宫内节育器异常的X线分析

目的　探讨宫内节育器异常的X线表现。方法　对我院门诊 6 2 4例放置节育器妇女进行立位透视检查 ,测量节育器位置 ,观察其形态。结果　 6 2 4例宫内放置节育器的妇女中 ,位置异常 75例 ,其中节育器经子宫颈脱落 32例 ,节育器变形 12例 ,节育器断裂 10例 ,带环妊娠 8例 ,放置两个节育器 10例 ,节育器嵌入子宫肌层 2例 ,节育器游离腹腔 1例。结论　定期对放环妇女进行X线检查十分必要。     

Radiology of cardiac devices and their complications

This article familiarizes the reader with several different cardiac devices including pacemakers and implantable cardioverter defibrillators, intra-aortic balloon pumps, ventricular assist devices, valve replacements and repairs, shunt-occluding devices and passive constraint devices. Many cardiac devices are routinely encountered in clinical practice. Other devices are in the early stages of development, but circumstances suggest that they too will become commonly found. The radiologist must be familiar with these devices and their complications.Cardiac devices such as pacemakers have now been improving patient morbidity and mortality for decades. Radiology has played an integral role in device pre-procedural planning, placement and continued evaluation. This article aims to review cardiac devices that have been in use for a long time, including pacemakers, implantable cardioverter defibrillators (ICDs), the intra-aortic balloon pump (IABP) and valve repairs/replacements. Decades of use have provided ample data regarding their normal radiographic appearances and complications. In addition, contemporary advances have impacted our understanding of newer devices and their complications. Because of the increasing use of these devices, it is of utmost importance to be aware of their complications. The ventricular assist devices (VADs) have benefitted greatly from recent technological advances, and they continue to evolve. Furthermore, new devices such as percutaneous valve replacements and passive constraint devices continue to emerge. Radiologists interpreting thoracic imaging studies should become familiar with their appearances and potential complications.     

Prosthetic devices within radiotherapy fields: planning implications and results

Prosthetic devices made of plastic or silicon are occasionally present in patients requiring radiotherapy (RT). The effect of RT on these devices and the potential implications of their presence on RT planning are relatively unknown. Three examples are presented in which various devices were included in RT fields. In two of the examples in vitro testing of the devices with high single doses of radiation was undertaken. Radiotherapy was given to all patients with high doses received by the devices. Minor adjustments were made to the planning techniques to reduce the doses to the devices. Neither significant complications nor any malfunctions of the devices were noted subsequently.     

Long-term follow-up of upper extremity implanted venous access devices in oncology patients

PURPOSE: To evaluate function and assess incidence of complications relating to upper extremity implanted venous access devices placed in oncology patients primarily for chemotherapy. MATERIALS AND METHODS: The authors retrospectively evaluated the clinical course of 205 upper extremity implanted venous access devices placed with fluoroscopic and sonographic guidance in 204 patients during a 2-year period. All patients had a diagnosis of malignancy for which chemotherapy was planned. Follow-up data were collected by patient examination, direct evaluation of device function, as well as chart review and review of relevant imaging procedures. A modified technique for device placement is described. RESULTS: The devices were placed successfully on the initial attempt in all cases. Clinical follow-up was obtained for 195 devices (95.1%) for a total device service period of 33,619 days (mean service interval = 169 days). Seventy-eight devices (40%) had service intervals greater than 180 days. Thirty-seven devices (19% of total devices) led to 39 complications (0.116 event/100 days). No immediate procedural complications were incurred. Eight complications occurred after 180 days of port service. Nineteen devices (9.7% of total devices followed) required removal as a result of complication. Common complications included port malfunction requiring urokinase to clear (n = 10; 0.030 event/100 days), ipsilateral upper extremity deep venous thrombosis (n = 9; 0.027), and local infection (n = 7, 0.021). A comparison of these results relative to other published series of similar devices placed for mixed indications is presented. CONCLUSIONS: Implanted venous access devices are an effective means of long-term venous access in oncology patients. Complication rates in this large series compared favorably to other published radiologic and surgical series. Analysis of complications in a subgroup of extended use implanted venous access devices (greater than 180 days follow-up) showed no statistically significant (P < .05) difference from the larger group of devices.     

