Assessment of Radiation Protection in Hand-Shielding Products With Mini C-Arm Fluoroscopy

Hand ◽  
2019 ◽  
pp. 155894471986593 ◽  
Author(s):  
Matthew B. Cantlon ◽  
Asif M. Ilyas
Keyword(s):  
Radiation Exposure ◽  
Index Finger ◽  
Proximal Phalanx ◽  
Left Index Finger ◽  
Surgical Glove ◽  
Thermoluminescent Dosimeters ◽  
Intraoperative Fluoroscopy ◽  
The Mean ◽  
The Right ◽  
Free Metal

Background: Previous studies have highlighted the particular risk of radiation exposure to the surgeon’s hands with intraoperative fluoroscopy. Although evidence exists that shielding equipment for the hands reduces exposure, the extent of protection is not well understood. Therefore, we set out to determine the degree to which radiation exposure to the surgeon’s hands is decreased with hand-shielding products. Methods: An anthropomorphic model was positioned to simulate a surgeon sitting at a hand table. Thermoluminescent dosimeters were placed on the proximal phalanx of each index finger. The right index finger dosimeter was covered with a standard polyisoprene surgical glove (control arm), whereas the left index finger dosimeter was covered with commercially available hand-shielding products (study arm): lead-free metal-oxide gloves, leaded gloves, and radiation-attenuating cream. Mini fluoroscope position, configuration, and settings were standardized. The model was scanned for 15 continuous minutes in each test run, and each comparative arm was run 3 times. Results: The mean radiation dose absorbed by the control and variable dosimeters across all tests was 44.8 mrem (range, 30-54) and 18.6 mrem (range, 14-26), respectively. Each hand-shielding product resulted in statistically lower radiation exposure than a single polyisoprene surgical glove. Conclusions: The mean radiation exposure to the hands was significantly decreased when protected by radiation-attenuating options. Each product individually resulted in a statistically significant decrease in hand exposure compared with the control. We recommend that in addition to efforts to decrease radiation exposure, surgeons consider routine use of hand-shielding products when using mini c-arm fluoroscopy.

scholarly journals Response preparation involves a release of intracortical inhibition in task-irrelevant muscles

2020 ◽  
Author(s):  
Isaac N. Gomez ◽  
Kara Ormiston ◽  
Ian Greenhouse
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Index Finger ◽  
Intracortical Inhibition ◽  
Left Index Finger ◽  
Task Condition ◽  
Response Preparation ◽  
Action Preparation ◽  
The Right ◽  
Task Irrelevant

AbstractAction preparation involves widespread modulation of motor system excitability, but the precise mechanisms are unknown. In this study, we investigated whether intracortical inhibition changes in task-irrelevant muscle representations during action preparation. We used transcranial magnetic stimulation (TMS) combined with electromyography in healthy human adults to measure motor evoked potentials (MEPs) and cortical silent periods (CSPs) in task-irrelevant muscles during the preparatory period of simple delayed response tasks. In Experiment 1, participants responded with the left-index finger in one task condition and the right-index finger in another task condition, while MEPs and CSPs were measured from the contralateral non-responding and tonically contracted index finger. During Experiment 2, participants responded with the right pinky finger while MEPs and CSPs were measured from the tonically contracted left-index finger. In both experiments, MEPs and CSPs were compared between the task preparatory period and a resting intertrial baseline. The CSP duration during response preparation decreased from baseline in every case. A laterality difference was also observed in Experiment 1, with a greater CSP reduction during the preparation of left finger responses compared to right finger responses. MEP amplitudes showed no modulation during movement preparation in any of the three response conditions. These findings indicate cortical inhibition associated with task-irrelevant muscles is transiently released during action preparation and implicate a novel mechanism for the controlled and coordinated release of motor cortex inhibition.New & NoteworthyIn this study we observed the first evidence of a release of intracortical inhibition in task-irrelevant muscle representations during response preparation. We applied transcranial magnetic stimulation to elicit cortical silent periods in task-irrelevant muscles during response preparation and observed a consistent decrease in the silent period duration relative to a resting baseline. These findings address the question of whether cortical mechanisms underlie widespread modulation in motor excitability during response preparation.

