Radiation exposure in prone vs. modified supine position during percutaneous nephrolithotomy: Results with an anthropomorphic model

Introduction: Radiation exposure during urologic procedures is still of concern in the urologist’s community. It has been reported that percutaneous nephrolithotomy (PCNL) in supine position will have less irradiation as the puncture is mostly done under ultrasound guidance. However, it can also be done under fluoroscopy guidance. Unfortunately, data on radiation exposure during PCNL is more lacking since they are often drawn form generalization and extrapolation, or not evaluating new procedures or different positions. The aim of our study was to compare the radiation dose depending on the position of the surgeon. Methods: A portable C-arm was used in standard mode (32 impulsions/second; 98kV, 3.8mA). Specific dosimeters were placed for lens, extremity and torso. Anthropomorphic models and hand phantom models were used to reproduce the position of surgeon and patient (with same bone density than human) during PCNL in prone and modified supine position. Fluoroscopy time (FT) was 6 minutes to obtain higher exploitable signal, and the results are given for a FT of 3 minutes (more realistic). Ten percent of the FT is done with an angulation of 15 degrees and the rest in anteroposterior position. Results: The equivalent doses (ED) are given in uSV (uncertainty k=2). During the modified supine position: neck, lens, right index finger, left thumb and index finger received ED of 99 (20%), 62 (18%), 437 (10%), 112 (12%), 204 (10%), respectively. In a prone position, the phantom received ED on the neck, lens, right thumb and index finger, left thumb and index finger of 85 (20%), 92 (12%), 401 (10%), 585 (10%), 295 (10%), 567 (10%), respectively. In both position, the right hand seems more exposed than the left hand. Conclusion: The effective dose is 1.5 and 1.3 fold higher for lens and extremities, respectively, in a prone position PCNL compared to a modified supine position. Both positioning are still well below the recommended limit for professional exposition.

Download Full-text

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

Hand ◽

10.1177/1558944719865937 ◽

2019 ◽

pp. 155894471986593 ◽

Cited By ~ 1

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.

Download Full-text

Investigation of the relationship of the morphometric measurements of the hands and fingers with the personality traits of leadership

International Journal of Basic and Applied Sciences ◽

10.14419/ijbas.v8i1.29310 ◽

2019 ◽

Vol 8 (1) ◽

pp. 5

Author(s):

Seda Sertel Meyvaci ◽

Rengin Kosif ◽

Murat Diramali ◽

Tugce Baki

Keyword(s):

Personality Traits ◽

Index Finger ◽

Charismatic Leadership ◽

Distal Phalanx ◽

Anthropometric Measurements ◽

Leadership Frames ◽

Left Hand ◽

Leadership Frame ◽

The Right ◽

The Relationship

Background: The hand is a functionally critical organ at the distal end of the upper extremity. Also, the creases in the hands and the digital flexion creases on the fingers are the important external anatomical landmarks.Objectives: There are no studies found in the literature, linking solely the leadership personality traits with the anthropometric measurements of the hand.Methods: This descriptive study was to investigate the relationship between the 44 anthropometric measurements about hand, and the leadership personality traits in young adults from both genders.Results: When the leadership frames were compared by the scores, human resource leadership scores were significantly higher in the females. The charismatic leadership frame scores positively correlated with the parameters in males; including the breadth of the right hand, the breadth of the left hand, the index finger length of the left hand, and the distal phalanx length of the index finger on the left hand. The transformational leadership score was positively correlated with the left hand width and with the distal phalanx of the index finger on the left hand. In females, it was found out that the frames of human leadership and charismatic leadership correlated negatively with the length of the right thumb.Conclusions: According to the results of our study, we concluded that the breadth of the hand and the measurements of the thumb and the index fingers can provide opinion on leadership personality traits.

Download Full-text

Shifts in Kinesthesis through Time and after Active and Passive Movement

Perceptual and Motor Skills ◽

10.2466/pms.1975.40.3.755 ◽

1975 ◽

Vol 40 (3) ◽

pp. 755-761 ◽

Cited By ~ 22

Author(s):

Brian Craske ◽

Martin Crawshaw

Keyword(s):

Shoulder Joint ◽

Index Finger ◽

Position Sense ◽

Passive Movement ◽

Active Movement ◽

Final Position ◽

Left Hand ◽

Limb Position ◽

Test Position ◽

The Right

The position sense of a stationary arm was investigated subsequent to an horizontally adductive movement with axis the shoulder joint. The right arm was the treated arm: it reached a test position actively, using minimal voluntary effort, or passively from each of 10 starting positions. The blindfolded S localized the index finger of the treated arm by attempting to touch it with the index finger of his left hand. The results indicate that subsequent to active movement the final position of a limb is more accurately known than a position resulting from passive movement. A second finding is that concomitant with both forms of limb placement there is a unidirectional drift of perceived limb position over trials.

