BARIUM SULFATE

To ensure the safety of medical personnel in healthcare organizations, radiation-shielding materials like protective clothing are used to protect against low-dose radiation, such as scattered rays. The extremities, particularly the hands, are the most exposed to radiation. New materials that can be directly coated onto the skin would be more cost-effective, efficient, and convenient than gloves. We developed protective creams using eco-friendly shielding materials, including barium sulfate, bismuth oxide, and ytterbium oxide, to avoid harmful effects of heavy metals like lead, and tested their skin-protective effects. Particularly, the radiation-shielding effect of ytterbium oxide was compared with that of the other materials. As shielding material dispersion and layer thickness greatly affect the efficacy of radiation-shielding creams, we assessed dispersion in terms of the weight percentage (wt%). The effective radiation energy was reduced by 20% with a 1.0-mm increase in cream thickness. Ytterbium oxide had a higher radiation-shielding rate than the other two materials. A 28% difference in protective effect was observed with varying wt%, and the 45 wt% cream at 63.4 keV radiation achieved a 61.3% reduction rate. Higher content led to a more stable incident energy-reducing effect. In conclusion, ytterbium oxide shows potential as a radiation-shielding material for creams.

Iodinated and gadolinium-based contrast media are used on a daily basis in most radiology practices. These agents often are essential to providing accurate diagnoses, and are nearly always safe and effective when administered correctly. However, reactions to contrast media do occur and can be life threatening. Therefore, it is critical for faculty and staff to know how reactions to contrast agents manifest and how to treat them promptly. The decline in renal function seen occasionally after intravenous administration of iodinated contrast agents is poorly understood and likely multifactorial, and its association with the contrast medium may be overemphasized. However, it is important that radiologists be aware of current understanding and strategies to decrease the incidence of renal dysfunction. Nephrogenic systemic fibrosis, a skin disease, is an adverse reaction related to use of some gadolinium-based contrast agents in patients with chronic renal failure. The types of gadolinium most often associated with this condition and the indications for withholding gadolinium are important and are discussed in this article. The use of enteric contrast agents and contrast agents during pregnancy and nursing are reviewed briefly. Current knowledge for safe use of contrast media and key concepts that all radiologists should know are summarized in this review.

Upper gastrointestinal bleeding (UGIB) is a potentially life-threatening condition. Although standard endoscopic therapies are effective, cases involving tumor-related bleeding or bleeding sites that are challenging to approach remain difficult to manage and are associated with elevated rates of rebleeding. Tranexamic acid (TXA), an antifibrinolytic agent, enhances hemostasis, whereas sucralfate, an antiulcer medication, creates a protective barrier over mucosal injuries. This study evaluated whether the topical application of TXA and sucralfate could reduce the rebleeding rate. This single-center, prospective, randomized controlled trial included patients with nonvariceal UGIB who received endoscopic hemostasis. All patients received standard endoscopic therapy. Subsequently, participants were randomly assigned to either standard group or intervention group. Those in the intervention group were treated with an additional endoscopic spray containing 1 g of TXA and 2 g of sucralfate. An additional 1 g of barium sulfate was applied as a radiopaque marker to evaluate the powder retaining time. All participants were monitored for 30 days to evaluate the incidence of rebleeding. Each group included 30 patients, with comparable baseline characteristics between them. The intervention group demonstrated a significantly lower 28-day rebleeding rate compared with the standard therapy group (10.0% vs 36.7%, P = 0.030).In addition, bleeding-free survival was significantly prolonged in the intervention group ( P = 0.018). Furthermore, the study found that the powder remained at the bleeding site for approximately 8-12 hours. Topical application of TXA and sucralfate during endoscopy is safe and potentially effective in reducing 28-day rebleeding for UGIB. This study was registered at ClinicalTrials.gov (NCT06421389).

