Radiology workload--a solution reviewed after 14 years' experience.

A method of controlling the radiological workload in a district general hospital, based on an estimation of the reasonable capacity of the department, was introduced in 1978. Measurement of the number of examinations performed compared with the estimated reasonable capacity shows that the method has been effective. An immediate 25% reduction in examinations was followed by a workload which varied between -4% and +16% of the capacity. An increase in the proportion of complex examinations in the period under review has been recognized. The method has encouraged referring doctors to exercise restraint and adopt guidelines, and helped persuade managers to increase capacity by appointing additional radiologists.

Avian heterophils and monocytes: phagocytic and bactericidal activities against Salmonella enteritidis.

The ability of heterophils and monocytes from domestic chickens and turkeys to phagocytize and kill Salmonella enteritidis (SE) was investigated using both a standard plate count (chickens only) and direct microscopic examination by staining with acridine orange (both chickens and turkeys). Optimal phagocytosis of SE by both chicken and turkey phagocytes required opsonization of the bacteria by antibodies as determined by both assays. However, heterophils from both the turkeys and chickens phagocytized more SE than did monocytes from either type of fowl. Regardless of the presence or absence of antibodies, heterophils were more efficient bactericidal cells than were the monocytes since only heterophils killed the intracellular bacteria while the majority of nonopsonized SE survived in the monocytes. Phagocytosis of SE did not result in an increase in the amount of superoxide anion released by the heterophils suggesting that the ultimate fate of the bacteria in these cells was not related to an oxygen-dependent mechanism.

Atlanto-axial rotatory fixation and fracture of the clavicle. An association and a classification.

Five children with atlanto-axial rotatory fixation (AARF) in association with fractures of the clavicle are described. It is postulated that the rotary fixation is a direct result of the trauma which produces the fracture. The importance of early diagnosis is stressed, since delayed diagnosis may lead to chronic deformity. Early diagnosis depends on awareness of the possibility of AARF, and either fluoroscoping the patient in order to take appropriate spot films or imaging the atlanto-axial joint by CT. A simple classification of AARF is proposed based on distinct radiological features which differentiate subluxation from dislocation.

Uterine prolapse and urinary tract obstruction.

Five patients are described with hydronephrosis and hydroureter associated with advanced uterine prolapse. Various hypotheses have been advanced in the literature to account for this neglected syndrome. A trial was carried out to assess whether all patients presenting with uterine prolapse should be screened to exclude urinary tract obstruction. Thirty-seven patients on the waiting list for surgery for various degrees of prolapse had an IVU and a blood urea estimation. No cases of ureteric obstruction were found, presumably because the lesser grades of prolapse predominated. It is, therefore, considered that all patients with prolapse do not need intravenous urography, which should be restricted to women with complete procidentia.

Evaluation of paintings of nonretarded and retarded persons by judges with and without art training.

Correlations between creativity and intelligence are generally reported to be low. In the present investigation, we examined whether judges with and without art training (N = 40 for each group) would evalute the paintings of nonretarded and retarded persons differently. Five paintings each were obtained from 15 nonretarded persons, 11 moderately retarded persons, and 11 severely retarded persons. Judges who had art training did not differentially rate the art of nonretarded and retarded persons, but they gave significantly higher ratings than did non-art-trained judges to the paintings of retarded persons.