diastolic(r=0.06,p=0.65)and end-systolic(r=0.06,=0.65)volumes,LV end-diastolic(=0.23,p=0.08)and end-systolic(r=0.18,p=0.16)volumes,and LV(r=—0.07,p=0.60)and RV(r<-0.01,p=0.97)ejection fraction.The CTR failed to distinguish betweenpatients with moderate to severe RV(AUC0.50)or LV(AUC 0.46)dilation from patients without ventriculardilation.Condlusions:The CTR based on the chest radiograph failed to reflect dilation or raduced ejectionfraction of either the right or the left ventricle in adolescents and young adults with repaired TOF.展开更多
BACKGROUND Pancreatic cystic neoplasms(PCNs)are increasingly detected due to advancements in radiographic techniques,with a prevalence of approximately 15%in the general population.These lesions range from benign to p...BACKGROUND Pancreatic cystic neoplasms(PCNs)are increasingly detected due to advancements in radiographic techniques,with a prevalence of approximately 15%in the general population.These lesions range from benign to premalignant and malignant,posing a diagnostic challenge.Accurate differentiation is critical,as premalignant and malignant PCNs often require surgical intervention,while benign cysts may only need monitoring unless symptomatic.Current diagnostic methods,including cross-sectional imaging,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration/biopsy,are specialized,not universally available,and have variable accuracy.Clinical and laboratory parameters such as carbohydrate antigen 19-9(CA 19-9),neutrophillymphocyte ratio,platelet-lymphocyte ratio,and red cell distribution width(RDW)have been associated with malignancy risk,though only CA 19-9 is guideline-supported.AIM To assess the malignancy risk of PCNs using preoperative clinical and routine laboratory parameters.METHODS A retrospective cohort study analyzed 70 patients who underwent surgery for PCNs at Ankara Bilkent City Hospital between February 2019 and March 2023.Patients were categorized into group A(benign or low-grade dysplasia,n=40)and group B(malignancy or high-grade dysplasia,n=30)based on postoperative pathology.Preoperative demographic and laboratory parameters,including age,RDW,albumin,and CA 19-9,were compared.Univariate and multivariate logistic regression analyses identified independent predictors of malignancy.Receiver operating characteristic curve analysis evaluated predictive performance,with internal validation using bootstrapping.RESULTS Group B patients were older(69.86±9.58 years vs 52.74±16.85 years,P<0.001)and had a higher incidence of diabetes mellitus(57.1%vs 21.4%,P=0.002).RDW(16.2%vs 13.7%,P<0.001),platelet-lymphocyte ratio(178 vs 126,P=0.008),and CA 19-9(21.7 U/mL vs 9.3 U/mL,P=0.009)were significantly higher in group B,while albumin was lower(41 g/L vs 45 g/L,P=0.008).Multivariate analysis identified age[odds ratio=1.067,95%confidence interval(CI):1.014-1.122,P=0.012]and RDW(odds ratio=1.784,95%CI:1.172-2.715,P=0.007)as independent predictors.The area under the curve for age,RDW,and their combination was 0.798(95%CI:0.695-0.900),0.801(95%CI:0.692-0.911),and 0.858(95%CI:0.771-0.944),respectively,with bootstrapped validation confirming stability.Cut-off values of age≥60 years and RDW≥15.5%balanced sensitivity and specificity,increasing malignancy risk 15.3-fold and 22.6-fold,respectively.CONCLUSION Age and RDW are independent predictors of malignancy in PCNs,aiding in patient selection for advanced diagnostics and surgery.Larger,multicenter studies are needed to validate these findings.展开更多
Gamma-ray imaging systems are powerful tools in radiographic diagnosis.However,the recorded images suffer from degradations such as noise,blurring,and downsampling,consequently failing to meet high-precision diagnosti...Gamma-ray imaging systems are powerful tools in radiographic diagnosis.However,the recorded images suffer from degradations such as noise,blurring,and downsampling,consequently failing to meet high-precision diagnostic requirements.In this paper,we propose a novel single-image super-resolution algorithm to enhance the spatial resolution of gamma-ray imaging systems.A mathematical model of the gamma-ray imaging system is established based on maximum a posteriori estimation.Within the plug-and-play framework,the half-quadratic splitting method is employed to decouple the data fidelit term and the regularization term.An image denoiser using convolutional neural networks is adopted as an implicit image prior,referred to as a deep denoiser prior,eliminating the need to explicitly design a regularization term.Furthermore,the impact of the image boundary condition on reconstruction results is considered,and a method for estimating image boundaries is introduced.The results show that the proposed algorithm can effectively addresses boundary artifacts.By increasing the pixel number of the reconstructed images,the proposed algorithm is capable of recovering more details.Notably,in both simulation and real experiments,the proposed algorithm is demonstrated to achieve subpixel resolution,surpassing the Nyquist sampling limit determined by the camera pixel size.展开更多
