Ray Department Research Articles

Evaluate the Radiation Exposure in X – Ray Departments and its Effect on the Radiologists in Different Babylon Hospitals

Evaluate the Radiation Exposure in X – Ray Departments and its Effect on the Radiologists in Different Babylon Hospitals

Robert Emil Steiner

Robert Emil Steiner was born in Vienna. After a happy childhood, political and racial iniquities soon oppressed his early student years at the University of Vienna and spelt emigration. He...

Wheezy Chest in Children : Findings and Outcome

Background: wheezy chest is a serious public health problem throughout the world, affecting people of all ages and were recognized as leading cause of morbidity and mortality in the under-five children in developing countries. The disease places a burden on the health services in term of admission to hospitals and health centers. Objectives: to identify some epidemiological aspects and fate of hospitalized cases of wheezy chest. Material and Methods: A descriptive study was used to the study 385 children with wheezy chest among those admitted to el-Husen university hospital, Cairo, from January to December 2012 using a pre-designed questionnaire to collect data from mothers of the admitted children. The children recruited were those < 12 years coming with respiratory distress for one year. The variables included are age, sex, education, income, crowding index, symptoms presented. Laboratory findings and x ray were done to some cases when needed in the clinical pathology and x ray departments at hospital in the routine investigation of such cases. Administrative and ethical issues as patient consent and confidentiality were followed in all steps of the study. The data were analyzed by SPSS program version 18. Descriptive and analytic statistics were done. The lowest accepted level of significance was 0.05 or less. Results: The highest affected age was infants (54%), males (53.7%), and of low income families (69.6%). Cough, dyspnea and tachypnea are the most frequent clinical findings (82.3%). Most investigations were normal, and more than half of cases have positive CRP. High percent had bronchovascular marking plus pneumonic patches and hyper-inflated chest in about 34.1% and 36.5% respectively. Most of admitted cases stayed at hospital for 10 days on average. High percent of the studied cases have respiratory distress (41.2%), wheezes (30.6%) and also recurrent wheezy chest (20.0%). The studied cases diagnosed as acute bronchiolitis (27.1%), bronchial asthma (18.8%) and bronchopneumonia (34.1%). The fates of cases were: improved with no complications (72.9%), improved with nebulizer (23.5%) and no case fatality recorded. Bronchopneumonia recorded highest CRP readings than the other acute respiratory infections. Conclusions and recommendations: wheezy chest is a major cause of hospitalization of male infant of poor families. Cough, dyspnoea and tachypnea were major findings. Wheezy chest were recognized as pneumonia, acute bronchiolitis, and bronchial asthma with better outcome. We recommend admission of severe cases of wheezy chest, and the wheezy chest with other health problems (liable for complications) to minimize over use of beds.