Medical and surgical devices in the emergency and trauma patient: what the radiologist should know,and how they can add value

A variety of different external and internal medical devices are used in the acute setting to maintain life support and manage severely injured and unstable trauma or emergency patients. These devices are inserted into the acutely ill patient with the specific purpose of improving outcome, but misplacement can cause additional morbidity and mortality. Consequently, meaningful interpretation of the position of devices can affect acute management. Some devices such as nasopharyngeal, nasogastric and endotracheal tubes and chest and surgical drains are well known to most clinicians, however, little formal training exists for radiologists in composing their report on the imaging of these devices. The novice radiologist often relies on tips and phrases handed down in an aural tradition or resorts to phrases such as: “position as shown”. Furthermore, radiologists with limited experience in trauma might not be familiar with the radiological appearance of other more specific devices. This review will focus on the most common medical devices used in acute trauma patients, indications, radiological appearance and their correct and suboptimal positioning.     

A Review of Commonly Used Intrauterine Contraceptive Devices.

The radiographic appearances of the most commonly used intrauterine contraceptives devices are reviewed, and methods are suggested to determine the extrauterine location of these devices. Complications resulting from the use of these devices are also discussed.     

Evaluation of cardiopulmonary devices on chest radiographs: digital vs analog radiographs

We compared digital and analog radiographs of the chest for use in detecting and evaluating a variety of cardiopulmonary devices in 40 patients. The devices included 23 endotracheal tubes, 21 Swan-Ganz catheters, 14 central venous pressure catheters, 11 prosthetic valves, 10 chest tubes, six pacemaker wires, and five intraaortic balloon pumps. Each patient had at least one device, with a maximum of five devices (average, 2.3). Forty digital/analog film pairs were compared by five radiologists, who assigned confidence levels for various judgments about each device. The results showed that there were no statistically significant differences in the identification of the devices except for prosthetic valves (all valves were detected on digital radiographs, compared with 62% on analog radiographs). The devices were detected on 96% of the digital radiographs and 90% of the analog radiographs. Although digital and analog radiographs were comparable for detection of most devices, the digital radiographs allowed greater confidence in the identification of the devices and in the identification of the tip and course of Swan-Ganz and central venous pressure catheters.     

A Peltier thermal cycling unit for radiopharmaceutical synthesis.

We have investigated the use of Peltier devices to rapidly cycle the temperature of reaction vessels in a radiopharmaceutical synthesis system. Peltier devices have the advantage that they can be actively cooled as well as heated, allowing precise and rapid control of vessel temperatures. Reaction vessel temperatures of between -6 degrees C and 110 degrees C have been obtained with commercially available devices with reasonable cycle times. Two devices have been used as the basis for a general purpose, two-pot synthesis system for production of [11C] compounds such as raclopride.     

An overview of vascular closure devices: What every radiologist should know

Haemostatic devices can be categorised according to their mechanism of action into three main types; namely pressure devices, topical haemostatic pads and vascular closure devices (VCD). Of these three categories, it is the development of VCDs that revolutionised management of endovascular procedures. Currently available VCDs fall into three major classes, those that use a collagen plug, those that use clips and those that perform suture closure at the arteriotomy site. This article provides a comprehensive review of the all three classes with examples of commercially available devices.     

胸腰椎前路短节段内固定器的发展与应用

胸腰椎前路短节段内固定按结构不同可分为钉-板系统和钉-棒系统,介绍两类中具有代表性的内固定特点、生物力学评价、临床应用及并发症。熟悉各种胸腰椎前路内固定特点、固定方式,有助于合理的选择内固定。     

穿戴式健康监测设备的现状与未来

智能手机与移动通信技术的迅速发展,为穿戴式健康监测提供了发展机遇。穿戴式健康设备能够监测用户的重要生理信号,通过手机接入移动通信网或互联网进行数据远程传送或共享,从而实现医学监护并降低医疗成本。本文概述了穿戴式健康设备的发展现状,指出穿戴式医疗发展机遇与风险挑战并存,并展望了其发展趋势。     

Evaluation and comparison of automated biopsy devices. Work in progress.