Background: Diagnostic reference levels for a number of common diagnostic radiological examinations against which individual centres could compare their performance have been recommended by relevant international agen...Background: Diagnostic reference levels for a number of common diagnostic radiological examinations against which individual centres could compare their performance have been recommended by relevant international agencies. Due to variations in different populations globally, local and national diagnostic reference levels are more reliable. To the best of our knowledge, no centre-specific study has been carried out and national surveys are not available. Objective: To establish a preliminary local and national diagnostic reference level in Nigeria. Methods: A pro-spective and cross-sectional study involving 30 conscious paediatrics and adult patients referred for head computed tomography scan. They were positioned supine and scanned according to the standard protocol for head computed tomography with manual mA selection. The total dose-length products were recorded at the end of the pre-contrast and post-contrast sequences respectively. The pre-contrast dose was taken into cognizance in the determination of the post-contrast value. The effective dose was established by multiplying the dose-length product by 0.0023 mSv.mGy-1.cm-1, a conversion coefficient for brain tissue adopted from the European Commission. Statistical Package for Social Sciences version 17.0 was used to analyze the data. Results: 30 paediatrics and adult patients of mixed gender participated in the study. Their ages ranged from 1 to 74 years with a mean age of 41.47 ± 23.30 years. The pre-contrast effective dose ranged from 1.93 mSv to 3.32 mSv with mean of 2.56 ± 0.51 mSv and 75th percentile of 3.11 mSv while the post-contrast effective dose ranged from 4.06 mSv to 6.97 mSv with mean of 5.27 ± 0.97 mSv and 75th percentile of 6.13 mSv. The mean effective dose from this work and two other isolated studies was 3.0 mSv. Conclusion: Although our quantified doses are below threshold limits for occupational exposures they are higher than the recommended level for the public. A further optimization of scanning protocols by the radiographers could lower the effective dose for patients undergoing contrast head computed tomography in our centre and in the country.展开更多
Background: Computed radiography has a wider exposure latitude when compared with film-screen imaging system. Consequently, the risk of dose creep is high. A conscientious effort is there-fore, needed by the radiograp...Background: Computed radiography has a wider exposure latitude when compared with film-screen imaging system. Consequently, the risk of dose creep is high. A conscientious effort is there-fore, needed by the radiographer to keep exposure as low as reasonably achievable. Objective: To derive a computed radiography exposure chart for a negroid population using AGFA photostimulable phosphor plates and a GE static X-ray machine. Materials and Method: A static X-ray machine, a digitizer, and photostimulable phosphor plates were used for the X-ray examination. Chest examinations were done at a Focus-Film-Distance (FFD) of 150 - 180 cm while all other examinations were conducted at 90 - 100 cm FFD. The range of exposure factors (kVp, mA and mAs) used by radiog-raphers in the centre was noted and the 90th percentile calculated. Over a three-month period, the patients were examined with the 90th percentile of tube potential (kVp) while keeping other factors constant. The kVp was gradually decreased and halted if radiologists and radiographers uncon-nected with the work expressed misgivings about the quality of the image. A similar procedure was adopted for the tube current (mA). The threshold adopted as low as reasonably achievable was the factor preceding the point of observation by other personnel. Metrics for central tendency from the statistical packages for social sciences, version 17.0 was used to analyze the data. Results: 335 subjects of both gender aged 0 - 92 years were examined by the researchers. Adult exposure factors used by the radiographers (and those derived by the researchers) had a range of 45 - 130 kVp (62 - 94 kVp), 63 - 320 mA (100 - 250 mA) and 4.0 - 25.0 mAs (5.0 - 20.0 mAs) respectively. Pediatric chest (and researchers-derived) factors were 50 - 75 kVp (52 - 65 kVp), 50 - 250 mA (100 - 220 mA) and 3.20 - 10.0 mAs (3.2 - 6.5 mAs) respectively. Conclusion: Upper threshold of adult (and paediatric) exposure factors in computed radiography with comparable equipment and accessories should not exceed 94 kVp (65 kVp), 250 mA (220 mA) and 20.0 mAs (6.5 mAs) respectively. The derived exposure chart is also adequate to address motion unsharpness in chest examinations.展开更多
AIM: To investigate the chest radiographic and high resolution computed tomography (HRCT) chest manifestations in glucocorticoid-na?ve allergic bronchopulmonary aspergillosis (ABPA) patients. METHODS: This is a prospe...AIM: To investigate the chest radiographic and high resolution computed tomography (HRCT) chest manifestations in glucocorticoid-na?ve allergic bronchopulmonary aspergillosis (ABPA) patients. METHODS: This is a prospective observational study and includes 60 consecutive glucocorticoid-na?ve patients with ABPA who underwent chest radiography and HRCT of the chest (1.25 mm every 10 mm) in the routine diagnostic workup for ABPA. RESULTS: Chest radiographs were normal in 50% of cases. Of the remainder, most patients demonstrated permanent findings in the form of parallel line and ring shadows suggesting bronchiectasis. Consolidation was detected in 17 cases but in the majority, the corresponding HRCT chest scan showed mucus-filled bronchiectatic cavities. Chest HRCT was normal in 22 patients, while central bronchiectasis (CB) was demonstrated in the remaining 38 patients. Bronchiectasis extended to the periphery in 33%-43% depending on the criteria used for defining CB. The other findings observed on HRCT were mucoid impaction, centrilobular nodules and high-attenuation mucus in decreasing order of frequency. CONCLUSION: Patients with ABPA can present with normal HRCT chest scans. Central bronchiectasis cannot be considered a characteristic feature of ABPA as peripheral bronchiectasis is commonly observed. Consolidation is an uncommon finding in ABPA.展开更多
