Detection of pneumonia was not measurably compromised by using digital cameras compared with film digitizers. The 3-fold lower cost of the digital camera makes this technology an affordable and widely accessible alternative for surveillance systems, vaccine trials, and perhaps clinical use.
abstract:The 60-film set was developed by experts (expert group) for examining 8 indices: sensitivity (X 1 ) and specificity (X 2 ) for pneumoconiosis, sensitivity(X 3 ) and specificity for (X 4 ) large opacities, sensitivity (X 5 ) and specificity (X 6 ) for pleural plaque, profusion increment consistency for small opacities (X 7 ), and shape differentiation for small opacities (X 8 ) of physicians' reading skills on pneumoconiosis X-ray according to ilO 2000 classification. The aim of this study was to assess the appropriateness of the exam film set for evaluating physicians' reading skills. 29 physicians (a1-group) and 24 physicians (a2-group) attended the 1st and 2nd "asian intensive Reader of Pneumoconioses" (aiR Pneumo) training course, respectively, and 22 physicians (b-group) attended brazilian training course. after training, they took examination of reading 60-film exam set. The examinees' reading results in terms of 8 indices were compared between the examinee groups and the Expert group by parametric unpaired t-test. The Examinee group consisting of a1-group, a2-group and b-group was inferior to the Expert group in all indices. There was no significant difference for X 7 of a1-group, X 7 and X 8 of a2-group (p>0.05) compared with the expert group. There was a significant difference in X 8 at p<0.05 between a1-group and a2-group, in X 3 at p<0.05 between a1-group and b-group, in both X 1 and in X 3 at p<0.05 between a2-group and b-group. accordingly, the 60-film set providing 8 indices designed might be a good method for evaluation of the physicians' reading proficiency at different training settings.
Chylothorax may rarely occur in osteolysis. A fatal case of bilateral chylothorax complicating massive osteolysis is described and the pathogenesis and management are discussed. (Thorax 1996;51:1277-1278 Keywords: chylothorax, massive osteolysis, Gorham's syndrome. His respiratory compromise necessitated repeated aspirations and, subsequently, bilateral intercostal tube drainage. Gastrointestinal rest and total parenteral hyperalimentation were promptly instituted. Lymphangiography showed normal lymph channels in the inguinal and lumbar areas, but areas ofminimal contrast leakage were noted in the upper and lower part of the left thoracic cavity; however, the thoracic duct was not visualised on the 24 and 48 hour films. Subsequent chest radiographs showed progressive resorption of the left first to third ribs, left transverse processes of the first to third thoracic vertebrae, part of the body of the seventh cervical vertebra, spinous process of the left scapula, and the right first and second ribs ( figure).
Division of MedicineDespite maximal nutritional support his condition deteriorated. Chest tube drainage persisted at a rate of approximately 1500 ml/day. By the third week a diagnosis of massive osteolysis was considered and open thoracotomy with a view to thoracic duct ligation was planned. However, the patient rapidly de- teriorated and died the following day. Necroscopic examination of the affected ribs showed enlargement of the marrow spaces which were completely replaced by numerous lymphatic vessels.
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