Download Full-text

Supine Percutaneous Nephrolithotripsy in Double-S Position

Advances in Urology ◽

10.1155/2018/7193843 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Giuseppe Giusti ◽

Antonello De Lisa

Keyword(s):

Urinary Tract ◽

Prone Position ◽

Supine Position ◽

Lower Risk ◽

External Genitalia ◽

Upper Urinary Tract ◽

Renal Lithiasis ◽

The Right ◽

Percutaneous Nephrolithotripsy ◽

Flexible Instruments

Background. At present, the percutaneous nephrolithotripsy (PCNL) is performed both in supine and in prone position. The aim of this paper is to describe an innovative position during PCNL. Methods. We describe a supine position. The patient’s legs are slightly abducted at the hips. The thorax is laterally tilted (inclination 30°–35°) and kept in the right position by one or two gel pads placed between the scapula and the vertebrae. External genitalia can be accessed at any time, so that it is always possible to use flexible instruments in the upper urinary tract. We used this position for a period of 12 months to treat with PCNL 45 patients with renal lithiasis. Results. All the procedures were successfully completed without complications, using the position we are describing. The following are some of its benefits: an easier positioning of the patient; a better exposure of the flank for an easier access to the posterior renal calyces of the kidney; a lower risk of pressure injuries compared to positions foreseeing the use of knee crutches; the possibility of combined procedures (ECIRS) through the use of flexible instruments; and a good fluoroscopic visualization of the kidney not overlapped by the vertebrae. Conclusions. This position is effective, safe, easy, and quick to prepare and allows for combined anterograde/retrograde operations.

Download Full-text

Choice Reaction Times for Structural Relationships between Possible Response Sequences

Perceptual and Motor Skills ◽

10.2466/pms.1993.77.3f.1203 ◽

1993 ◽

Vol 77 (3_suppl) ◽

pp. 1203-1212 ◽

Cited By ~ 2

Author(s):

Kazunori Shidoji

Keyword(s):

Index Finger ◽

Ring Finger ◽

Reaction Times ◽

Middle Finger ◽

Left Hand ◽

Right Hand ◽

Structural Relationships ◽

Middle Ring ◽

The Right ◽

Choice Reaction Times

To investigate human motor programming, choice reaction times were measured on tasks for which subjects made choices between two alternative finger-tapping-movement sequences. The total-number-of-responses and the hierarchical editor models were tested. In Exp. 1 the choice was carried on the situations with the same total numbers of possible responses and different structural relations between alternative sequences. The right-hand reaction times in mirror choice (e.g., subject chose between the middle, index, and ring finger sequences of the left or right hand) were shorter than those in nonmirror choice (e.g., subject chose between the middle, index, and ring finger sequence on one hand and the middle, ring, and index finger sequence on the other hand); the total-number-of-responses model was not supported. In Exp. 2 two conditions had the same operation numbers of the hierarchical editor model. In Condition 1 subjects chose between the index finger of the right hand and the ring, index, and middle finger sequence of the left hand. In Condition 2 subjects chose between the index, ring, and middle finger sequences of the left or right hand. The reaction time in the former condition was shorter than that in the latter condition. Exp. 2 exhibited a counterexample of the hierarchical editor model that had been fairly robust in previous studies.

Download Full-text

Comparative Study of Percutaneous Nephrolithotomy in Supine and Prone Positions

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v19i1.3346 ◽

2021 ◽

Vol 19 (1) ◽

pp. 154-157

Author(s):

Anup Chapagain ◽

Robin Bahadur Basnet ◽

Chitaranjan Shah ◽

Arvind Kumar Shah ◽

Parash Mani Shrestha ◽

...