The author presents three cases of esophageal rupture during the treatment of massive esophageal variceal bleeding with Sengstaken-Blakemore (SB) tube. In each case, simple auscultation was used to guide SB tube inser...The author presents three cases of esophageal rupture during the treatment of massive esophageal variceal bleeding with Sengstaken-Blakemore (SB) tube. In each case, simple auscultation was used to guide SB tube insertion, with chest radiograph obtained only after complete inflation of the gastric balloon. Two patients died of hemorrhagic shock and one died of mediastinitis.The author suggests that confirmation of SB tube placement by auscultation alone may not be adequate.Routine chest radiographs should be obtained before and after full inflation of the gastric balloon to confirm tube position and to detect tube dislocation.展开更多
Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools,specially imaging methods, have become mandatory.From the si...Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools,specially imaging methods, have become mandatory.From the simple intra-oral periapical X-rays, advanced imaging techniques like computed tomography, cone beam computed tomography, magnetic resonance imaging and ultrasound have also found place in modern dentistry. Changing from analogue to digital radiography has not only made the process simpler and faster but also made image storage, manipulation(brightness/contrast, image cropping, etc.) and retrieval easier. The three-dimensional imaging has made the complex cranio-facial structures more accessible for examination and early and accurate diagnosis of deep seated lesions. This paper is to review current advances in imaging technology and their uses in different disciplines of dentistry.展开更多
Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascari...Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascariasis is rare.An old female presented with dysphagia after an intake of several red bean buns and haw jellies.The barium meal examination revealed a spherical defect in the lower esophagus.Esophageal bezoar or esophageal carcinoma was considered at the beginning.The patient fasted,and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate.Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb.The conclusive diagnosis was ascariasis.The esophageal space-occupying lesion might be the entangled worm bolus.Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up.Authors report herein this rare case of Ascaris lumbricoides in the esophagus,emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.展开更多
With the technical development of new warhead designs and improvised explosive device protection,irregular casing filled with explosive has been paid more attention recently. In this paper, we studied the fragmentatio...With the technical development of new warhead designs and improvised explosive device protection,irregular casing filled with explosive has been paid more attention recently. In this paper, we studied the fragmentation of a type of D-shaped casing, which is a common asymmetric casing in the field of warhead design. Based on the radiograph technique, static explosive experiments were conducted with D-shaped casings under four different eccentric initiation ratios to explore their fragmentation. A numerical model was then established to simulate the dynamic response of D-shaped casing filled with explosive. The results of numerical simulation were found to agree well with the experimental data.According to the results of numerical simulation and experimental data, the dynamic responses of Dshaped casing were analyzed. The results of the current work pave way for the innovative design of new warhead and for further studying the dynamic response of asymmetric casing.展开更多
AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis wa...AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.展开更多
文摘Assessing the competence of registered radiographers’ clinical work is of great importance because of the recent change in nursing focus and rapid technological development. Self-assessment assists radiographers to validate and improve clinical practice by identifying their strengths as well as areas that may need to be developed. The aim of the study was to develop and psychometrically test a specially designed instrument, the Radiographers Competence Scale (RCS). A cross sectional survey was conducted comprising 406 randomly selected radiographers all over Sweden. The study consisted of two phases;the development of the instrument and evaluation of its psychometric properties. The first phase included three steps: 1) construction of the RCS;2) pilot testing of face and content validity;and 3) creation of a web-based 54-item questionnaire for testing the instrument. The second phase comprised psychometric evaluation of construct validity, internal consistency reliability and item reduction. The analysis reduced the initial 54 items of the RCS to 28 items. A logical two-factor solution was identified explaining 53.8% of the total variance. The first factor labelled “Nurse initiated care” explained 31.7% of the total variance. Factor 2 labelled “Technical and radiographic processes” explained 22.1% of the total variance. The scale had good internal consistency reliability, with a Cronbach’s alpha of 0.87. The RCS is a short, easy to administer scale for capturing radiographers’ competence levels and the frequency of using their competence. The scale was found to be valid and reliable. The self-assessment RCS can be used in management, patient safety and quality improvement to enhance the radiographic process.
