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Alternative Exposure Parameters and Post Process Noise Reduction Expect Considerable Dose Reduction in Single Mammograph. Views—Initial Experience on Mastectomy Specimens

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Advances in Breast Cancer Research 2013年第3期2卷 91-96页

作者： Adriana M. J. Bluekens Ruben Evan Engen Nico Karssemeijer klaas h. schuur Mireille J. M. Broeders Gerard J. den h.eten Gerard J. den h.eten Department of Radiology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands National Expert and Training Centre for Breast Cancer Screening Nijmegen The Netherlands St. Elisabeth.h.spital Department of Radiology Tilburg The Netherlands

Objective: To experimentally indicate a lower limit of dose in mammograph.c imaging yielding adequate image quality for complementary diagnostic views, by evaluation of image series with.different exposure parameters and additional image processing on mastectomy specimens with.diverse path.logy. Meth.ds: Image series were obtained on seven specimens with.different target-filter combinations at different exposure values. Th.ee experienced radiologists assessed th. lowest acceptable dose level per specimen using a relative grading tech.ique. With.th. standard image as reference, fibroglandular tissue and path.logical structures, including microcalcifications, were evaluated. Subsequently, a series of pixel binning processes was tested and subjectively assessed on th. selected images. Results: Th. lowest dose level at wh.ch.image quality was acceptable, and ach.eved with.a W/Ag target-filter combination at 32 kV and 4 mAs. Th.se images can be acquired with.10.4% to 22.4% of th. average glandular dose in standard images. Post process pixel binning added to th. interpretability of such.low dose images. Conclusion: Th.s specimen study suggests th.t dose level of mammograph. images migh. be reduced substantially by general application of a W/Ag spectrum, particularly wh.n combined with.post process noise reduction. Future studies sh.uld focus on th. feasibility of th.s tech.ique in clinical mammograph..

关键词： Digital Mammograph. Dose Reduction

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Resection of complex pancreatic injuries: Bench.arking postoperative complications using th. Accordion classification

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World Journal of Gastrointestinal Surgery 2017年第3期9卷 82-91页

作者： Jake E Krige Eduard Jonas Sandie R Th.mson Urda K Kotze Mash.ko Setsh.di Pradeep h.Navsaria Andrew J Nicol Surgical Gastroenterology Unit Department of Surgery University of Cape Town Health Sciences Faculty Observatory Groote schuur h.spital Observatory Department of Medicine University of Cape Town Health Sciences Faculty Department of Surgery Trauma Centre University of Cape Town Health Sciences Faculty Observatory

AIM To bench.ark severity of complications using th. Accordion Severity Grading System(ASGS) in patients undergoing operation for severe pancreatic injuries. METh.DS A prospective institutional database of 461 patients with.pancreatic injuries treated from 1990 to 2015 was reviewed. One h.ndred and th.rty patients with.AAST grade 3, 4 or 5 pancreatic injuries underwent resection(pancreatoduodenectomy, n = 20, distal pancreatectomy, n = 110), including 30 wh. h.d an initial damage controllaparotomy(DCL) and later definitive surgery. AAST injury grades, type of pancreatic resection, need for DCL and incidence and ASGS severity of complications were assessed. Uni-and multivariate logistic regression analysis was applied. RESULTS Overall 238 complications occurred in 95(73%) patients of wh.ch.73% were ASGS grades 3-6. Nineteen patients(14.6%) died. Patients more likely to h.ve complications after pancreatic resection were older, h.d a revised trauma score(RTS) h.cked on admission, h.d grade 5 injuries of th. h.ad and neck of th. pancreas with.associated vascular and duodenal injuries, required a DCL, received a larger blood transfusion, h.d a pancreatoduodenectomy(PD) and repeat laparotomies. Applying univariate logistic regression analysis, mech.nism of injury, RTS h.ck on admission, DCL, increasing AAST grade and type of pancreatic resection were significant variables for complications. Multivariate logistic regression analysis h.wever sh.wed th.t only age and type of pancreatic resection(PD) were significant. CONCLUSION Th.s ASGS-based study bench.arked postoperative morbidity after pancreatic resection for trauma. Th. detailed outcome analysis provided may serve as a reference for future institutional comparisons.

关键词：胰损害复杂并发症手风琴分类

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Ⅱ区屈肌腱修复装置——多中心、随机、盲试、临床试验

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骨科动态 2005年第3期1卷 121-131页

作者： BRIAN W.SU MICh.EL SOLOMONS ANDREW BARROW MATSh.DISO E.SENOGE MARCO GILBERTI LAWRENCE LUBBERS EDWARD DIAO h.MATTh.W QUTTKIN MELVIN P. ROSENWASSER 费起礼（译） Investigation performed at Columbia University Medical Center New York NY Groote Schuur Hospital Cape Town Johannesburg General Hospital Johannesburg and King Edward Ⅷ Hospital Durban South Africa 天津医院手显微外科 300211

背景：不锈钢Teno Fix肌腱修复装置的生物力学特性较缝合修复有所改善．并在狗模型中有很好的相容性。本文的目的是在临床上对Teno Fix修复与缝合修复作比较。方法：67例单纯Ⅱ区屈肌腱损伤随机地用Teno Fix修复或4股交叉缝合修复。共8... 详细信息

背景：不锈钢Teno Fix肌腱修复装置的生物力学特性较缝合修复有所改善．并在狗模型中有很好的相容性。本文的目的是在临床上对Teno Fix修复与缝合修复作比较。方法：67例单纯Ⅱ区屈肌腱损伤随机地用Teno Fix修复或4股交叉缝合修复。共85个损伤指：34个指用Teno Fix，51个指作对照．采用改良Kleinert康复技术，术后4周开始主动屈指。术后6个月由肓测检查者测定患者的手指活动范围．臂、肩、手的伤残（DASh.记分，捏力，握力和口诉的疼痛记分以及评价肿胀和神经系统恢复。经常间断地监测包括装置的移动和断裂等不良结果。结果：51指缝合修复中有9指肌腱断裂，而Teno Fix修复中无一指肌腱断裂（p〈0．01）。断裂的9指中5指因抵抗医疗装置的活动而造成。组间的活动范围，DASh.分、捏力、握力、肿胀或神经系统恢复差异无显著性。Teno Fix组疼痛和肿胀的消退比对照组稍慢。患者在6个月随访时，24例Teno Fix修复中16例和27例对照修复组中19例结果为优良。1例Teno Fix装置移动和被挤出，继发伤口感染。总的85指手术中，4指肌腱粗细不适合于用所提供的装置，9指被认为暴露不适当而无法置入锚。结论：如肌腱粗细和暴露满意，用Teno Fix修复屈肌腱损伤是安全和有效的。与传统修复方法相比．用Teno Fix作肌腱修复，其肌腱断裂率较低而功能结果相似，特别适用于对康复方案不配合者。

关键词： Ⅱ区屈肌腱损伤肌腱修复医疗装置临床试验随机多中心缝合修复肌腱断裂生物力学特性

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