The goal of effective primary tooth infection treatment is to keep the child healthy. The need to find the optimum root canal paste, however, was driven by the complex morphology of primary root canals and the desire for shorter therapy sessions. To evaluate and compare the clinical and radiographic success of zinc oxide eugenol, Zinc oxide-Propolis, and endoflas as obturating materials in the pulpectomy of primary teeth at 3, 6 and 9 months of follow-up. Pulpectomy of 60 nonvital primary molars was accomplished in 50 children aged 4-9 years. Teeth were randomly divided into three equal groups of 20 molars according to the type of root canal filling material. Pulpectomy was performed in a single or multiple visits depending on the condition of the tooth, and a stainless-steel crown was used for final restoration. Clinical and radiographic results were evaluated double-blindly at baseline (1 week), and at 3, 6 and 9 months, while radiographic results were evaluated at baseline (1 week), and at 6 and 9 months. Data were analysed using the Chi-square/Fisher's exact test, and the P value was set at 0.05. Endoflas and a mixture of zinc oxide powder with Propolis showed promising results (100%), whereas zinc oxide eugenol showed a lower success rate than the other two materials (85%). Endoflas and a combination of zinc oxide powder with Propolis can be a promising material as an alternative to Zinc Oxide Eugenol for obturation in primary teeth.

Most threshold limit values are based on animal experiments. Often, the question remains whether these data reflect the situation in humans. As part of a series of investigations in our exposure lab, this study investigates whether the results on the inflammatory effects of particles that have been demonstrated in animal models can be confirmed in acute inhalation studies in humans. Such studies have not been conducted so far for barium sulfate particles (BaSO 4 ), a substance with very low solubility and without known substance-specific toxicity. Previous inhalation studies with zinc oxide (ZnO), which has a substance-specific toxicity, have shown local and systemic inflammatory respones. The design of these human ZnO inhalation studies was adopted for BaSO 4 to compare the effects of particles with known inflammatory activity and supposedly inert particles. For further comparison, in vitro investigations on inflammatory processes were carried out. Sixteen healthy volunteers were exposed to filtered air and BaSO 4 particles (4.0 mg/m 3 ) for two hours including one hour of ergometric cycling at moderate workload. Effect parameters were clinical signs, body temperature, and inflammatory markers in blood and induced sputum. In addition, particle-induced in vitro-chemotaxis of BaSO 4 was investigated with regard to mode of action and differences between in vivo and in vitro effects. No local or systemic clinical signs were observed after acute BaSO 4 inhalation and, in contrast to our previous human exposure studies with ZnO, no elevated values of biomarkers of inflammation were measured after the challenge. The in vitro chemotaxis induced by BaSO 4 particles was minimal and 15-fold lower compared to ZnO. The results of this study indicate that BaSO 4 as a representative of granular biopersistent particles without specific toxicity does not induce inflammatory effects in humans after acute inhalation. Moreover, the in vitro data fit in with these in vivo results. Despite the careful and complex investigations, limitations must be admitted because the number of local effect parameters were limited and chronic toxicity could not be studied.

Monitoring and assessment of soil quality are important in mining areas. In this study, indexical, spatiotemporal, and chemometric models were developed to monitor and assess the pollution level and health risk of potentially toxic elements (PTEs) within the Iyamitet-Okurumutet mine province, SE Nigeria. Surface soils were sampled within the mine area and analyzed for pH, cation exchange capacity, organic matter, and PTEs (Pb, Zn, Cd, Mn, Fe, Ba) following standard techniques. It was revealed that the soils are slightly acidic and the enrichment of PTEs except for Cd (4.08 mg/kg -1 ) was within recommended standards. Contamination factor, enrichment factor, and pollution index suggest that the soils are moderately polluted. Geospatial maps and ecological risk indices revealed that higher ecological risk imprints seem to increase towards the south-eastern parts of the area. Chemometric analysis revealed that PTE enrichment in the soil is majorly influenced by anthropogenic activities. Further, bioavailability/bioaccessibility risk assessment index (BRAI) and health risk assessment models were developed to quantify the bioavailable/human bioaccessible portion of elements in soils and the associated health risks. The BRAI ranged from high (3 ≥ 5) to very high (> 5) risk of human bioaccessibility; hence, greater amount of PTEs will be bioaccessible for absorption into the human gastrointestinal system than they would for plants uptake. The hazard index and lifetime cancer risk (LCR) revealed that most of the samples present high chronic cancer risks from dermal contact and ingestion for children and adults. The LCR values ranged between 1.0E-6 and 1.0E - 04, with the children population showing greater vulnerability to cancer risks.