Music Affects Learning of a Braille-Like Task by Sighted Subjects

1989 ◽  
Vol 69 (3-1) ◽  
pp. 923-929
Author(s):  
Robert F. Kennison ◽  
Richard A. Mcfarland
Keyword(s):  
College Students ◽  
Sensory Input ◽  
Index Finger ◽  
Practical Importance ◽  
Left Index Finger ◽  
Interhemispheric Competition ◽  
Male College ◽  
The Right ◽  
The Brain ◽  
Male College Students

24 consistently right-handed male college students felt sets of four Braille symbols with either the right or the left index finger and identified by touch alone which two of the four symbols in each set were identical. During the task music was played to either the right ear, the left ear, both ears, or neither ear. Significantly fewer errors were made when the music was in the ear contralateral to whichever hand performed the task. The ipsilateral, binaural, and no-music groups did not differ significantly from each other. It is suggested that monaural music to the ear contralateral to the engaged hand led to reduced interhemispheric competition acting on the hemisphere controlling the hand. Such a facilitating effect may be of practical importance in tasks during which one hemisphere receives the bulk of the task-related sensory input and/or processes the final order from the brain to the task-related muscles.

scholarly journals Does a fluoro-assisted direct anterior approach for total hip arthroplasty pose an excessive risk of radiation exposure to the surgeon?

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 6
Author(s):  
Yuta Jinnai ◽  
Tomonori Baba ◽  
Xu Zhuang ◽  
Hiroki Tanabe ◽  
Sammy Banno ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Radiation Exposure ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Proximal Femoral Fracture ◽  
Fluoroscopy Time ◽  
Exposure Level ◽  
Intraoperative Fluoroscopy ◽  
Significant Difference ◽  
The Mean

Introduction: Intraoperative fluoroscopy can be easily used because patients are placed in the supine position during total hip arthroplasty via direct anterior approach (DAA-THA) to reduce complications. However, the cumulative level of radiation exposure by intraoperative fluoroscopy increases as the annual number of cases increases, increasing the risk of influencing the health of both the patients and medical workers. The objective of the study was to compare the radiation exposure time of DAA-THA with osteosynthesis and to determine if the level of radiation exposure exceeded safety limits. Material and methods: DAA-THA was performed in 313 patients between January 2016 and July 2018 and 60 patients with proximal femoral fracture were treated with osteosynthesis. The intraoperative fluoroscopy time was retrospectively surveyed and compared between these two groups. A total of eight surgeons operated DAA-THA employing the same procedure using a traction table. A total of nine surgeons operated osteosynthesis and fluoroscopy was appropriately used during reduction and implant insertion. Results: The mean operative time of DAA-THA was 103.3 min and that of osteosynthesis was 83.3 min, showing a significant difference (p < 0.05). The mean intraoperative fluoroscopy time was 0.83 min (SD ± 0.68) in DAA-THA and 8.91 min (SD ± 8.34) in osteosynthesis showing a significant difference (p < 0.05). Conclusions: The intraoperative exposure level was significantly lower and the fluoroscopy time was significantly shorter in DAA-THA than in osteosynthesis for proximal femoral fracture. It was clarified that the annual cumulative radiation exposure level in DAA-THA does not exceed the tissue dose limit.

Cortical Representation of Swallowing: A Modified Dual Task Paradigm

2002 ◽  
Vol 94 (3) ◽  
pp. 1029-1040 ◽  
Author(s):  
Stephanie K. Daniels ◽  
David M. Corey ◽  
Cristen L. Barnes ◽  
Nikki M. Faucheaux ◽  
Daniel H. Priestly ◽  
...  
Keyword(s):  
Dual Task ◽  
Right Hemisphere ◽  
Index Finger ◽  
Finger Tapping ◽  
Left Index Finger ◽  
Cortical Representation ◽  
Word Repetition ◽  
Dual Task Paradigm ◽  
Left And Right ◽  
The Right