Nonalcoholic Fatty Liver Disease and Acute Ischemic Stroke

To the Editor: Nonalcoholic fatty liver disease is associated with a higher risk of self-reported cardiovascular disease.1 A recent systematic review also found persons with nonalcoholic fatty liver disease to have a 13% relative increase in carotid intima-media thickness.2 The risk of acute ischemic stroke in relation to inflammatory markers of nonalcoholic fatty liver disease remains unknown. We conducted a cross-sectional records-based study at the London Health Sciences Centre in London, Ontario. We included adults aged 20 to 75 years with suspected acute stroke between January 2005 and December 2009; had all undergone diffusion-weighted magnetic resonance imaging (MRI), which is sensitive and specific for early changes of acute ischemic stroke. Persons with an acute ischemic stroke were considered cases, and those whose scan was negative served as controls. Study entry required that a patient have had serum alanine aminotransferase and aspartate aminotransferase concentrations measured within 90 days before, or within 72 hours after, the MRI. Patients with evidence of intracranial hemorrhage or malignancy on MRI were excluded. The primary study outcome was biochemical evidence of inflammatory nonalcoholic fatty liver disease, defined as an elevated serum alanine aminotransferase concentration ≥95th percentile among the controls. The study was done in accordance with a research protocol approved through the Research Ethics Boards of the London Health Sciences Centre. We included 103 cases with, and 200 controls without, acute stroke, confirmed by diffusion-weighted imaging MRI. Details of participant characteristics are listed in the eAppendix (https://links.lww.com/EDE/A443). Transaminases were measured within a median of 2 days (cases) and 17 days (controls) of the diffusion-weighted imaging MRI. The adjusted odds ratio (OR) for acute stroke in the presence of an elevated alanine aminotransferase was 3.3 (95% confidence interval [CI] = 1.3–8.4) (Table). Similar elevations were observed for as partate aminotransferase concentration, as well as for alanine aminotransferase or aspartate aminotransferase in conjunction with an aspartate aminotransferase:alanine aminotransferase ratio under 2.0 (Table).TABLE: Risk of Stroke Associated With Biochemical Markers of Inflammatory Nonalcoholic Fatty Liver DiseaseA study strength was the inclusion of both cases and controls who underwent sensitive diffusion-weighted MRI imaging for the assessment of acute stroke. This likely reduced the presence of diagnostic suspicion or referral bias,3 and correctly assigned persons with acute stroke as cases and those without acute stroke as controls. Second, we adjusted for a number of stroke risk factors, but not serum triglycerides or hepatic fat on imaging studies.1,4 Others have observed nonalcoholic fatty liver disease to predict the future risk of cardiovascular disease independent of metabolic syndrome.1,4 Among 1221 healthy Japanese men and women, the adjusted OR was 4.1 (95% CI = 1.6–11), but there were only 22 cardiovascular events, of which 12 were self-reported ischemic strokes.4 In a second study of 248 diabetic cases with cardiovascular disease, including just 29 nonfatal ischemic strokes, the associated OR between non alcoholic fatty liver disease and cardiovascular disease was 1.5 (95% CI =1.1–1.7).1 Our study, which focused exclusively on acute ischemic stroke, complements these findings. Confirmatory data are needed regarding whether nonalcoholic fatty liver disease is an independent risk factor for ischemic stroke. If so, then measurement of alanine aminotransferase or aspartate aminotransferase—both of which are readily available and inexpensive—could be considered along with traditional stroke risk factors such as serum glucose, lipids, and blood pressure. Ivan Ying Department of Medicine Schulich School of Medicine and Dentistry London Health Sciences Center University of Western Ontario London, Ontario Gustavo Saposnik Division of Neurology Department of Medicine St. Michael's Hospital University of Toronto Toronto, Ontario Marian J. Vermeulen Institute for Clinical Evaluative Sciences University of Toronto Toronto, Ontario Andrew Leung Department of Medical Imaging Schulich School of Medicine and Dentistry London Health Sciences Centre University of Western Ontario London, Ontario Joel G. Ray Departments of Medicine, Obstetrics and Gynecology Health Policy Management and Evaluation St. Michael's Hospital University of Toronto Toronto, Ontario [email protected]

Giant vulval tumor due to tuberculosis

International Journal of Gynecology & ObstetricsVolume 110, Issue 1 p. 69-70 Brief communications Giant vulval tumor due to tuberculosis Sunesh Kumar, Sunesh Kumar Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this authorPushpalatha Kameshwarachari, Corresponding Author Pushpalatha Kameshwarachari [email protected] Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, IndiaCorresponding author. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.Search for more papers by this authorRuma Ray, Ruma Ray Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this author Sunesh Kumar, Sunesh Kumar Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this authorPushpalatha Kameshwarachari, Corresponding Author Pushpalatha Kameshwarachari [email protected] Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, IndiaCorresponding author. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.Search for more papers by this authorRuma Ray, Ruma Ray Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this author First published: 20 April 2010 https://doi.org/10.1016/j.ijgo.2010.02.010Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume110, Issue1July 2010Pages 69-70 RelatedInformation