To determine the dominant arterial supply to the scrotum. Experimental anatomic study. Intact male canine cadavers (n = 10). Barium sulfate was injected into the internal iliac artery (n = 7) or into the pudendoepigastric trunk (n = 3). The perineal, scrotal, and prescrotal skin was sharply dissected from cadavers and radiographed. Angiograms were subjectively reviewed by 3 investigators. Angiograms were completed successfully in all 10 dogs, with no difference between frozen and fresh cadavers. The dominant blood supply to the scrotum was consistently identified as arising from the ventral perineal arteries, originating from the internal pudendal arteries, coursing ventrally and cranially toward the caudal scrotum before terminating as the dorsal scrotal arteries (n = 7). The blood supply to the cranial scrotum was more limited (n = 3) as only the cranial border of the scrotum was perfused by the ventral scrotal arteries. Based on this anatomic perfusion study, the dorsal scrotal arteries appear to supply a larger area than the ventral scrotal arteries. These results provide evidence to justify further consideration of a scrotal flap using the caudal perineal skin as the main cutaneous pedicle to reconstruct defects located on the caudal, medial, and lateral thighs in dogs. Such a flap should be based on the caudal blood supply and the base of this flap should be located caudal to the scrotum to preserve its main blood supply.

To describe the angiosomes of the dorsal and ventral perineal arteries in dogs and identify landmarks for axial pattern flaps based on these vessels. To describe the differences between male and female dogs regarding their respective angiosomes. To present a case report demonstrating the successful use of the dorsal perineal artery skin flap to reconstruct a perianal wound. Anatomic study. Eight canine cadavers: four males and four females. One clinical canine case. Nonselective barium sulfate angiography was performed via injection of the descending aorta. Skin excised from the perineum and thighs was evaluated via gross inspection and radiography to identify angiosomes. A single clinical case utilizing the dorsal perineal artery axial pattern flap was used to reconstruct a wound in a live dog. A primary cutaneous branch of the ventral perineal artery was identified consistently in all cadavers with positive contrast radiography. The ventral perineal artery cutaneous angiosome was subjectively more robust than the dorsal perineal angiosome. A cutaneous branch of the dorsal perineal artery was observed radiographically in all specimens. The primary cutaneous angiosomes of both arteries extended at least two-thirds of the length of the caudal thigh. In the clinical case, a perineal wound was repaired successfully with a dorsal perineal artery flap. The ventral and dorsal perineal arteries possessed robust cutaneous angiosomes with apparently abundant vasculature and broad coverage on the caudal thigh, which were consistent in male and female cadavers. The dorsal and ventral perineal arteries provide a rich blood supply to the skin of the caudal thigh. Axial pattern skin flaps created within these angiosomes may survive consistently.

