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Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice. 放射学检查成本核算。中级转诊医院与全科医院放射检查费用分析。
Pub Date : 1996-01-01
A L Lääperi

The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and nonmonetary variables was developed. In it the radiologist, radiographer and examination-specific equipment costs were allocated to the examinations applying estimated cost equivalents. Some minor cost items were replaced by a general cost factor (GCF). The program is suitable for internal cost accounting of radiological departments as well as regional planning. If more accurate cost information is required, cost assignment employing the actual consumption of the resources and applying the principles of activity-based cost accounting is recommended. As an application of the cost accounting formula the average costs of the radiological examinations were calculated. In conventional radiography the average proportion of the cost factors in the total material was: personnel costs 43%, equipment costs 26%, material costs 7%, real estate costs 11%, administration and overheads 14%. The average total costs including radiologist costs in the hospitals were (FIM): conventional roentgen examinatio

本研究的目的是分析中间转诊医院和全科医院的放射检查成本结构,并建立一个考虑所有相关成本因素的放射检查成本核算系统,适用于放射科管理和放射资源的区域规划。这些资料包括1991年在芬兰皮坎马医院区的5家中级转诊医院和13家公共保健中心进行的174 560次基本放射检查。医院的所有放射科都由一名放射学专家管理。公共保健中心的放射科是在全科医生自我转诊的基础上运作的。数据提取自审查清单、库存和资产负债表;部分数据经过估计或计算。根据检查类型和使用的设备进行放射检查:常规检查、造影剂检查、超声检查、乳房x光检查和使用移动设备的x线检查。大多数检查(87%)包括常规x线摄影。成本分析将成本项目分为5个成本因素:人员成本、设备成本、材料成本、房地产成本和管理成本。伦琴设备使用的折旧时间为10年,超声设备使用的折旧时间为5年,其他资本货物使用的折旧时间为5 - 10年。年利率为10%。使用基于2家医院样本的标准平均值来计算特定检查的放射科医师时间、放射科医师时间和材料成本。设计了主要成本项目分配方式不同的四种成本核算版本。对不同分配方法对检查组成本和成本结构影响的方差进行双向分析。在成本分析的基础上,开发了包含货币变量和非货币变量的成本会计程序。其中,放射科医生、放射技师和特定检查设备的费用按估计费用等价物分配给各项检查。一些次要的成本项目被一般成本因素(GCF)取代。该程序适用于放射科内部成本核算和区域规划。如果需要更准确的成本信息,建议采用资源的实际消耗和应用作业成本会计原则来分配成本。作为成本核算公式的应用,计算了放射检查的平均费用。在常规x线摄影中,成本因素在总材料中的平均比例为:人员成本43%,设备成本26%,材料成本7%,房地产成本11%,管理和管理费用14%。包括放射科医师费用在内的医院平均总费用为(FIM):常规x线检查188次,造影剂检查695次,超声检查296次,乳房x线检查315次,移动设备x线检查1578次。除放射科医生费用外,公共保健中心的平均总费用为(FIM):常规x线检查107,造影剂检查988,超声检查203,乳房x光检查557。1991年的平均汇率是1美元= 4.046斐济元。在一段时间内(例如1年),使用某台设备进行一次放射检查(或一组检查)的费用计算公式如下:a2/ sigma ax*ax+ b2/ sigma bx*bx+ d1/d5*dx+ e1 + [(c1+ c2) + d4 + (e2 - e3) + f5 + g1+ g2+ i]/n。
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引用次数: 0
Clinical experience with iobitridol 250-300 in digital subtraction angiography. Double-blind randomized studies vs. iopromide and iohexol. 碘比妥250 ~ 300在数字减影血管造影中的临床应用体会。双盲随机研究对比碘丙胺和碘己醇。
Pub Date : 1996-01-01
J C Bouard, D Lyonnet, J P Illes, C Bouard-Monnier, O Rouviere, C Pangaud

Iobitridol was clinically tested in DSA against iopromide (i.v. DSA) or iohexol (i.a. DSA) in 139 patients. Seven patients participated in the i.v. DSA trial and 60 in the i.a. DSA study. Each examination was rated as diagnostic or not and the image quality was noted. Nature, onset, intensity and outcome of each adverse reaction were recorded. There was no significant difference in imaging quality and side effect occurrence between the 2 groups. We conclude that iobitridol is a safe and efficient contrast medium, which can be recommended for DSA examinations.