Trends in Obesity in Pregnancy

ArticlePlus Click on the links below to access all the ArticlePlus for this article. Please note that ArticlePlus files may launch a viewer application outside of your web browser. https://links.lww.com/EDE/A233 To the Editor: There is a strong relationship between a woman’s weight just prior to pregnancy, or in early pregnancy, and her risk of gestational diabetes mellitus, preeclampsia, placental dysfunction, and adverse perinatal events1–5 In the past decade, the prevalence of obesity among pregnant women may have increased.6,7 Less is known about ethnic-specific temporal trends in maternal weight and the risk of obesity in pregnancy. Examining these trends is the goal of the Trends in Obesity in Pregnancy Study, which is a population-based study, derived using an administrative database, as described elsewhere.4 Briefly, since late 1993, standardized maternal serum screening has been available to all women in Ontario, at 15 to 20 weeks’ gestation, through their physician or midwife. Steady uptake has occurred from 1994 onward. Data about maternal date of birth, parity, ethnicity, and weight are recorded in a standardized fashion on a form, completed by the caregiver at the time of the screening. We defined the mutually exclusive overweight, obese, and severely obese states as presented in the footnote to the Table 1.8,9 The prevalence of each state in the years 1994 and 2000 were compared using polychotomous logistic regression analysis. The resulting odds ratios were adjusted for maternal age, ethnicity, parity, gestational age at weight measurement and presence of a multifetal pregnancy.TABLE 1: General Characteristics of Participants at the Time of Maternal Serum Screening in Ontario, 1994–2000A total of 369,740 women underwent maternal serum screening, at an average of 16.3 weeks’ gestation (Table 1). In each ethnic group, the median gravidity was 2 and the median parity 1. Among all women, as well as within each of the 4 ethnic groups, there was a significant increase in mean maternal weight over time, based on a time- series model incorporating a linear trend term (P < 0.001; Fig. 1 available with the electronic version of this article at www.epidem.com). Among all women, the prevalence of the overweight state increased from 9.6% in 1994 to 11.4% in 2000 (adjusted odds ratio = 1.37; 95% confidence interval = 1.31–1.43). The prevalence of obesity rose from 4.0% to 5.6% (1.7; 1.6–1.8), and severe obesity increased from 0.99% to 1.5% (1.8;1.6–2.0). As a limitation, height was not recorded in TOPS, and body mass index was not calculated. At the same time, maternal weight approximates BMI quite well,10,11 and by limiting our assessment of mean weight to each ethnic group, we were able to control, to a degree, for the variation in height between racial groups.12 Since maternal weight was recorded at around the same gestational age, and we further adjusted for gestational age, ethnicity and other factors, variance and confounding were likely minimized. The data from this study are consistent with other studies of temporal weight trends in pregnancy.6,13 These data also parallel rising trends of obesity among children and adolescents in the United Kingdom8 and United States.9 Together, they emphasize that the rate of obesity and morbid obesity in pregnancy is likely to increase over the next decade. This study provides novel information about weight trends according to broad ethnic groups, and the results highlight the need to consider preventive strategies among all ethnic groups, including those traditionally deemed to be at “low risk,” such as women of Asian ancestry. Given that weight loss during pregnancy may have untoward effects, preventing maternal obesity requires action before a woman reaches her reproductive years. Promoting controlled calorie-energy intake and higher energy expenditure in childhood or adolescence may be the most sensible approach.14,15 Ongoing epidemiologic surveillance is needed to detect any change in the incidence of preeclampsia, gestational diabetes mellitus, operative or preterm delivery or perinatal mortality, also stratified by maternal weight or BMI before, or in early pregnancy. Joel G. Ray Departments of Medicine, Obstetrics and Gynecology, and Health Policy Management and Evaluation [email protected] Rosane Nisenbaum Gita Singh Centre for Research on Inner City Health Chris Meier Department of Medical Affairs St. Michael’s Hospital University of Toronto Toronto, Ontario Andrea Guerin Schulich School of Medicine & Dentistry University of Western Ontario London, Ontario Philip R. Wyatt Department of Genetics York Central Hospital Richmond Hill, Ontario Marian J. Vermeulen Institute for Clinical Evaluative Sciences University of Toronto Toronto, Ontario