Keyword(s):

Radiation Dose ◽

Prone Position ◽

Percutaneous Nephrolithotomy ◽

Supine Position ◽

Operative Duration ◽

Stone Free Rate ◽

The Mean ◽

Group 2 ◽

Free Rate ◽

Group 1

Background: The aim of the study is the compare efficacy and safety of percutaneous nephrolithotomy in supine and prone positions. Percutaneous nephrolithotomy is conventionally performed in prone position but in recent years numbers of supine percutaneous nephrolithotomies is increasing globally.Methods: The hospital based cross-sectional observational study was conducted in the Department of Urology, Bir Hospital from July 2018 to January 2020. A total of 81 consecutive patients undergoing percutaneous nephrolithotomy were divided into two groups, with 38 patients in Supine (Group 1) and 43 patients in Prone (Group 2) positions, respectively. Patient’s demographics, access time, operative duration, stone free rate, radiation dose and duration, irrigation fluid volume, post-operative hemoglobin drop and complications were compared.Results: Demographic and stone characteristics were comparable in both groups. Supine Group (Group 1) had significantly shorter operative duration than Prone Group (Group 2), 44.63 ± 12.44minsvs 53.02 ±12.67mins (p< 0.04). The mean radiation duration was 99.11 ± 61.17secs in Group 1 and 108.40 ± 51.65 secs in Group 2 (p=0.46), respectively. Although the mean radiation dose was lower in Group 1 (375.1µGym2) than in Group 2 (465.7 µGym2), it was not statistically significant(p=0.24). The stone free rate at 1 month duration were comparable with 92.1% and 93.02% in Group 1 and Group 2 respectively (p=0.16). Overall complication rates were similar in both groups (15.7% in Group 1 vs 16.2% in Group 2), respectively. None of the patients in both groups had complications higher than Clavien IIIa.Conclusions: PCNL in supine position has significantly shorter operative time with similar complications and stone free rates as compared to prone position.Keywords: percutaneous nephrolithotomy; prone position; supine position

Download Full-text

Functional Overlap of Finger Representations in Human SI and SII Cortices

Journal of Neurophysiology ◽

10.1152/jn.2001.86.4.1661 ◽

2001 ◽

Vol 86 (4) ◽

pp. 1661-1665 ◽

Cited By ~ 41

Author(s):

Cristina Simões ◽

Markus Mertens ◽

Nina Forss ◽

Veikko Jousmäki ◽

Bernd Lütkenhöner ◽

...

Keyword(s):

Index Finger ◽

Ring Finger ◽

Middle Finger ◽

Response Latencies ◽

Left Hand ◽

Tactile Stimuli ◽

Somatosensory Cortices ◽

Somatosensory Evoked Fields ◽

Left And Right ◽

The Right

We aimed to find out to what extent functional representations of different fingers of the two hands overlap at the human primary and secondary somatosensory cortices SI and SII. Somatosensory evoked fields (SEFs) were recorded with a 306-channel neuromagnetometer from 8 subjects. Tactile stimuli, produced by diaphragms driven by compressed air, were delivered to the fingertips in three different conditions. First, the right index finger was stimulated once every 2 s. Then two other stimuli were interspersed, in different sessions, to right- or left-hand fingers (thumb, middle finger, or ring finger) between the successive right index finger stimuli. Strengths of the responses to right index finger stimuli were evaluated in each condition. Responses to right index finger stimuli were modeled by three current dipoles, located at the contralateral SI and the SII cortices of both hemispheres. The earliest SI responses, peaking around 65 ms, were suppressed by 18% ( P < 0.05) when the intervening stimuli were presented to the same hand; intervening stimuli to the other hand had no effect. The SII responses were bilaterally suppressed by intervening stimuli presented to either hand: in the left SII, the suppression was 39 and 42% ( P < 0.01) and in the right SII 67 and 72% ( P < 0.001) during left- and right-sided intervening stimuli, respectively. Left- and right-sided intervening stimuli affected similarly the SII responses and had no effect on the response latencies. The results indicate a strong and symmetric overlap of finger representations for both hands in the human SII cortices, and a weaker functional overlap for fingers of the same hand in the SI cortex.

Download Full-text

Triple Open Dislocation in the Index Finger of the Hand Without a High-Energy Trauma

Revista Chilena de Ortopedia y Traumatología ◽

10.1055/s-0040-1718452 ◽

2020 ◽

Vol 61 (03) ◽

pp. 090-093

Author(s):

María Amparo Fontestad Utrillas ◽

Paúl Vicente Alonso de Armiño ◽

Marta Sancho Rodrigo

Keyword(s):

Closed Reduction ◽

Index Finger ◽

High Energy ◽

Rare Entity ◽

Level Of Evidence ◽

High Energy Trauma ◽

Left Hand ◽

Right Hand ◽

Active Mobilization ◽

The Right

AbstractA simultaneous double dislocation (both proximal [PIP] and distal [DIP] interphalangeal joints) of a triphalangeal finger is a rare entity. The most common hand affected is the right hand. In the case of a closed triple dislocation (metacarpophalangeal [MCP], PIP and DIP joints); there are only two cases in the literature revised. In this case, we report an open triple dislocation in the index finger of the left-hand of a 54-year-old man treated by closed reduction and 3 weeks of immobilization followed by active mobilization with satisfactory results. Level of evidence 3