对139例患者进行了碘比替醇与碘丙咪啶(不含DSA)或碘己醇(不含DSA)的DSA临床试验。7名患者参加了静脉注射DSA试验,60名患者参加了静脉注射DSA研究。每次检查被评为诊断性或非诊断性,并记录图像质量。记录各不良反应的性质、发生、强度及转归。两组患者的影像质量及不良反应发生率无显著差异。结论:碘比啶醇是一种安全有效的造影剂,可推荐用于DSA检查。
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引用次数: 0
Pharmacokinetic profile of iobitridol. 碘吡醇的药动学特征。
Pub Date : 1996-01-01
A Dencausse, X Violas, H Feldman, P Havard, C Chambon

Iobitridol (Xenetix) is a new triiodinated monomer, nonionic, low-osmolality contrast agent. Animal pharmacokinetic studies (rats, rabbits, dogs) and in vitro studies show that it is a marker of extracellular fluid, i.e. it is distributed in the interstitial space, it does not penetrate into cells, it does not cross the healthy blood-brain barrier (BBB), it does not bind to proteins, and it is eliminated by glomerular filtration without secretion or reabsorption. These characteristics determine its use as an urography and angiography contrast agent as well as the precautions necessary to be taken, which are classical for contrast agents of this classification, related to administration in pathophysiologic populations (patients with renal failure, pregnant women or nursing mothers, neonates, etc. )

Iobitridol (Xenetix)是一种新型的三碘化单体、非离子型、低渗透压造影剂。动物药代动力学研究(大鼠、兔、狗)和体外研究表明,它是细胞外液的标志物,即它分布在间质空间,不渗透到细胞中,不穿过健康的血脑屏障(BBB),不与蛋白质结合,在没有分泌或重吸收的情况下被肾小球滤过消除。这些特点决定了其作为泌尿造影和血管造影造影剂的用途,以及必要的预防措施,这是该分类造影剂的经典应用,与病理生理人群(肾功能衰竭患者、孕妇或哺乳期妇女、新生儿等)的给药有关。
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引用次数: 0
Anatomical variations of the tympanic and mastoid portions of the facial nerve canal. A radioanatomical investigation. 面神经管鼓室和乳突部的解剖变异。放射解剖学研究。
Pub Date : 1996-01-01
P A Dimopoulos, C Muren, O Smedby, K Wadin

Purpose: To obtain information on the morphology of the tympanic and mastoid portions of the facial nerve canal, and on the appearance of unusual vascular channels and anomalies such as dehiscences.

Material and methods: One hundred and two temporal bone preparations were examined by conventional radiography to evaluate mastoid pneumatization. Of these, 73 were examined by high resolution CT in order to test the ability of the method to detect dehiscences in the bony wall of the tympanic portion of the canal and the accompanying channels along its mastoid portion. Subsequently produced plastic preparations were used to measure the length and width of these 2 portions of the facial canal.

Results: Our study reports observations on the three-dimensional morphology of the canal in the plastic casts. The study shows variations in the course and dehiscences of the tympanic portion. Additional bony channels along the mastoid portion are described. These results supplement those in previous investigations.

Conclusion: The measurement results agree with those of previous investigations. The course of the tympanic portion is S-shaped and has an impression on its upper surface. High resolution CT reproduces dehiscences of the bony canal in a percentage similar to that of microscopical methods and in relevant sites. Pneumatization does not influence the dimensions of the 2 portions.