The performance of four automated biopsy devices (Bard Biopty, Bard Monopty, Microvasive ASAP 18, Medical Device Technologies Ultra-Cut) was compared when they were used to obtain 96 liver and 96 kidney samples from eight dogs under ultrasound guidance. There was no significant difference in the lengths of the samples obtained with the four devices. The Monopty device yielded a significantly greater mean weight of both kidney (30.8%) and liver (31.6%) samples compared with the other devices. There were no significant differences between the four devices relative to cellular and histologic preservation, crush artifact, and number of renal glomeruli or liver lobules and portal triads. Renal subcapsular hematomas were identified in most instances, and there was no difference between the devices in the amount of renal trauma resulting from their use. There was only one instance of severe injury to the liver. The choice of instrument should remain one of personal preference, since all four devices were satisfactory and none produced significantly greater renal or hepatic injury.     

Applications of percutaneous mechanical thrombectomy in pulmonary embolism

Percutaneous mechanical thrombectomy (PMT) has matured into a reliable and valuable therapeutic tool in acute vascular diseases. PMT devices are designed to achieve rapid clearance of acute occlusion in large arteries and veins. This article provides a summary of cumulated experience on pulmonary embolism (PE) treatment with PMT devices. PMT devices are a heterogeneous group of devices that uses different forms of energy. Most of the devices do not totally eliminate thrombus rather fragment in small particles. The rationale of PMT is based on the rapid relief of central pulmonary obstruction. PMT in massive PE provides efficacious and safe debulking of centrally located thrombus in PE, lowering pulmonary artery pressures and improving hemodynamics and blood oxygenation. This results in lowering mortality if compared with natural history of PE, and reduced procedure time if compared with pharmacological thrombolysis. The clinical indications for percutaneous intervention in PE are discussed in the text.     

Cone beam CT: a current overview of devices

The purpose of this study was to review and compare the properties of all the available cone beam CT (CBCT) devices offered on the market, while focusing especially on Europe. In this study, we included all the different commonly used CBCT devices currently available on the European market. Information about the properties of each device was obtained from the manufacturers’ official available data, which was later confirmed by their representatives in cases where it was necessary. The main features of a total of 47 CBCT devices that are currently marketed by 20 companies were presented, compared and discussed in this study. All these CBCT devices differ in specific properties according to the companies that produce them. The summarized technical data from a large number of CBCT devices currently on the market offer a wide range of imaging possibilities in the oral and maxillofacial region.     

Percutaneous arterial closure devices

Advances in interventional angiography such as covered stent technology and adjunctive anticoagulation and antiplatelet therapy for arterial recanalization have reached the margins of percutaneous application. In these circumstances, compression methods of arterial closure require prolonged compression or long arterial sheath dwell times that increase procedural time, complication rates, and patient discomfort. Percutaneous arterial closure devices offer the potential of rapid hemostasis and shorter times to ambulation and discharge. These benefits have costs, in terms of the price of the devices and complications of their use. A Web search identified approved and pending devices. A Medline search identified device studies that were reviewed to assess the efficacy and complication rates of device-mediated closure versus the gold standard of manual compression. Studies that compared devices were evaluated to determine if any particular device was superior. The arterial closure devices were equivalent to manual compression in the establishment of hemostasis in the diagnostic population. However, complication rates were higher. In the therapeutic populations, the devices were as efficacious as manual compression, without correction of anticoagulation, and the complication rates were similar. No individual device was clearly superior.     

New techniques in lumbar spinal instrumentation: what the radiologist needs to know

Lumbar spinal fusion is a commonly performed procedure, and, despite changes in cage types and fixation hardware, radiologists have, over the years, become familiar with the imaging features of typical spinal fusion and many of the complications seen in patients after surgery, including pseudoarthrosis, hardware loosening, and recurrent or residual disk herniation. Recently, however, novel approaches and devices have been developed, including advances in minimally invasive surgery, the increasing use of osteoinductive materials, and a wide variety of motion-preserving devices. These new approaches and devices manifest with characteristic imaging features and the potential for unusual and unexpected complications. Several of these devices and approaches are experimental, but many, including those devices used in lateral approaches to fusion, as well as the use of bone morphogenic protein, disk arthroplasty, and interspinous spacers, are seen with increasing frequency in daily clinical practice. Given the recent advances in spinal fusion surgery, it is important that radiologists have a basic understanding of the rationale behind these procedures, the common imaging features of the devices, and the complications associated with their use.     