文摘Objective: The work aims to determine the radiographers’ preference between primary and secondary radiation fields for imprinting anatomical markers on radiographs. Methodology: Processed radiographs from the darkroom with evidence of radiographic anatomical markings were selected randomly and reviewed using a viewing box, within a 4-week period. The radiation field in which markers were placed was noted for each radiograph. Faintly-appearing and partly coned- off markers were excluded. Simple statistical tools were used to derive central tendency. Result: 623 radiographs were assessed. 89.0% (n = 555) had markers in the primary radiation field while 11.0% (n = 68) were in the secondary radiation field. 98% (n = 611) of markers did not obstruct essential anatomy while 2% (n = 12) did, but the radiographs were neither repeated nor rejected because of the twin reason of reportability and the need to avoid additional radiation dose to patients. Conclusion: Radiographers in the centre preferred the primary radiation field for marker placement to avoid cone-off, cut-off and illegibility which leads to repeat. This, however, does not offer superior advantage to markers placed in secondary radiation field. It is recommended that marker placement preference should be guided by the need for legibility, aesthetics and avoidance of essential anatomy.
文摘Background:Radiographers were at risk of x-ray radiation.Ministry of Heath of Indonesia made a regulation act no.33 year 2007 to secure radiographers on ionizing radiations by using radiation protection equipment(RPE).Objective:This study identified the factors affecting compliance towards RPE among radiographers and determined the correlation between influencing factors and compliance towards RPEs.Methods:The study conducted a quantitative descriptive-correlational design in a cross sectional approach.A total of 103 radiographers answered the online self administered questionnaires from 9 government hospitals at Jakarta,Indonesia.Results:It was identified that personal factors were the knowledge and motivations while the availability of RPEs and standard operating procedures were environmental factors.The knowledge(p=0.001,r=0.321)and motivations(p=0.018,r=0.232),and availability of RPE(p=0.138,r=0.146)and standard operating procedures(p=0.023,r=0.224)were factors affecting a compliance to RPEs.It was however determined that gender(p=0.251,r=0.113),and place of work(p=0.479,r=0.070)were not correlated to both personal and environmental factors.On the contrary,age(p=0.031,r=0.212),highest educational attainment(p=0.039,r=0.203),years of experience(p=0.001,r=0.336),and training(p=0.001,r=0.341)influenced both personal and environmental factors affecting compliance of radiographers towards RPEs.Findings:It was found that Dr.Cipto Mangunkusumo(p=0.271),Persahabatan(p=0.133),Fatmawati(p=0.357),Otak Nasional(p=0.238),Pasar Rebo(p=0.356),Tarakan(0.255),and Koja(p=0.199)hospitals were not probable to comply towards RPEs.Only Infeksi Sulianti Suroso(p=0.21),and Budhi Asih(p=0.0002)hospitals were most probable to comply towards RPEs.
文摘Objective:To assess the radiation protection practices and knowledge among radiographers in the central region of Ghana.Methods:A cross-sectional study was carried out among practicing radiographers in three selected hospitals.The study was carried out from January to October 2021.A self-administered questionnaire comprising three sections was given out to 20 participants to answer.Data were analyzed statistically using the Statistical Package for Social Sciences(SPSS)version 25.0 and logistic regression analysis.Results:The study revealed that over ninety percent of the radiographers had dosimeters but only 25%wear them always.Adherence to radiation protection measures and practices was found to be generally fairly satisfactory,but was high in the age group 35-45.However,Knowledge of radiation protection practices amongst the radi-ographers was generally high.Working experience of fewer than 5 years(P=0.035)gave a high odds ratio(OR)and was of a significant value in determining the radiation training and courses undertaken by these radiographers.Conclusions:The adherence to radiation protection practices was fairly satisfactory,and the knowledge of radi-ation protection practices was generally high,but that is not enough.There is more room for improvement to ensure knowledge is put into practice to enhance proper safety measures,ensure effective work,and overall reduce the negative effects of ionizing radiation.