Download Full-text

FUNGSI DAN TEKNIK PERMAINAN ALAT MUSIK TRADISIONAL MANDAILING UYUP-UYUP DI DESA PARGARUTAN JAE TAPANULI SELATAN

Grenek Music Journal ◽

10.24114/grenek.v7i2.10896 ◽

2018 ◽

Vol 7 (2) ◽

pp. 153

Author(s):

Eben Ezer Silaban

Keyword(s):

Index Finger ◽

Musical Instrument ◽

Standing Position ◽

Sound Sources ◽

Left Hand ◽

Determine Function ◽

Qualitative Descriptive ◽

Opposite Sex ◽

Rice Stalks ◽

The Right

This study aims to determine Function, Game Techniques and Organic Uyup-Uyup In PargarutanVillage Jae Tapanuli Selatan. The purpose of this research is to know the function, game techniqueand organology of mandailing uyup-uyup instrument in Pargarutan Jae Tapanuli Selatan Villagecommunity. The theory used is function, game technique and organology. The function of music isto express the taste and simultaneously as an activity of various types of human communication.Organology is the study of the structure of musical instruments based on sound sources, how toproduce sounds and system of alignment. Game technique is a way or technique of touch on amusical instrument over a particular tone according to the instructions or notation. The methodused in this research is qualitative descriptive method. The sample in this research is one artist andfive people of Pargarutan Jae Village. Data collection was done by observation, interview, anddocumentation. This research was taken in Pargarutan Jae Village, and this research was carriedout from October 2017. The function of Uyup-uyup music instrument in South Tapanuli there arethree of the first is the function of emotional disclosure is a medium for someone to express feelingsand emotional through the game of uyup-uyup instruments that use systematic way of presentingthe sound. The second is the entertainment function in which the South Tapanuli also needentertainment that is the entertainment of playing a uyup-uyup instrument at rest in the rice fields.Third is the Communication Function where when calling the opposite sex across the paddy fieldthe man repeatedly played uyup-uyup. Organic musical instrument Uyup-uyup consists of fiveparts, namely rice stalks, coconut leaves and lidi as a binder of coconut leaves. The game techniquein the uyup-uyup instrument is divided into the first three sections that are played in a sitting /standing position, the second way of blowing uyup-uyup is by way of the mouth is placed at thebase of the top of the uyup-uyup instrument, the third position of the finger finger, first startingfrom the left hand with the beginning of the index finger and the second hole of the middle fingerand then on the right hand begins with the index finger and the hole of both middle fingers.

Download Full-text

Description of ABO-Rhesus Blood Group and Fingerprint Patterns Students D-3 Teknologi Transfusi Darah of STIKES Guna Bangsa Yogyakarta

Journal of Health ◽

10.30590/vol6-no2-p105-111 ◽

1970 ◽

Vol 6 (2) ◽

pp. 105-111

Author(s):

St. Raihanun ◽

Diani Mentari ◽

Meyta Wulandari ◽

Relita Pebrina

Keyword(s):

Blood Group ◽

Index Finger ◽

Ring Finger ◽

Blood Type ◽

Cross Sectional ◽

Left Hand ◽

Descriptive Research ◽

Group A ◽

Rhesus Blood Group ◽

The Right

Human identification is the recognition of individuals based on some physical characteristics that are unique to individuals. Fingerprints are constant, individuality and form the most reliable criteria for identification. ABO-Rhesus Blood group is also one method used to identify someone, because blood type is inheritance. This research was conducted to see the description of ABO-Rhesus blood group and fingerprint patterns students D-3 Teknologi Transfusi Darah STIKES Guna Bangsa Yogyakarta. In this study using quantitative cross sectional descriptive research and blood group samples were taken using the slide method and fingerprint patterns were taken using the fingerprint method. In this study there were 78 samples, 58 females (74.36%) and 20 males (25.64%). The ABO blood group that is dominant is blood type O(35.90%), followed by blood group A(29.49%), B(28.21%), and AB(6.41%). The dominant Rhesus blood type is the positive Rhesus blood group. The percentage of fingerprint patterns in this study was loop 61.03%, whorl 37.56%, and arch 1.41%. The characteristics of the right and left hand fingerprint patterns have the same percentage of arch fingerprint patterns found on the index finger. Whorl fingerprint patterns are found on the ring finger. Loop fingerprint patterns are found on the little finger.

Download Full-text