Scatter radiation intensities around full-field digital mammography units

The aim of this study was to investigate the scatter radiation intensity around digital mammography systems and apply these data to standard shielding calculations to reveal whether shielding design of existing breast screening rooms is adequate for the use of digital mammography systems. Three digital mammography systems from GE Healthcare, Hologic and Philips were employed in the study. A breast-equivalent phantom was imaged under clinical workload conditions and scatter radiation intensities around the digital mammography systems were measured for a range of angles in three planes using an ionisation chamber. The results were compared with those from previous studies of film-screen systems. It may be deduced from the results that scattering in the backward direction is significant for all three systems, while scattering in the forward direction can be significant for some planes around the GE and Hologic systems. Measurements at typical clinical settings on each system revealed the Philips system to have markedly lower scatter radiation intensities than the other systems. Substituting the measured scattered radiation intensity into shielding calculations yielded barrier requirements similar to those already in place at the screening centres operating these systems. Current radiation protection requirements based on film-screen technology remain sufficient when applied to rooms with digital mammography installations and no alteration is required to the structural shielding.

UV inhibits allergic airways disease in mice by reducing effector CD4 T cells

BACKGROUND

In human asthma, and experimental allergic airways disease in mice, antigen-presenting cells and CD4(+) effector cells at the airway mucosa orchestrate, and CD4(+)CD25(+) regulatory T cells attenuate, allergen immunity. UV irradiation of skin before sensitization with ovalbumin (OVA) causes significantly reduced asthma-like responses in respiratory tissues.

OBJECTIVE

To determine whether UV-induced changes in CD11c(+) cells, CD4(+)CD25(+) effector cells or CD4(+)CD25(+) regulatory cells in the trachea and airway draining lymph nodes (ADLNs) were responsible for reduced allergic airways disease.

METHODS

The phenotype and function of CD11c(+) cells and CD4(+)CD25(+) cells in the trachea and ADLNs of UV- and non-irradiated, OVA-sensitized mice was examined 24 h after a single exposure to aerosolized OVA.

RESULTS

No changes in the function of CD11c(+) cells from UV-irradiated mice were observed. CD4(+)CD25(+) cells from UV-irradiated, OVA-sensitized mice harvested 24 h after OVA aerosol proliferated less in response to OVA in vitro and were unable to suppress the proliferation of OVA-sensitized responder cells. This result suggested reduced activation of effector T cells in the airway mucosa of UV-irradiated, OVA-sensitized mice. To exclude regulatory cells of any type, there was similar proliferation in vivo to aerosolized OVA by CFSE-loaded, OVA-TCR-specific CD4(+) cells adoptively transferred into UV- and non-irradiated, OVA-sensitized mice. In addition, there was no difference in the expression of regulatory T cell markers (Foxp3, IL-10, TGF-beta mRNA). To examine effector T cells, ADLN cells from UV-irradiated, OVA-sensitized and -challenged mice were cultured with OVA. There was reduced expression of the early activation marker CD69 by CD4(+)CD25(+) cells, and reduced proliferation in the absence of the regulatory cytokine, IL-10.

CONCLUSION

Reduced allergic airways disease in UV-irradiated mice is due to fewer effector CD4(+)CD25(+) cells in the trachea and ADLNs, and not due to UV-induced regulatory cells.

Low frequency TENS is less effective than high frequency TENS at reducing inflammation-induced hyperalgesia in morphine-tolerant rats

Both transcutaneous electrical nerve stimulation (TENS) and morphine are commonly used for relief of pain. Extensive research has been done on the effectiveness of each of these two methods for pain relief when given independently. However, very little literature exists examining the effectiveness of their combined use. Systemically administered morphine activates mu opioid receptors and when administered for prolonged periods results in analgesic tolerance. Low (4 Hz) and high (100 Hz) frequency TENS activate mu- and delta-opioid receptors, respectively, It is thus possible that TENS would be less effective in morphine-tolerant subjects. The current study investigated the effectiveness of high- and low-frequency TENS in the reversal of hyperalgesia in inflamed rats that were morphine-tolerant. Morphine tolerance was induced by subcutaneous implantation of morphine pellets over 10 days. Knee joint inflammation was induced by injection of kaolin and carrageenan into the knee joint cavity. Secondary heat hyperalgesia was tested by measuring the paw withdrawal latency to radiant heat (1) before pellet implantation (either morphine or placebo), (2) after pellet implantation and before inflammation, (3) after inflammation and (4) after TENS. Both high (100 Hz) and low (4 Hz) frequency TENS caused nearly 100% inhibition of secondary hyperalgesia in animals receiving placebo pellets. In contrast, the hyperalgesia in morphine-tolerant animals with knee joint inflammation was unaffected by low frequency TENS but fully reversed by high frequency TENS. These results suggest that patients who are tolerant to morphine may respond better to high frequency TENS than to low frequency TENS.

Acute pain services in New Zealand hospitals; a survey

AIM

To describe the services available for the treatment of acute pain in surgical hospitals in New Zealand.

METHODS

A survey of all surgical hospitals in New Zealand was undertaken in 1994 by postal questionnaire, followed up by telephone when necessary for completeness or clarification. A subset of these hospitals was resurveyed in 1996.

RESULTS

Completed questionnaires were obtained from 62 surgical hospitals (78% of the 79 surveyed). Of these, 38 operated within 23 publicly funded crown health enterprises (CHEs), the remainder being privately funded institutions. A formal pain service, with designated medical and/or nursing time, was in operation in only 12 hospitals, all of which were larger institutions (150 beds or more) within CHEs. Informal pain services were in operation in 28 additional hospitals, including 8 of 24 private hospitals. Most hospitals employed a wide range of analgesic modalities, although epidural infusions and nerve block infusions were used in a greater proportion of hospitals with a formal acute pain service. By 1996 the number of hospitals with nursing and/or medical positions designated for acute pain management had increased.

CONCLUSION

Most New Zealand surgical hospitals use a wide range of modern analgesic modalities and an increasing number are providing formal acute pain services with designated medical and/or nursing time.