Diagnostic reference levels in the X–ray department

This article reviews developments in Europe over the past 10 years in the radiation protection of patients undergoing medical X-ray examinations that led to the requirement in the EC Medical Exposure Directive of 1997 that all Member States should establish Diagnostic Reference Levels (DRLs). The purpose of DRLs is explained and methods for deriving national DRLs that comply with the requirements of the Directive are described. Suitable patient dose quantities are defined and dose measurement methods and patient sampling techniques that can be used both by the appropriate authorities for setting national DRLs, and by individual X-ray departments for checking compliance with them, are discussed. Finally, the progress made over the past 5 years in translating the requirements of the Directive into national legislation, including the provision of guidance on the use of DRLs for X-ray departments, is reviewed. It relies heavily on the author’s experience of how these matters are progressing in the UK, but will hopefully be of some practical help to the staff in X-ray departments from all over Europe.

Paediatric dose reduction with the introduction of digital fluorography.

Fluoroscopy guided examinations in a paediatric X ray department were initially carried out on a unit that used a conventional screen-film combination for spot-films. A new fluoroscopy unit was installed with the facilities of digital fluorography and last image hold. Comparison of equipment performance showed that the dose per image for screen-film and digital fluorography was 3 microGy and 0.4 microGy, respectively. Although the screen-film had superior image quality, the department's radiologist confirmed that digital fluorography provided a diagnostic image. Patient dose measurements showed that introduction of the new unit caused doses to fall by an average of 70%, although fluoroscopy time had not changed significantly. The new unit produced 40% less air kerma during fluoroscopy. The remaining 30% reduction in dose was due to the introduction of digital fluorography and last image hold facilities. It is concluded that the use of digital fluorography can be an effective way of reducing paediatric dose.

Patient Dosimetry and Reference Doses: Practical Considerations

The Council Directive 97/43/EURATOM requires Member States to guarantee the establishment of diagnostic reference levels in radiodiagnostics. Patient dosimetry and image quality are basic controls in quality assurance programmes, according to the predictive capability to diagnose the correct behaviour of an X ray facility, including both X ray equipment and examination protocol. This paper addresses the role of both items in the framework of optimisation and the approach of the quality assurance programmes to interventional and digital radiology, fields where the reference levels are scarcely developed and a number of practical challenges must be solved. Expertise in the use of diagnostic reference levels and foresights on quality assurance in an X ray department of a university hospital with digital equipment are described.

Measurement of Entrance Skin Doses to Patients in Four Common Diagnostic Examinations by Thermoluminescence Dosimetry in Nigeria

Entrance surface doses (ESD) to patients were monitored in four common diagnostic X ray examinations (chest, hand and wrist, lumbar spine and skull) at the outpatient X ray department of the University College Hospital (UCH), Ibadan. Measurement was based on thermoluminescence dosimetry (TLD) techniques using lithium fluoride discs and a Vinten Solaro TLD reader. Some spread was observed in the values of doses received by patients for each of the examinations. It is greatest for the examination of the skull PA and least for the examination of the skull LAT and lumbar spine AP; due mainly to variations in the sizes of the patients examined. For all examinations the values of the mean ESD obtained range from a minimum of 0.310 ± 0.071 mGy to a maximum of 5.66 ± 0.782 mGy for the examination of the hand and wrist PA and lumbar spine LAT, respectively.

The Quality Criteria for Diagnostic Radiographic Images in Paediatrics

Because of their longer life expectancy, the risk of late manifestations of detrimental radiation effects is greater i children than in adults. Many paediatric radiographic examinations are performed by surgeons, paediatricians and adult radiologists with variable knowledge of specific paediatric pathology, radiographic technique and radioprotection. Therefore, in order to optimise medical exposures in children, it is essential to develop quality criteria specifically adapted to paediatric imaging that can be used throughout Europe. With the help of the European Commission, the European Network of Paediatric Radiologists (ENPR). has laid out the status of paediatric radiology in Europe and then elaboratec European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Paediatrics. The applicability of the quality criteria has been checked in large European trials involving about 160 X ray departments. These quality criteria are currently being extended to include paediatric fluoroscopy and CT.

