Comparison of image quality in chest, hip and pelvis examinations between mobile equipment in nursing homes and static indirect radiography equipment in the hospital.

INTRODUCTION: A hospital environment can be a significant burden and a health risk especially for dementia patients. Mobile x-ray equipment (ME) is used to enable imaging of these patients at home. The aim was to compare image quality (IQ) of chest, hip and pelvis images from ME to the stationary equipment (SE) used in a hospital department. METHODS: We analysed examinations of the chest (n = 20), hip (n = 64) and pelvis (n = 32). Images were equally obtained from each setting of ME and SE. All images were graded using Visual Grading Analysis (VGA) by three radiographers (hip and pelvis) and three radiologists (chest). Technical IQ assessment was done by 80 additional images of a Contrast-Detail Radiography phantom (CDRAD). RESULTS: All chest images were approved for diagnostic use, as well as the hip AP and pelvis images from SE. 'Approved proportion of ME images was for HIP antero-posterior (AP) and pelvis, 78% [95% CI: 52-94%] and 81% [95% CI: 54-96%] respectively. Hip axial had an overall low, but not significant different approval rate. Ordered logistic regression indicated higher IQ of HIP AP and pelvic images from SE. This contrasts that the CDRAD substudy indicated better IQ, expressed as IQFinv, from ME. CONCLUSION: The VGA showed higher IQ for the SE system, while the CDRAD showed higher IQ for the ME system. IMPLICATIONS FOR PRACTICE: Dementia patients can be examined at their home if the acquisition is optimised according to image quality in conjunct to radiation dose. Performing imaging out of the hospital and coordinating the patients' further treatment are new work areas for radiographers and requires excellent communication skills.

Functional analysis of the structural basis of homophilic cadherin adhesion.

The structures of many cell surface adhesion proteins comprise multiple tandem repeats of structurally similar domains. In many cases, the functional significance of this architecture is unknown, and there are several cases in which evidence for individual domain involvement in adhesion has been contradictory. In particular, the extracellular region of the adhesion glycoprotein cadherin consists of five tandemly arranged domains. One proposed mechanism postulated that adhesion involves only trans interactions between the outermost domains. However, subsequent investigations have generated several competing models. Here we describe direct measurements of the distance-dependent interaction potentials between cadherin mutants lacking different domains. By quantifying both the absolute distances at which opposed cadherin fragments bind and the quantized changes in the interaction potentials that result from deletions of individual domains, we demonstrate that two domains participate in homophilic cadherin binding. This finding contrasts with the current view that cadherins bind via a single, unique site on the protein surface. The potentials that result from interactions involving multiple domains generate a novel, modular binding mechanism in which opposed cadherin ectodomains can adhere in any of three antiparallel alignments.

Osteochondral lesions of the talar dome in children. A 24 (7-36) year follow-up of 13 cases.

13 patients who in childhood had had osteochondral lesions (OCL) of the talar dome participated in a long-term follow-up including physical examination, computed tomography (CT) and conventional radiographs. Most of the cases were caused by trauma. Conventional radiographs showed abnormal findings in 4 cases and CT in a further one. In 3 cases the primary lesion could still be seen as an osteochondral defect, and 2 had a loose body in the joint. 3 of these 5 patients had mild symptoms. We conclude that arthrosis following OCL in childhood is infrequent and recommend conservative treatment initially. In those with persisting symptoms, additional imaging evaluation with CT and MRI is recommended.

Immunosuppressive effect of total body irradiation and cyclosporine A on graft survival and the lymphatic system in a cardiac hamster-to-rat transplantation model.

The aim of the study was to evaluate the effect of total body irradiation (TBI) and cyclosporine A (CyA) on graft survival and the lymphatic system in a concordant hamster-to-rat heart transplantation model, and to compare these effects with those of total lymphoid irradiation (TLI). Preoperatively TBI was given as a single dose of 5 Gy, CyA was given intramuscularly at a dose of 10 mg/kg/day. TBI prolonged graft survival to seven days. Combined TBI and CyA prolonged graft survival to ten days. The effect of TBI on graft survival, total white blood cell count (WBC) and differential counts was reproducible but not as distinct as the effect of TLI. Analysis of changes in WBC and differential counts combined with the morphology of the grafts at rejection and of spleens from TBI- and CyA-treated animals indicates a reproducible immunosuppressive effect of TBI and a severe type of acute humoral rejection with vasculitis and cellular infiltrates dominated by macrophages and neutrophilic granulocytes. In conclusion, we find TBI a simple pretreatment which may be useful in combination with other immunosuppressive treatment as preoperative induction and depletion therapy.