基金Supported by the Orthopaedic Research Foundation of Western Australia,Freie Akademische Gesellschaft Baseland Swiss Orthopaedics.
文摘Intertrochanteric fractures,prevalent among older adults,pose significant clinical challenges due to high morbidity,mortality,and complication rates.Despite advancements in surgical methods and implant technology,one-year mortality remains between 20%and 30%,with up to 20%of survivors requiring revision surgery due to mechanical complications.Accurate fracture reduction and precise implant positioning are critical determinants of successful outcomes.This review synthesizes current literature on key radiographic parameters essential for evaluating fracture reduction quality and implant placement in intertrochanteric fracture fixation.Standardized intraoperative imaging techniques,such as correct anteroposterior and lateral fluoroscopic views,are fundamental for identifying malalignment.Important radiographic measures include the neck shaft angle,greater trochanter orthogonal line,anterior cortical line,and calcar displacement assessment.Reduction quality indices,notably the Baumgaertner and Chang Reduction Quality Criteria,provide reliable frameworks for predicting mechanical complications.Additionally,implant positioning parameters—including tip-apex distance,Calcar-referenced tip-apex distance,Cleveland zones,and Parker’s ratio index—are discussed as predictors of mechanical complications.Enhanced understanding and application of these radiographic criteria can improve surgical precision,reduce complications,and ultimately optimize patient outcomes in intertrochanteric fracture management.
文摘Mucopolysaccharidoses(MPS)encompass a spectrum of inherited lysosomal storage disorders caused by deficiencies in enzymes required for glycosami-noglycan(GAG)degradation.These enzymatic deficits lead to GAG accumulation within lysosomes,resulting in progressive multiorgan damage,with skeletal ab-normalities prominently affecting diagnostic imaging.Radiologists play a crucial role in identifying characteristic skeletal changes,including skull defor-mities like J-shaped sella turcica,cranial thickening,spinal abnormalities such as odontoid hypoplasia and kyphosis,and unique thoracic and pelvic malformations.This review synthesizes radiographic findings across MPS subtypes,underscoring the importance of early diagnosis and continual imaging to monitor disease progre-ssion,particularly in the context of enzyme replacement therapy(ERT).While ERT offers symptom stabilization,it provides limited reversal of established structural abnormalities.Comprehensive radiographic assessment remains in-dispensable for guiding both symptomatic management and potential surgical intervention,thereby enhancing clinical outcomes for MPS patients.
文摘Objective:Deep learning(DL)has become the prevailing method in chest radiograph analysis,yet its performance heavily depends on large quantities of annotated images.To mitigate the cost,cold-start active learning(AL),comprising an initialization followed by subsequent learning,selects a small subset of informative data points for labeling.Recent advancements in pretrained models by supervised or self-supervised learning tailored to chest radiograph have shown broad applicability to diverse downstream tasks.However,their potential in cold-start AL remains unexplored.Methods:To validate the efficacy of domain-specific pretraining,we compared two foundation models:supervised TXRV and self-supervised REMEDIS with their general domain counterparts pretrained on ImageNet.Model performance was evaluated at both initialization and subsequent learning stages on two diagnostic tasks:psychiatric pneumonia and COVID-19.For initialization,we assessed their integration with three strategies:diversity,uncertainty,and hybrid sampling.For subsequent learning,we focused on uncertainty sampling powered by different pretrained models.We also conducted statistical tests to compare the foundation models with ImageNet counterparts,investigate the relationship between initialization and subsequent learning,examine the performance of one-shot initialization against the full AL process,and investigate the influence of class balance in initialization samples on initialization and subsequent learning.Results:First,domain-specific foundation models failed to outperform ImageNet counterparts in six out of eight experiments on informative sample selection.Both domain-specific and general pretrained models were unable to generate representations that could substitute for the original images as model inputs in seven of the eight scenarios.However,pretrained model-based initialization surpassed random sampling,the default approach in cold-start AL.Second,initialization performance was positively correlated with subsequent learning performance,highlighting the importance of initialization strategies.Third,one-shot initialization performed comparably to the full AL process,demonstrating the potential of reducing experts'repeated waiting during AL iterations.Last,a U-shaped correlation was observed between the class balance of initialization samples and model performance,suggesting that the class balance is more strongly associated with performance at middle budget levels than at low or high budgets.Conclusions:In this study,we highlighted the limitations of medical pretraining compared to general pretraining in the context of cold-start AL.We also identified promising outcomes related to cold-start AL,including initialization based on pretrained models,the positive influence of initialization on subsequent learning,the potential for one-shot initialization,and the influence of class balance on middle-budget AL.Researchers are encouraged to improve medical pretraining for versatile DL foundations and explore novel AL methods.