Fungal fimbriae are composed of collagen.

Fungal fimbriae are surface appendages that were first described on the haploid cells of the smut fungus, Microbotryum violaceum. They are long (1-20 microm), narrow (7 nm) flexuous structures that have been implicated in cellular functions such as mating and pathogenesis. Since the initial description, numerous fungi from all five phyla have been shown to produce fimbriae on their extracellular surfaces. The present study analyses the protein component of M.violaceum fimbriae. The N-terminus and three internal amino acid sequences were determined. All four show a strong similarity to sequences which are characteristic of the collagen gene family. Enzymatic digests and immunochemical analyses support this finding. Based on these results, it is suggested that the proteinaceous subunits of fimbriae should be termed fungal collagens. Previously, collagen has been found only among members of the kingdom Animalia where it is the principal component of the animal extracellular matrix and is the most abundant animal protein. The unexpected finding of collagen in the members of the Mycota suggests that it may have evolved from a common ancestor that existed before the divergence of fungi and animals. Further, native fungal fimbriae can function as a mammalian extracellular matrix component. They can act as a substratum which permits animal cells to adhere, spread, and proliferate in a manner similar to animal collagens. The implications of this finding to both phylogeny and pathology are discussed.

Occupational asthma due to glutaraldehyde and formaldehyde in endoscopy and x ray departments.

Glutaraldehyde is the best disinfectant for fibreoptic endoscopes. It is also used in the processing of x ray films. A number of studies have reported eye, nose, and respiratory symptoms in exposed workers. Three individual case reports of occupational asthma in endoscopy workers and a radiographer have also been published. We describe a further seven cases of occupational asthma due to glutaraldehyde in endoscopy and x ray departments, together with exposure levels measured during the challenge tests and in 19 endoscopy and x ray departments in the region. Eight workers were referred for investigation of suspected occupational asthma following direct or indirect exposure to glutaraldehyde at work. They were investigated by serial measurements of peak expiratory flow (PEF) and specific bronchial provocation tests. Glutaraldehyde levels were measured using personal and static short and longer term air samples during the challenge tests and in 13 endoscopy units and six x ray darkrooms in the region where concern about glutaraldehyde exposure had been expressed. Three of the workers investigated with occupational asthma came from departments where glutaraldehyde air measurements had been made; the others came from other hospitals or departments. The diagnosis of occupational asthma was confirmed in seven workers, all of whom had PEF records suggestive of occupational asthma and positive specific bronchial challenge tests to glutaraldehyde. Bronchial provocation testing was negative in one worker who was no longer exposed and who had a less clearcut history of occupational asthma. Three workers also had a positive specific bronchial challenge to formaldehyde. The mean level of glutaraldehyde in air during the challenge tests was 0.068 mg/m3, about one tenth of the short term occupational exposure standard of 0.7 mg/m3. The levels obtained in the challenge chamber were similar to those measured in 13 endoscopy suites and six x ray darkrooms where median short term levels were 0.16 mg/m3 during decantation in endoscopy suites and < 0.009 mg/m3 in darkrooms. Glutaraldehyde can cause occupational asthma. The exposure levels measured in the workplace suggest that sensitisation may occur at levels below the current occupational exposure standard.

The laryngeal mask airway: safe in the X ray department?

The laryngeal mask airway: safe in the X ray department?