Adjustable loop ACL suspension devices demonstrate less reliability in terms of reproducibility and irreversible displacement

Purpose

The aim of this study was to perform a comprehensive biomechanical examination of frequently applied femoral cortical suspension devices, comparing the properties of both fixed and adjustable fixation mechanisms. It was hypothesized that adjustable loop devices demonstrate less consistent fixation properties with increased variability compared to fixed loop devices.

Methods

Nine frequently applied fixation button types were tested, six adjustable and three rigid loop devices. Six samples of each device type were purchased. Each device was installed in a servo-hydraulic mechanical testing machine, running a 2000 cycle loading protocol at force increments between 50 and 500 N. Irreversible displacement in mm was measured for all of the tested samples of each implant. Ultimately, maximum load to failure was applied and measured in Nm. An irreversible displacement of 3 mm was considered failure of the implant.

Results

Three of the six adjustable devices (GraftMax?, TightRope® ToggleLoc?) demonstrated a median displacement above the threshold of clinical failure before completion of the cycles. All adjustable loop devices showed a wide intragroup variation in terms of irreversible displacement, compared to fixed-loop devices. Fixed-loop devices provided consistent reproducible results with narrow ranges and significantly lower irreversible displacement (p?<?0.05), the maximum being 1.4 mm. All devices withstood an ultimate force of more than 500 N.

Conclusion

Adjustable loop devices still show biomechanical inferiority and demonstrate heterogeneity of fixation properties with wide- and less-reproducible displacement ranges resultant to the mechanism of adjustment, denoting less reliability. However, three adjustable devices (RIGIDLOOP? Adjustable, Ultrabutton ^?, ProCinch?) demonstrate fixation capacities within the margins of clinical acceptance. RIGIDLOOP? Adjustable provides the most comparable fixation properties to fixed loop devices.

     

Embolic protection devices: methods, techniques, and data

Emboli prevention devices have become an integral part of carotid stenting and have dramatically lowered the risk of stroke during the procedure. A variety of devices are available with different performance characteristics. Filter devices are the current mainstay and have high technical success rates. Slow flow through the filters can happen with large embolic burdens and should be treated with aspiration prior to filter retrieval.     

Peripheral arterial applications of percutaneous mechanical thrombectomy

Various devices have been introduced for the purpose of percutaneous mechanical thrombectomy (PMT). These devices show promise as a valuable treatment option in acute arterial thrombotic occlusions, in addition to the gold-standard surgical method, the Fogarty balloon embolectomy, and local fibrinolysis therapy. Local fibrinolytic therapy cannot be used in the presence of contraindications, and can be time-consuming in limb threatening situations. Surgical intervention can also result in intimal vessel wall injury and is of limited value in infrageniculate occlusions. In this review, currently available PMT devices for peripheral arterial applications will be introduced, and their advantages, drawbacks and finally the reported clinical experience with these devices will be presented.     

SugarSync forensic analysis

Cloud storage services are popular with both individuals and businesses as they offer cost-effective, large capacity storage and multi-functional services on a wide range of devices such as personal computers (PCs), Mac computers, and smart mobile devices (e.g. iPhones). However, cloud services have also been known to be exploited by criminals, and digital forensics in the cloud remains a challenge, partly due to the diverse range of cloud services and devices that can be used to access such services. Using SugarSync (a popular cloud storage service) as a case study, research was undertaken to determine the types and nature of volatile and non-volatile data that can be recovered from Windows 8, Mac OS X 10.9, Android 4 and iOS 7 devices when a user has carried out different activities such as upload and download of files and folders. We then document the various digital artefacts that could be recovered from the respective devices.