文摘Routine postoperative radiographs after surgical fixation of pediatric distal-radius fractures have long been part of standard care.Yet growing evidence shows that these images rarely change management in stable cases,adding unnecessary cost,radiation exposure,and clinical burden.A recent study highlights this issue and questions whether routine imaging truly benefits patient outcomes.As orthopedic care shifts toward more patient-centered and value-driven models,there is increasing support for the judicious use of radiographs,reserving imaging for cases where clinical examination or patient symptoms suggest a potential problem.This shift would reflect a broader movement within orthopedic practice:Aligning tradition with necessity,and optimizing care based on evidence rather than habit.
文摘Badk ground:The role of cardiothoracic ratio(CTR)from the chest radiograph for assessmentof ventricular enlargement and function in rpaired tetralogy of Fallot(TOF)is conflicting.This study aimnedto determnine the associations between CTR and cardiac magnetic resonance(CMR)-derived ventricularvolumes and indices of ventricular function in adolescents and young adults with repaired TOF.Methods:The CTR and CMR findings,performed within 12 months of each other,were reviewed in 76 patients aged22.1±6.4 years.Associations between CTR and CMR parameters including right(RV)and left ventricular(LV)volumes and ejecticn fraction were determined.Diagnostic accuracies of CTR in identify ing moderateto severe RV or LV dilation were assessed by calculation of area under the receiver operator characteristiccurves(AUC),Results:Patients with normal CTR and those with increased CTR>0.5 had simnilar right andleft ventricular volumes,ejection fraction,and pulmonary regurgitant fraction(all p>0.05),There wereno significant oorrelations between CTR and RV end-diastolic(r=0.06,p=0.65)and end-systolic(r=0.06,=0.65)volumes,LV end-diastolic(=0.23,p=0.08)and end-systolic(r=0.18,p=0.16)volumes,and LV(r=—0.07,p=0.60)and RV(r<-0.01,p=0.97)ejection fraction.The CTR failed to distinguish betweenpatients with moderate to severe RV(AUC0.50)or LV(AUC 0.46)dilation from patients without ventriculardilation.Condlusions:The CTR based on the chest radiograph failed to reflect dilation or raduced ejectionfraction of either the right or the left ventricle in adolescents and young adults with repaired TOF.
文摘BACKGROUND Pancreatic cystic neoplasms(PCNs)are increasingly detected due to advancements in radiographic techniques,with a prevalence of approximately 15%in the general population.These lesions range from benign to premalignant and malignant,posing a diagnostic challenge.Accurate differentiation is critical,as premalignant and malignant PCNs often require surgical intervention,while benign cysts may only need monitoring unless symptomatic.Current diagnostic methods,including cross-sectional imaging,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration/biopsy,are specialized,not universally available,and have variable accuracy.Clinical and laboratory parameters such as carbohydrate antigen 19-9(CA 19-9),neutrophillymphocyte ratio,platelet-lymphocyte ratio,and red cell distribution width(RDW)have been associated with malignancy risk,though only CA 19-9 is guideline-supported.AIM To assess the malignancy risk of PCNs using preoperative clinical and routine laboratory parameters.METHODS A retrospective cohort study analyzed 70 patients who underwent surgery for PCNs at Ankara Bilkent City Hospital between February 2019 and March 2023.Patients were categorized into group A(benign or low-grade dysplasia,n=40)and group B(malignancy or high-grade dysplasia,n=30)based on postoperative pathology.Preoperative demographic and laboratory parameters,including age,RDW,albumin,and CA 19-9,were compared.Univariate and multivariate logistic regression analyses identified independent predictors of malignancy.Receiver operating characteristic curve analysis evaluated predictive performance,with internal validation using bootstrapping.RESULTS Group B patients were older(69.86±9.58 years vs 52.74±16.85 years,P<0.001)and had a higher incidence of diabetes mellitus(57.1%vs 21.4%,P=0.002).RDW(16.2%vs 13.7%,P<0.001),platelet-lymphocyte ratio(178 vs 126,P=0.008),and CA 19-9(21.7 U/mL vs 9.3 U/mL,P=0.009)were significantly higher in group B,while albumin was lower(41 g/L vs 45 g/L,P=0.008).Multivariate analysis identified age[odds ratio=1.067,95%confidence interval(CI):1.014-1.122,P=0.012]and RDW(odds ratio=1.784,95%CI:1.172-2.715,P=0.007)as independent predictors.The area under the curve for age,RDW,and their combination was 0.798(95%CI:0.695-0.900),0.801(95%CI:0.692-0.911),and 0.858(95%CI:0.771-0.944),respectively,with bootstrapped validation confirming stability.Cut-off values of age≥60 years and RDW≥15.5%balanced sensitivity and specificity,increasing malignancy risk 15.3-fold and 22.6-fold,respectively.CONCLUSION Age and RDW are independent predictors of malignancy in PCNs,aiding in patient selection for advanced diagnostics and surgery.Larger,multicenter studies are needed to validate these findings.