Speed of Medical X Ray Screen/Film/Processing System in Danish Hospitals

The speed of screen/films in cassettes used for the lumbar spine examination in 25 Danish X ray departments has been examined under field conditions. The film is exposed in seven steps at a focus - film distance of approximately 1.8 m at 90 kV with an aluminium absorber of 29 mm in the beam, in addition to the filtration of tube and diaphragm. Prior to the exposure of the film the air kerma in the plane of the film is measured and at the same time a reading is taken from a monitor chamber placed close to the light beam diaphragm. When exposing the film the air kerma in the plane of the film is calculated from this monitor reading. The speed is calculated as 1 mGy multiplied by the reciprocal of the air kerma in the plane of the film needed to produce a net density of 1.0. Of the systems 28% had a measured speed equal to or higher than the nominal speed and 72% of the systems had a lower: 12% of the systems met the guidelines of the Commission of the European Communities concerning speed whereas 88% did not.

Polymerization of olefins through heterogeneous catalysis—the effect of condensation cooling on particle ignition

Journal of Applied Polymer ScienceVolume 43, Issue 7 p. 1387-1390 NoteFree Access Polymerization of olefins through heterogeneous catalysis—the effect of condensation cooling on particle ignition R. A. Hutchinson, R. A. Hutchinson Department of Chemical Engineering, University of Wisconsin—Madison, Madison, Wisconsin, 53706Search for more papers by this authorW. H. Ray, Corresponding Author W. H. Ray Department of Chemical Engineering, University of Wisconsin—Madison, Madison, Wisconsin, 53706Department of Chemical Engineering, University of Wisconsin—Madison, Madison, Wisconsin, 53706===Search for more papers by this author R. A. Hutchinson, R. A. Hutchinson Department of Chemical Engineering, University of Wisconsin—Madison, Madison, Wisconsin, 53706Search for more papers by this authorW. H. Ray, Corresponding Author W. H. Ray Department of Chemical Engineering, University of Wisconsin—Madison, Madison, Wisconsin, 53706Department of Chemical Engineering, University of Wisconsin—Madison, Madison, Wisconsin, 53706===Search for more papers by this author First published: 5 October 1991 https://doi.org/10.1002/app.1991.070430722Citations: 17AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Reference 1 W. H. Ray, in Transition Metal Catalyzed Polymerizations, R. P. Quirk, Ed., Cambridge University Press, New York, 1988, p. 563. 2 C. R. Raufast, Hydrocarbon Process., 63 (5), 105 (1984). 3 I. D. Burdett, paper presented at AIChE National Meeting, Washington, 1988. 4 R. A. Hutchinson and W. H. Ray, J. Appl. Polym. Sci., 34, 657 (1987). 5 U. S. Pat. 4,543,399 (1985), to Union Carbide. 6 U. S. Pat. 4,588,790 (1986), to Union Carbide. 7 D. Luss, in Chemical Reactor Theory; A Review, L. Lapidus and N. R. Amundson, Eds., Prentice-Hall, Englewood Cliffs, NJ, 1977, p. 191. 8 W. E. Ranz and W. R. Marshall, Jr., Chem. Eng. Prog., 48, 141 (1952). 9 R. A. Hutchinson, Ph.D. thesis, University of Wisconsin-Madison, 1990. 10 U. S. Pat. 3,639,377 (1972), to BASF. Citing Literature Volume43, Issue75 October 1991Pages 1387-1390 ReferencesRelatedInformation

How well can radiographers triage x ray films in accident and emergency departments?

To assess the ability of radiographers to identify abnormal radiographs of patients attending accident and emergency departments. Prospective study over six weeks. Teaching hospital casualty x ray department. 3394 consecutive patients referred for radiography. Radiographs were assessed by radiographers who were offered a four point triage scheme: normal, abnormal, insignificantly abnormal, or further advice required. Comparison of radiographers' assessments with an assessment made independently by the reporting radiologists. Overall disagreement between the radiographers and radiologists was 9.4%. There were 7% false positives and 14% false negatives. Most errors occurred in assessing radiographs of the skull, facial bones, chest, abdomen, and soft tissues. Unselected radiographers can offer useful advice on radiographs to casualty officers, but their high rate of false positive diagnoses indicates that they cannot triage casualty radiographs sufficiently accurately to allow them to extend their current reporting role.