It is unclear whether the cortical representation of swallowing is lateralized to the left cerebral hemisphere, right hemisphere, or bilaterally represented. As dysphagia is common in acute stroke, it is important to elucidate swallowing lateralization to facilitate earlier detection of stroke patients who may be at greater risk for dysphagia and aspiration. In this study, a modified dual task paradigm was designed to study laterality of swallowing in a group of 14 healthy, young, right-handed, male adults. The subjects were studied at baseline and with interference. Baseline conditions, performed separately, were continuous swallowing, finger tapping using the right and left index fingers, and word repetition. Interference tasks, including tapping with the right index finger, tapping with the left index finger, and word repetition, were completed with and without swallowing. Finger-tapping rate was measured, and x-ray samples of the swallowing task were taped to measure swallowing rate and volume swallowed. At baseline, the rate of tapping the right index finger was significantly faster than that of the left index finger. There was a significant decline in the tapping rates of both left and right index fingers with swallowing interference. The volume per swallow was significantly reduced during the interfering language task of silent repetition. These results offer partial support for a bilateral representation of swallowing as well as suggest an important left hemispheric contribution to swallowing. However, it cannot be concluded that the left hemisphere is more important than the right, as a comparable right hemisphere task was not studied.

Investigation concerning the Radiation Exposure of the Medical Personnel during F-l8-FDG-PET Studies

2000 ◽  
Vol 39 (03) ◽  
pp. 77-81 ◽  
Author(s):  
E. Will ◽  
B. Beuthien-Baumann ◽  
H. Linemann
Keyword(s):  
Radiation Exposure ◽  
Fdg Pet ◽  
Medical Personnel ◽  
Radiation Shielding ◽  
Annual Dose ◽  
Radiation Level ◽  
Left Hand ◽  
Thermoluminescent Dosimeters ◽  
Reduce Radiation Exposure ◽  
The Mean

Summary Aim: The aim of the investigation was the identification of those working steps with the highest radiation exposure for the medical personnel during F-l8-FDG-PET studies and to evaluate the effectiveness of radiation protection devices and instructions developed in our PET-center. Methods: The personal dose and hand dose were measured for each working procedure during F-l8-FDG-PET studies using electronic personal dosimeters and thermoluminescent dosimeters respectively. Additionally, measurements of the radiation level near the patient were taken. Results: The mean personal dose resulting from syringe preparation was 1 μSv/syringe, from injection 3 μSv/patient, from blood sampling during quantitative studies 6 μSv/study, and from positioning and handling of the patient 6 μSv/study. The mean hand dose per syringe preparation was 710 μSv for each hand. The mean hand dose during injection was 13 μSv for the right hand and 27 μSv for the left hand. All above mentioned values were measured applying the routine radiation shielding in use in our PET center. Conclusion: With the developed radiation shielding and means to reduce radiation exposure applied the allowed annual dose for medical personnel are not exceeded. One exception is the hand dose resulting from syringe preparation. An automatic or remote filling device should be used at this working step.

Anterior Interosseous Neuropathy in Instrumental Musicians

2006 ◽  
Vol 21 (3) ◽  
pp. 137-141
Author(s):  
Richard J Lederman
Keyword(s):  
Index Finger ◽  
Age At Onset ◽  
Flexor Digitorum Profundus ◽  
Left Index Finger ◽  
Pronator Quadratus ◽  
Motor Branch ◽  
Neuralgic Amyotrophy ◽  
Electrodiagnostic Testing ◽  
The Right ◽  
Flexor Digitorum

The anterior interosseous nerve is a pure motor branch of the median nerve supplying the flexor pollicis longus, flexor digitorum profundus of the index and middle fingers, and pronator quadratus. Anterior interosseous neuropathy is rare and typically causes weakness of flexion of the tips of the thumb and index finger. Four instrumentalists, 3 violinists and 1 pianist (3 males, 1 female), seen from 1986 to 2002 at our clinic, are the subjects of this report. Age at onset ranged from 16 to 76 yrs. A possible precipitating factor was identified in each. One violinist could not hold the bow; two others noted inability to stabilize the distal left first (index) finger. The pianist noted impaired dexterity of the right hand. Examination showed weakness of flexion of the distal phalanx of the index finger and thumb and variable weakness of forearm pronation. Electrodiagnostic testing confirmed the diagnosis in all four patients. All improved over time. One symphony violinist continued to play for over 15 yrs, despite some persisting difficulty with the left index finger. Another violinist recovered function almost completely but suffered a stroke affecting the opposite hand 2.5 years later. The third violinist retired from the symphony on disability because his recovery was delayed for >1 yr. The young pianist is playing 4 to 5 hrs/day. It is likely that at least three of the four had a localized form of neuralgic amyotrophy.

