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[Computerized tomography of the thorax in intensive care patients].

Thoracic CT for patients in intensive care is cumbersome but provides important additional information in the presence of complicated lung changes. Total opacification of a lung field visualised on conventional portable films may be due to infiltration and/or fluid and/or collapse by using the clinical information in conjunction with densitometric measurements. CT may help in the differentiation of pulmonary oedema, particularly in the presence of ARDS and its complications. It is also possible to accurately localise abscesses and empyemas in the presence of extensive consolidation. This makes it possible to drain abscesses or empyemas, or pleural fluid in unusual situations, which has become loculated, or to aspirate a pneumothorax.

Adult↗

Calculating concentration of inhaled radiolabeled particles from external gamma counting: external counting efficiency and attenuation coefficient of thorax.

We determined the overall external counting efficiency of radiolabeled particles deposited in the sheep lung. This efficiency permits the noninvasive calculation of the number of particles and microcuries (microCi) from gamma-scintillation lung images of the live sheep. Additionally, we have calculated the attenuation of gamma radiation (120 keV) by the posterior chest wall and the gamma-scintillation camera collection efficiency of radiation emitted from the lung. Four methods were employed in our experiments: (1) by light microscopic counting of discrete carbonized polystyrene particles with a count median diameter (CMD) of 2.85 microns and tagged with cobalt-57 (57Co), we delineated a linear relationship between the number of particles and the emitted counts per minute (cpm) detected by well scintillation counting; (2) from this conversion relationship we determined the number of particles inhaled and deposited in the lungs by scintillation counting fragments of dissected lung at autopsy; (3) we defined a linear association between the number of particles or microcuries contained in the lung and the emitted radiation as cpm detected by a gamma scintillation camera in the live sheep prior to autopsy (external counting efficiency); and (4) we compared the emitted radiation from the lungs of the live sheep to that of whole excised lungs in order to calculate the attenuation coefficient (ac) of the chest wall. The mean external counting efficiency was 4.00 X 10(4) particles/cpm (5.1 X 10(-3) microCi/cpm), the camera collection efficiency was 1 cpm/10(4) disintegrations per minute (dpm), and the ac had a mean of 0.178/cm. The external counting efficiency remained relatively constant over a range of particles and microcuries, permitting a more general use of this ratio to estimate number of particles or microcuries depositing after inhalation in a large mammalian lung if a similarly collimated gamma camera system is used.

Animals↗

Radio-protective aprons during radiological examinations of the thorax: an optimum strategy.

The current work investigates the most effective type/position of aprons for postero-anterior (PA) and lateral projections of the chest. Two apron-types were investigated: 'Mavig' half apron and Amray light plus' wrap-around apron. The half apron was positioned at the X-ray tube or image receptor side of an anthropomorphic phantom for PA and lateral projections. Radiation dose at positions corresponding to ovaries, uterus and testes was measured with thermoluminescent dosemeters. The wrap-around apron offers a higher level of protection for PA and lateral projections compared with the half apron, regardless of where the latter was positioned, with dose reductions of up to 88% compared with no apron. For the PA position, the half apron should be positioned in a gender-specific way, facing the X-ray tube for females and the image receptor for males. With all apron types/positions, gonadal dose is still clearly evident, from internal scatter, emphasising the importance of other protective practices such as collimation.

Body Burden↗

Direct lymphatic drainage from a melanoma on the back to paravertebral lymph nodes in the thorax.

Preoperative lymphoscintigraphy with Tc-99m antimony sulfide colloid was performed in a patient with cutaneous melanoma on the lower back just to the right of the midline. There was direct lymphatic drainage to paravertebral nodes in the chest on the right side at the level of the sixth and seventh thoracic vertebrae. There was also drainage directly to the right groin and via a series of interval nodes to the right axilla. Knowledge of the presence of such drainage may influence the surgical management of patients.

Antimony↗