[CD15 focus score for diagnostics of periprosthetic joint infections : Neutrophilic granulocytes quantification mode and the development of morphometric software (CD15 quantifier)]. / CD15-Fokus-Score zur Diagnostik der periprothetischen Gelenkinfektion : Neutrophile-Granulozyten-Quantifizierungs-Modus und Entwicklung einer morphometrischen Software ("CD15-Quantifier").

BACKGROUND: The aim of this project was to devise a quantification method for neutrophils within a single focal point through the development of a CD15 focus score which enables bacterial infections in synovial-like interface membranes (SLIM) to be diagnosed. METHODS: In this study a histopathological classification of 91 SLIM removed during revision surgery from the hips (n = 59) and knees (n = 32) was performed. Neutrophils were identified immunohistochemically by means of a CD15-specific monoclonal antibody. The quantitative evaluation of CD15-positive neutrophils (CD15Ne) used the principle of maximum focal infiltration (focus) together with an assessment of a single focal point (0.3 mm(2)). This immunohistochemical approach made it possible to develop the CD15 quantifier software, which automatically quantifies CD15Ne. RESULTS: The SLIM cases with positive microbiological findings (n = 47) had significantly (p < 0.001, Mann-Whitney U-test) more CD15Ne/focal point than cases with negative microbiological findings (n = 44). A count of 50 CD15Ne/focal point was identified as the optimum threshold when diagnosing periprosthetic joint infections (PJI) using the CD15 focus score. If the microbiological findings are used as a gold standard, the diagnostic sensitivity is 0.83, and the specificity is 0.864 with a positive predictive value (PPV) of 0.87, a negative predictive value (NPV) of 0.83, an accuracy of 0.846 and an area under the curve (AUC) of 0.878. The evaluation of findings for the preparations using the CD15 quantifier software (n = 31) deviated by an average of 12 cells from the histopathological evaluation findings (CD15 focus score). Above a cell count of 62, the CD15-quantifier needs on average 32 s less than the pathologist. CONCLUSION: The immunohistochemical CD15 focus score has a high diagnostic value and allowed the development of the CD15 quantifier software. This provides an automated procedure, which shortens the mentally tiring and time-consuming process of microscopic cell counting and thus makes a contribution towards the standardization of tools for diagnosing PJI.

[Digital slide training portal. Training slides available on the Internet from the German division of the IAP]. / Digitales Lehrserienportal. Lehrserienverleih der deutschen Abteilung der IAP über das Internet.

Alternatively to sending glass slides via mail order, the German division of the IAP established a digital slide training portal on the Internet. Following the principle of virtual microscopy, histology slides were scanned completely in high resolution, stored on a server, and can be accessed over the Internet. The slide training portal can be used with current Internet browsers without additional plugins. Working on digital slides with the virtual microscope is easy but flexible. Loading a detail image using image streaming technologies takes about 500 ms with the German research network (DFN) and about 3 s with DSL. The digital slide training portal of the German IAP provides a clear choice and is always available for every member. Despite the little experience some users had with the Internet and diagnostics at the monitor, image quality and usability were rated as good.

Supply and demand for radiation therapists: a United States perspective for 1997-2002.

The purpose of this paper is to review the current and future employment plans of radiation therapists and administrators that employ them so that the supply and demand for these individuals is quantified. The survey was funded by the American Society of Radiologic Technologists and implemented by the Task Force on Human Resources. In April 1997 a questionnaire was mailed to a sample of radiation therapy administrators identified by the mailing list of the Society of Radiation Oncology Administrators (SROA). Another questionnaire was mailed to a sample of radiation therapists holding active certificates with the American Registry of Radiologic Technologists. Results of the survey indicated an increased demand for radiation therapists based on plans for facility expansion. Individuals anticipating retirement in the next five years ranged from 7% of the radiation therapists and 12% of the administrators surveyed. A model was developed which projected a shortfall of therapists ranging from 0% (-13 positions) in 1998 to 3% (-403 positions) projected for 2002. The paper concludes that the supply of radiation therapists did not meet the demand in the time period measured; 1998-2002. An increase in newly educated radiation therapists is needed to fill the openings created by those leaving the field. The survey should be repeated at successive intervals to accurately track and project both the supply of and the demand for radiation therapists.

[Churg-Strauss syndrome]. / Churg-Strauss-Syndrom.

In a 47-year-old man presenting with chronic bronchitis since 1978, a weight loss of 11 kg in 9 months and deteriorated general condition, the x-ray film of the thorax revealed numerous pulmonary nodules of up to 4 cm size. Laboratory findings were characterised by enhanced ESR, blood eosinophilia of 7% and a lot of eosinophilic granulocytes in the sputum. The findings could not be clarified despite many additional examinations including bronchoscopy with transbronchial biopsy. Thoracotomy was finally considered imperative. Pulmonary biopsy revealed necrotising vasculitis, eosinophilic infiltration and epithelioid granuloma, characteristic changes of allergic granulomatous vasculitis (Churg-Strauss syndrome). The condition quickly responded to corticosteroid administration.

Salivary gland choristoma of the middle ear.

Salivary gland choristoma (ectopic salivary gland tissue) is an unusual condition that occurs in various locations within the middle ear. It is a distinct histopathologic entity that should be differentiated from other epithelial lesions of the middle ear. Since the lesion commonly involves the facial nerve, its recognition is particularly critical to avoid unnecessary severing of the nerve.