Objective: To investigate the architecture of the cutaneous branch-chained blood vessels in the medial lower leg and provide the anatomical basis for design and clinical application of the cutaneous branch-chained flap from this region. Methods: The experimental research method was used. From March to May 2023, the anatomical study was conducted on the 5 voluntarily donated fresh adult (aged 50 to 70 years, all male) cadaveric specimens from Hangzhou Normal University School of Basic Medical Sciences. The fine anatomy under microscope was performed on each lower leg specimens of 5 corpses (1 lower leg specimen was conducted with digital radiography (DR) scan before fine anatomy), to observe, measure, and record the course of posterior tibial artery, quantity of perforator, the distance between the perforating point of each perforator and the medial condyle of tibia, the external diameter of posterior tibial artery perforator, the length of perforator pedicle, the horizontal distance between the posterior tibial artery perforator and the saphenous nerve, and the course of each perforator within superficial fascia after crossing the deep fascia and the distribution of the cutaneous branch-chains. The DR scan under the perfusion of barium sulfate was conducted in one lower leg specimen to observe the distribution of cutaneous branch-chained vascular network (hereinafter referred to as vascular chain) between perforators. Transparent skin specimen was made from one leg specimen after anatomy to observe the distribution of perforators and vascular chains between perforators. Results: In 5 lower leg specimens, the upper part of posterior tibial artery was located deep in soleus muscle, and the lower part was located between the medial edge of gastrocnemius muscle and flexor digitorum longus muscle. A total of 28 posterior tibial artery perforators were identified, with an average of 5.6 branches in each lower leg. The distance between the perforating point of perforator and the medial condyle of tibia ranged from 6.5 to 36.0 cm, mainly distributed at 22.0 (15.1, 28.1) cm from the medial condyle of tibia, in zones 3 to 6. The external diameters of perforators of posterior tibial arteries were 0.7-1.1 mm. The length of perforator pedicle was 1.0-4.5 cm, and the horizontal distance between the posterior tibial artery perforator and the saphenous nerve was 0.5-3.0 cm. The fine anatomy under microscope showed that the posterior tibial artery perforators had long upward and downward branches after crossing the deep fascia, and the ascending branches and descending branches were anastomosed longitudinally to form the nutrient cutaneous branch-chain in the medial lower leg. DR scan and transparent skin specimen both showed that longitudinal vascular chain was formed between the posterior tibial artery perforators, the transparent skin specimen also showed that longitudinal blood vessel chains included the direct connecting vessels in the adipose layer and the indirect connecting vessels in the subdermal layer. Conclusions: The cutaneous branch-chained vessels in the medial lower leg are constructed by posterior tibial artery perforators, direct connecting vessels, indirect connecting vessels, and traffic branches. The cutaneous branch-chained flap is reliable in terms of vascular anatomy, and can carry the saphenous nerve for partial restoration of its sensation, thus it is an ideal flap. 目的： 对小腿内侧皮支链进行血管构筑研究，探讨该区域皮支链皮瓣的设计和临床应用的解剖学基础。 方法： 采用实验研究方法。2023年3—5月，对来自于杭州师范&

Personnel using X-ray devices, the main source of radiation in medical institutions, are primarily affected by scattered rays. When interventionists use radiation for examinations/treatments, their hands may enter the radiation-generating area. The shielding gloves used for protection against these rays restrict movement and cause discomfort. Here, a shielding cream that directly adheres to the skin was developed and examined as a personal protective device; further, its shielding performance was verified. Bismuth oxide and barium sulfate were selected as shielding materials and comparatively evaluated in terms of thickness, concentration, and energy. With increasing wt% of the shielding material, the protective cream became thicker, resulting in improved protection. Furthermore, the shielding performance improved with increasing mixing temperature. Because the shielding cream is applied to the skin and has a protective effect, it must be stable on the skin and easy to remove. During manufacturing, the bubbles were removed, and the dispersion improved by 5% with increasing stirring speed. During mixing, the temperature increased as the shielding performance increased by 5% in the low-energy region. In terms of the shielding performance, bismuth oxide was superior to barium sulfate by approximately 10%. This study is expected to facilitate the mass production of cream in the future.

Pulse oximetry is a non-invasive method for measuring blood oxygen saturation. However, its detection scheme heavily relies on single-point measurements. If the oxygen saturation is measured at a single location, the measurements are influenced by the profile of illumination, spatial variations in blood flow, and skin pigment. To overcome these issues, imaging systems that measure the distribution of oxygen saturation have been demonstrated. However, previous imaging systems have relied on red and near-infrared illuminations with different profiles, resulting in inconsistent ratios between transmitted red and near-infrared light over space. Such inconsistent ratios can introduce fundamental errors when calculating the spatial distribution of oxygen saturation. In this study, we developed a novel illumination system specifically designed for a pulse oximetry imaging system. For the illumination system, we customized the integrating sphere by coating a mixture of barium sulfate and white paint inside it and by coupling eight red and eight near-infrared LEDs. The illumination system created identical patterns of red and near-infrared illuminations that were spatially uniform. This allowed the ratio between transmitted red and near-infrared light to be consistent over space, enabling the calculation of the spatial distribution of oxygen saturation. We believe our developed pulse oximetry imaging system can be used to obtain spatial information on blood oxygen saturation that provides insight into the oxygenation of the blood contained within the peripheral region of the tissue.