基金supported by the National Natural Science Foundation of China(Grant No.12175183)。
文摘Gamma-ray imaging systems are powerful tools in radiographic diagnosis.However,the recorded images suffer from degradations such as noise,blurring,and downsampling,consequently failing to meet high-precision diagnostic requirements.In this paper,we propose a novel single-image super-resolution algorithm to enhance the spatial resolution of gamma-ray imaging systems.A mathematical model of the gamma-ray imaging system is established based on maximum a posteriori estimation.Within the plug-and-play framework,the half-quadratic splitting method is employed to decouple the data fidelit term and the regularization term.An image denoiser using convolutional neural networks is adopted as an implicit image prior,referred to as a deep denoiser prior,eliminating the need to explicitly design a regularization term.Furthermore,the impact of the image boundary condition on reconstruction results is considered,and a method for estimating image boundaries is introduced.The results show that the proposed algorithm can effectively addresses boundary artifacts.By increasing the pixel number of the reconstructed images,the proposed algorithm is capable of recovering more details.Notably,in both simulation and real experiments,the proposed algorithm is demonstrated to achieve subpixel resolution,surpassing the Nyquist sampling limit determined by the camera pixel size.
文摘Background: Diagnostic reference levels for a number of common diagnostic radiological examinations against which individual centres could compare their performance have been recommended by relevant international agencies. Due to variations in different populations globally, local and national diagnostic reference levels are more reliable. To the best of our knowledge, no centre-specific study has been carried out and national surveys are not available. Objective: To establish a preliminary local and national diagnostic reference level in Nigeria. Methods: A pro-spective and cross-sectional study involving 30 conscious paediatrics and adult patients referred for head computed tomography scan. They were positioned supine and scanned according to the standard protocol for head computed tomography with manual mA selection. The total dose-length products were recorded at the end of the pre-contrast and post-contrast sequences respectively. The pre-contrast dose was taken into cognizance in the determination of the post-contrast value. The effective dose was established by multiplying the dose-length product by 0.0023 mSv.mGy-1.cm-1, a conversion coefficient for brain tissue adopted from the European Commission. Statistical Package for Social Sciences version 17.0 was used to analyze the data. Results: 30 paediatrics and adult patients of mixed gender participated in the study. Their ages ranged from 1 to 74 years with a mean age of 41.47 ± 23.30 years. The pre-contrast effective dose ranged from 1.93 mSv to 3.32 mSv with mean of 2.56 ± 0.51 mSv and 75th percentile of 3.11 mSv while the post-contrast effective dose ranged from 4.06 mSv to 6.97 mSv with mean of 5.27 ± 0.97 mSv and 75th percentile of 6.13 mSv. The mean effective dose from this work and two other isolated studies was 3.0 mSv. Conclusion: Although our quantified doses are below threshold limits for occupational exposures they are higher than the recommended level for the public. A further optimization of scanning protocols by the radiographers could lower the effective dose for patients undergoing contrast head computed tomography in our centre and in the country.
文摘Background: Computed radiography has a wider exposure latitude when compared with film-screen imaging system. Consequently, the risk of dose creep is high. A conscientious effort is there-fore, needed by the radiographer to keep exposure as low as reasonably achievable. Objective: To derive a computed radiography exposure chart for a negroid population using AGFA photostimulable phosphor plates and a GE static X-ray machine. Materials and Method: A static X-ray machine, a digitizer, and photostimulable phosphor plates were used for the X-ray examination. Chest examinations were done at a Focus-Film-Distance (FFD) of 150 - 180 cm while all other examinations were conducted at 90 - 100 cm FFD. The range of exposure factors (kVp, mA and mAs) used by radiog-raphers in the centre was noted and the 90th percentile calculated. Over a three-month period, the patients were examined with the 90th percentile of tube potential (kVp) while keeping other factors constant. The kVp was gradually decreased and halted if radiologists and radiographers uncon-nected with the work expressed misgivings about the quality of the image. A similar procedure was adopted for the tube current (mA). The threshold adopted as low as reasonably achievable was the factor preceding the point of observation by other personnel. Metrics for central tendency from the statistical packages for social sciences, version 17.0 was used to analyze the data. Results: 335 subjects of both gender aged 0 - 92 years were examined by the researchers. Adult exposure factors used by the radiographers (and those derived by the researchers) had a range of 45 - 130 kVp (62 - 94 kVp), 63 - 320 mA (100 - 250 mA) and 4.0 - 25.0 mAs (5.0 - 20.0 mAs) respectively. Pediatric chest (and researchers-derived) factors were 50 - 75 kVp (52 - 65 kVp), 50 - 250 mA (100 - 220 mA) and 3.20 - 10.0 mAs (3.2 - 6.5 mAs) respectively. Conclusion: Upper threshold of adult (and paediatric) exposure factors in computed radiography with comparable equipment and accessories should not exceed 94 kVp (65 kVp), 250 mA (220 mA) and 20.0 mAs (6.5 mAs) respectively. The derived exposure chart is also adequate to address motion unsharpness in chest examinations.
