What is the pelvic lymph node normal size? Determination from normal MRI examinations.

PURPOSE: There are few previous reports on maximal pelvic lymph node sizes and no data on normal mesorectal nodes. Therefore, the aim of the study was to estimate the normal size of pelvic lymph nodes and to determine the upper limits of the normal range. MATERIALS AND METHODS: Pelvic magnetic resonance imaging (MRI) examinations were prospectively carried out using a Intera 1.5 T magnet (Philips, the Netherlands), on 36 healthy volunteers (22 females, 14 males, mean age 25 years). A balanced fast field echo (b-FFE) sequence was used with the following parameters: 3-mm-thick contiguous slice, matrix 512 × 512. Short axis diameters of pelvic and inguinal lymph nodes were measured in each anatomic territory (internal iliac, external iliac, common iliac, mesorectum and inguinal). After normalization of the measurements, the influences of age, gender, laterality and territory were evaluated. Upper limits (95th percentile) were then calculated. RESULTS: A total of 1147 lymph nodes were measured. Age, gender and side (right/left) had no significant influence on size. The upper limits of the normal range were, respectively, 5.3, 4.4, 6.3 and 3.9 mm for the external and common iliac, internal iliac, inguinal and mesorectum nodes. CONCLUSION: This work presents maximal normal values for each pelvic area, and the values for mesorectum nodes are reported for the first time. ADVANCES IN KNOWLEDGE: The mesorectum nodes should be considered as abnormal when they are over 4 mm in short diameter. For the other node areas, the upper limits of the normal range were, respectively, 6, 6, 5, 7 mm for the external and common iliac, internal, iliac and inguinal nodes for the short axis.

Nurses' attitudes toward nursing research at a metropolitan medical center.

To support the implementation of a nursing research initiative in a large medical center, we collected baseline data on nurses' attitudes toward nursing research, perception of the institution as a research environment, and personal involvement in research activities. This study replicates that conducted by Rizzuto, Bostrom, Suter, and Chenitz [Predictors of nurses' involvement in research activities. Western Journal of Nursing Research, 16(2), 193-204] in 1994. To better understand the findings, we traced the historical evolution of nursing research through successive American Nurses Association codes of ethics. Our review of the literature presents (in table format) factors that encourage and those that impede nursing research. The study results validate the work of other researchers: nurses' positive attitudes toward research are discordant with their actual involvement in research activities. The data suggest that positive attitudes and perceived institutional support are not enough to increase involvement in nursing research; as such, we describe additional institutional infrastructure and forms of educational support.