[On sources of error in examination of the esophagus for evaluation of enlargement of the left atrium].
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With the introduction of the German industrial protocol for quality assurance of X-ray equipment, everybody using X-ray machines fell into some sort of trap or found some of the procedures misleading. Vigorous discussions were held on every conceivable aspect of this and other protocols, and are still in progress. This paper points out some of the common traps and considers a new type dosimeter, which allows a definite separation of quality assurance of X-ray equipment and of processing and which can also be used in future for quality assurance of digital radiography equipment.
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A study was made of errors in plasma sodium, potassiu, chloride and calcium determinations caused by venous stasis and forearm exercise during venipuncture. Blood samples were taken from both arms of healthy young adults, one arm being used as a control. Analyses were performed in a routine hospital laboratory and the technicians were unaware of the identity of the samples. Laboratory precision was assessed at the same time.Venous stasis alone for two minutes caused no significant change, but the use of continuous slow forearm exercise for one minute caused mean elevations of 0.73 mEq./1. in potassium, and 0.4 mg. per 100 ml. in calcium, the maximum elevations being 1.1 mEq/1. and 1.3 mg. per 100 ml., respectively. A clinically unimportant but significant increase in sodium values of 1.40 mEq./1. was also observed. Chloride values were not affected. In addition there was a substantial error in calcium determinations in the laboratory, which emphasizes the need for repeated calcium determinations to avoid diagnostic error.The conclusion is reached that forearm exercise must be avoided during venipuncture.
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