Provision of gastrointestinal endoscopy and related services for a district general hospital. Working Party of the Clinical Services Committee of the British Society of Gastroenterology.

(1) The number of endoscopic examinations performed is rising. Epidemiological data and the workload of well developed units show that annual requirements per head of population are approaching: Upper gastrointestinal 1 in 100 Flexible sigmoidoscopy 1 in 500 Colonoscopy 1 in 500 ERCP 1 in 2000 (2) Open access endoscopy to general practitioners is desirable and increasingly sought. For a district general hospital serving a population of 250,000, this workload entails about 3500 procedures annually, performed during 10 half day routine sessions plus emergency work. (3) High standards of training and experience are needed by all staff, who must work in purpose built accommodation designed to promote efficient and safe practice. (4) The endoscopy unit should be adjacent to day care facilities and near the x ray department. There should be easy access to wards. (5) An endoscopy unit needs at least two endoscopy rooms; a fully ventilated cleaning/disinfection area; rooms for patient reception, preparation, and recovery; and accommodation for administration, storage, and staff amenities. (6) The service should be consultant based. At least 10 clinical sessions are required, made up of six or more consultant sessions and two to four clinical assistant, hospital practitioner, or staff specialist sessions. Each consultant should be expected to commit at least two sessions weekly to endoscopy. Extra consultant sessions may be needed to provide an efficient service. (7) A specially trained nursing sister (grade G or H) and five other endoscopy nurses are needed to care for the patients; their work may be supplemented by care assistants. (8) A new post of endoscopy department assistant (analogous to an operating department assistant) is proposed to maintain and prepare instruments, and to give technical assistance during procedures. (9) A full time secretary should be employed. Records, appointments, and audit should be computer based. (10) ERCP needs the collaboration of an interventional radiologist working with high quality x ray equipment in a specially prepared radiology screening room. This facility may need to serve more than one hospital. (11) A gastrointestinal measurement laboratory can conveniently be combined with the endoscopy unit. In some hospitals one or more gastrointestinal measurement technicians may staff this laboratory. (12) An endoscopy unit is a service department analogous to a radiology department. It needs an annual budget.

Konstanzprüfung der Empfindlichkeit von Verstärkerfolien

The sensitivity of the intensifying screens used in two X ray departments of the same hospital was compared under quality control conditions. An unacceptable sensitivity spread was assessed in the comparison between screens of the same type but from different production charges. Inadequate cassette pressure was detected in a number of cassettes using images of a wire net.

Polymerization of olefins through heterogeneous catalysis—V. Gas-liquid mass transfer limitations in liquid slurry reactions

Journal of Applied Polymer ScienceVolume 36, Issue 6 p. 1513-1513 ErratumFree Access Polymerization of olefins through heterogeneous catalysis—V. Gas-liquid mass transfer limitations in liquid slurry reactions S. Floyd, S. Floyd Department of Chemical Engineering, University of Wisconsin, Madison, Wisconsin 53706Search for more papers by this authorR. A. Hutchinson, R. A. Hutchinson Department of Chemical Engineering, University of Wisconsin, Madison, Wisconsin 53706Search for more papers by this authorW. H. Ray, W. H. Ray Department of Chemical Engineering, University of Wisconsin, Madison, Wisconsin 53706Search for more papers by this author S. Floyd, S. Floyd Department of Chemical Engineering, University of Wisconsin, Madison, Wisconsin 53706Search for more papers by this authorR. A. Hutchinson, R. A. Hutchinson Department of Chemical Engineering, University of Wisconsin, Madison, Wisconsin 53706Search for more papers by this authorW. H. Ray, W. H. Ray Department of Chemical Engineering, University of Wisconsin, Madison, Wisconsin 53706Search for more papers by this author First published: 5 September 1988 https://doi.org/10.1002/app.1988.070360621Citations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume36, Issue65 September 1988Pages 1513-1513 RelatedInformation