文摘AIM: To investigate the chest radiographic and high resolution computed tomography (HRCT) chest manifestations in glucocorticoid-na?ve allergic bronchopulmonary aspergillosis (ABPA) patients. METHODS: This is a prospective observational study and includes 60 consecutive glucocorticoid-na?ve patients with ABPA who underwent chest radiography and HRCT of the chest (1.25 mm every 10 mm) in the routine diagnostic workup for ABPA. RESULTS: Chest radiographs were normal in 50% of cases. Of the remainder, most patients demonstrated permanent findings in the form of parallel line and ring shadows suggesting bronchiectasis. Consolidation was detected in 17 cases but in the majority, the corresponding HRCT chest scan showed mucus-filled bronchiectatic cavities. Chest HRCT was normal in 22 patients, while central bronchiectasis (CB) was demonstrated in the remaining 38 patients. Bronchiectasis extended to the periphery in 33%-43% depending on the criteria used for defining CB. The other findings observed on HRCT were mucoid impaction, centrilobular nodules and high-attenuation mucus in decreasing order of frequency. CONCLUSION: Patients with ABPA can present with normal HRCT chest scans. Central bronchiectasis cannot be considered a characteristic feature of ABPA as peripheral bronchiectasis is commonly observed. Consolidation is an uncommon finding in ABPA.
文摘The author presents three cases of esophageal rupture during the treatment of massive esophageal variceal bleeding with Sengstaken-Blakemore (SB) tube. In each case, simple auscultation was used to guide SB tube insertion, with chest radiograph obtained only after complete inflation of the gastric balloon. Two patients died of hemorrhagic shock and one died of mediastinitis.The author suggests that confirmation of SB tube placement by auscultation alone may not be adequate.Routine chest radiographs should be obtained before and after full inflation of the gastric balloon to confirm tube position and to detect tube dislocation.
文摘Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools,specially imaging methods, have become mandatory.From the simple intra-oral periapical X-rays, advanced imaging techniques like computed tomography, cone beam computed tomography, magnetic resonance imaging and ultrasound have also found place in modern dentistry. Changing from analogue to digital radiography has not only made the process simpler and faster but also made image storage, manipulation(brightness/contrast, image cropping, etc.) and retrieval easier. The three-dimensional imaging has made the complex cranio-facial structures more accessible for examination and early and accurate diagnosis of deep seated lesions. This paper is to review current advances in imaging technology and their uses in different disciplines of dentistry.
文摘Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascariasis is rare.An old female presented with dysphagia after an intake of several red bean buns and haw jellies.The barium meal examination revealed a spherical defect in the lower esophagus.Esophageal bezoar or esophageal carcinoma was considered at the beginning.The patient fasted,and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate.Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb.The conclusive diagnosis was ascariasis.The esophageal space-occupying lesion might be the entangled worm bolus.Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up.Authors report herein this rare case of Ascaris lumbricoides in the esophagus,emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.
基金supported by the National Natural Science Foundation of China [grant number 11772059]the National KeyResearch and Development Program of China [grant number 2017yfc0822300]+1 种基金the 111 Project[grant number G20012017001]the Foundation of State Key Laboratory of Explosion Science and Technology of China[grant number KFJJ13-1Z]
文摘With the technical development of new warhead designs and improvised explosive device protection,irregular casing filled with explosive has been paid more attention recently. In this paper, we studied the fragmentation of a type of D-shaped casing, which is a common asymmetric casing in the field of warhead design. Based on the radiograph technique, static explosive experiments were conducted with D-shaped casings under four different eccentric initiation ratios to explore their fragmentation. A numerical model was then established to simulate the dynamic response of D-shaped casing filled with explosive. The results of numerical simulation were found to agree well with the experimental data.According to the results of numerical simulation and experimental data, the dynamic responses of Dshaped casing were analyzed. The results of the current work pave way for the innovative design of new warhead and for further studying the dynamic response of asymmetric casing.
基金Canadian Institute of Health Science(CIHR)and Zimmer,Warsaw,United States
文摘AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.