Generalized and Lateralized Effects of Concurrent Verbalization on a Unimanual Skill

1971 ◽  
Vol 23 (3) ◽  
pp. 341-345 ◽  
Author(s):  
Marcel Kinsbourne ◽  
Jay Cook
Keyword(s):  
Motor Control ◽  
Cerebral Hemisphere ◽  
Index Finger ◽  
Left Index Finger ◽  
Distraction Effect ◽  
Left Cerebral Hemisphere ◽  
Verbal Activity ◽  
Right Hand ◽  
Concurrent Verbalization ◽  
The Right

After practice, subjects balanced a dowel rod on the right and on the left index finger while speaking and while remaining silent. As compared to control, the verbal condition yielded shorter balancing times for the right hand, but longer ones for the left. A speculative model postulates enhancement of the practised skill by virtue of the distraction effect of the concurrent activity. This is counteracted on the right by interference with right-sided motor control by the left cerebral hemisphere due to verbal activity programmed by the same hemisphere.

Braille Reading: Effects of Different Hand and Finger Usage

1980 ◽  
Vol 74 (9) ◽  
pp. 338-343 ◽  
Author(s):  
M.J.C. Mommers
Keyword(s):  
Index Finger ◽  
Middle Finger ◽  
Left Index Finger ◽  
The Right ◽  
Left Middle ◽  
Blind Students

Reviews the literature on hand and finger usage in reading braille. Describes an experiment using 25 blind students to test whether they read faster and/or more accurately with: the left index finger rather than the right one; the left middle finger rather than the right one; the index finger rather than the middle finger; and, with spontaneous hand usage (usually both hands), whether the student read faster and/or more accurately than with the index finger of one hand.

scholarly journals Occupational Radiation Exposure to Workers Used18F-FDG

2019 ◽  
Vol 29 (4) ◽  
pp. 100
Author(s):  
Ahmed Ali Wabdan
Keyword(s):  
Radiation Exposure ◽  
Radiation Risk ◽  
Whole Body ◽  
Thermoluminescent Dosimeters ◽  
Medical Physicist ◽  
Positron Emission ◽  
Pet Ct ◽  
Medical Physicists ◽  
The Mean ◽  
18F Fdg

The increasing interest of medical institutes in the development of imaging services to include the hybrid system [Positron Emission Tomography combined with Computed Tomography(PET/CT)], this system is acquiring explosive growth due to its ability to accurately detect and stage many types of cancer and follow the progress of treatments. An increasing demand for use of (18F-FDG PET) in oncology has been the main reason for its growth. The physical characteristics of positron emissions result in higher radiation risk for staff and growing use of PET/CT for diagnostic purposes increase radiation exposure. The objective of this study was to estimate the radiation exposure to the medical physicists, technicians and nurses working in three Egyptian nuclear medicine institutes under our investigations, based on the whole body collective dose measured by thermoluminescent dosimeters (TLDs) and the effective dose per study received by medical staff were measured by electronic pocked dosimeters and the finger doses by ring dosimeter during a period of six months. The (mean± SD) dose measured per PET/CT procedure were (2.45±0.137, 3.22±0.218 and 1.69±0.11) μSv for the medical physicist, technician and nurse respectively. The (mean± SD) dose measured per MBq of 18F-FDG were (7.35±0.43, 9.73±0.66 and 5.13±0.33) nSv/MBq for the medical physicist, technician and nurse respectively. The (mean± SD) finger dose measured per 18F-FDGPET/CT scans were (179.9±24.94, 8.82±2.912 and 24.15±4.164) μSv for the medical physicist, technician and nurse respectively.

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