Bovine tuberculosis (bTB) not only poses a zoonotic threat to humans but also has a significant economic impact on livestock production in many areas of the world. Effective vaccines for humans, livestock, and wildlife are highly desirable to control tuberculosis. Suitable large animal models are indispensable for meaningful assessment of vaccine candidates. Here, we describe the refinement of an animal model for bTB in goats. Intrabronchial inoculation procedure via video-guided endoscopy in anesthetized animals, collection of lungs after intratracheal fixation in situ , and imaging of lungs by computed tomography (CT) were established in three goats using barium sulfate as surrogate inoculum. For subsequent infection experiments, four goats were infected with 4.7 × 10 2 colony-forming units of M. bovis by intrabronchial inoculation using video-guided endoscopy with spray catheters. Defined amounts of inoculum were deposited at five sites per lung. Four age-matched goats were mock-inoculated. None of the goats developed clinical signs until they were euthanized 5 months post infection, but simultaneous skin testing confirmed bTB infection in all goats inoculated with M. bovis . In tissues collected at necropsy, M. bovis was consistently re-isolated from granulomas in lymph nodes, draining the lungs of all the goats infected with M. bovis . Further dissemination was observed in one goat only. Pulmonary lesions were quantified by CT and digital 2D radiography (DR). CT revealed mineralized lesions in all the infected goats ranging from <5 mm to >10 mm in diameter. Small lesions <5 mm predominated. The DR failed to detect small lesions and to determine the exact location of lesions because of overlapping of pulmonary lobes. Relative volume of pulmonary lesions was low in three but high in one goat that also had extensive cavitation. CT lesions could be correlated to gross pathologic findings and histologic granuloma types in representative pulmonary lobes. In conclusion, video-guided intrabronchial inoculation with spray catheters, mimicking the natural way of infection, resulted in pulmonary infection of goats with M. bovis . CT, but not DR, presented as a highly sensitive method to quantify the extent of pulmonary lesions. This goat model of TB may serve as a model for testing TB vaccine efficacy.

An ideal flap for fingertip injuries should cover a significant loss of substance and avoid joint flexion to prevent later contracture and joint stiffness. In this study, the authors describe a modified homodigital island flap-the homodigital propeller flap-to better meet these requirements. An anatomical model of fingertip loss is used to analyze the advancement achieved without flexion of the finger. Twenty-four fresh-frozen fingers were dissected. Wires were inserted to maintain joints in extension. The skin paddle was similar in location to a homodigital island flap. The neurovascular bundle was dissected without exceeding the proximal interphalangeal joint and was released from the proximal half of the paddle. Then, the homodigital propeller flap was rotated 180 degrees to cover the defect. A mixture of India ink and barium sulfate was injected into the pedicle artery after the release of the proximal half of the flap from the neurovascular pedicle to assess residual flap vascularization. India ink highlights the residual subcutaneous vascularization network of the cutaneous paddle. A radiographic study of the flap was then performed to visualize the subcutaneous vascular network of the cutaneous paddle. The homodigital propeller flap achieved an average cutaneous advancement of 18 mm (range, 15 to 22 mm) and allowed full coverage of cutaneous defects for all fingers while maintaining the proximal interphalangeal joint in strict extension. The homodigital propeller flap is a refinement of the classic homodigital island flap. It allows efficient coverage of fingertip defects because of a large advancement without flexion of the finger, reducing the risk of stiffness.