目的:获取面神经管鼓室和乳突部分的形态学信息,以及异常血管通道和裂隙等异常的外观。材料与方法:采用常规x线摄影对102例颞骨标本进行检查,评价乳突充气情况。其中,73例采用高分辨率CT检查,以测试该方法检测中耳道鼓室部分和乳突部分伴随通道骨壁开裂的能力。随后制作的塑料制剂被用来测量这两部分面部管的长度和宽度。结果:我们的研究报告了在塑料铸型中观察到的根管三维形态。研究显示了鼓室部分的过程和裂缝的变化。描述了乳突部分的其他骨通道。这些结果补充了以前的调查结果。结论:测量结果与前人的研究结果一致。鼓室部分的过程为s形,并在其上表面上有压痕。高分辨率CT再现骨管开裂的百分比与显微镜方法和相关部位相似。气动不影响两个部分的尺寸。
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引用次数: 0
Safety and efficacy of Xenetix, a new iodinated contrast agent, in pediatric angiocardiography. Xenetix,一种新型碘化造影剂,在儿童心血管造影中的安全性和有效性。
Pub Date : 1996-01-01
A M Rossignol, J R Lusson, A Chantepie, J Losay

Purpose: The aim of this work was to study the safety and efficacy of iobitridol 350 in pediatric angiocardiography compared to iopamidol 370.

Material and methods: 40 children participated in each test group. Each examination was rated as diagnostic or nondiagnostic and the image quality was noted. Nature,onset,intensity as well as outcome of each adverse reaction was reported.

Results: There was no significant difference in either image quality or clinical safety between the 2 groups.

Conclusion: Iobitridol is a safe and effective contrast agent for pediatric angiocardiography.

目的:本研究的目的是比较异比尼多350与iopamidol 370在小儿心血管造影中的安全性和有效性。材料与方法:每组40名儿童。每次检查被评为诊断性或非诊断性,并记录图像质量。报告每种不良反应的性质、发作、强度和结局。结果:两组患者在影像质量和临床安全性方面均无显著差异。结论:碘比利多是一种安全有效的小儿心血管造影造影剂。
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引用次数: 0
Intravascular contrast agents. Current problems and future solutions-- a review. 血管内对比剂。当前的问题和未来的解决方案——回顾。
Pub Date : 1996-01-01
M A Bettman
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引用次数: 0
Iobitridol 300 compared to iopromide 300--a double-blind randomized phase-III study of clinical tolerance in total body CT. Iobitridol 300与ioproide 300的比较——一项全身CT临床耐受性的双盲随机iii期研究。
Pub Date : 1996-01-01
H M Hoogewoud, B Woessmer

Unlabelled: PURPOSE, MATERIAL AND METHODS: The clinical safety of iobitriodol 300 mg I/ml and iopromide 300 mg I/ml were compared in a randomized double blind phase-III study conducted on 60 patients undergoing abdominal CT for a variety of indications. Each examination was rated as diagnostic or nondiagnostic and the image quality was noted. Nature, onset, intensity as well as outcome of each adverse reaction were recorded.

Results: There was no significant difference in imaging quality and side effects between the contrast media. In this study, both iobitridol and iopromide provided excellent image quality and a low rate of side effects.

Conclusion: Iobitridol is a safe and effective nonionic contrast agent for contrast-enhanced body CT.

目的、材料和方法:在一项随机双盲iii期研究中,对60例因各种适应症接受腹部CT检查的患者进行了碘比妥300mg I/ml和碘丙啶300mg I/ml的临床安全性进行了比较。每次检查被评为诊断性或非诊断性,并记录图像质量。记录各不良反应的性质、发生、强度及转归。结果:两种造影剂在成像质量和不良反应方面无显著差异。在本研究中,碘比醇和碘丙胺均具有良好的图像质量和低的副作用率。结论:碘比啶醇是一种安全有效的非离子型体CT增强造影剂。
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引用次数: 0
Role of transarterial embolization in the management of cerebral arteriovenous malformations. 经动脉栓塞在脑动静脉畸形治疗中的作用。
Pub Date : 1996-01-01
G Wikholm
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引用次数: 0
Radioanatomical detail of the human temporal bone in relation to pneumatization. A correlative radioanatomical investigation. 与气化有关的人类颞骨放射解剖学细节。相关放射解剖学研究。
Pub Date : 1996-01-01
P A Dimopoulos
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引用次数: 0
Stabilization of the hydrophilic sphere of iobitridol, a new nonionic iodinated contrast agent. 新型非离子碘化造影剂碘比醇亲水球的稳定。
Pub Date : 1996-01-01
D Meyer, M Petta, M H Fouchet, M Vadel, M Schaefer, M Dugast-Zrihen, M Guillemot

The chemotoxicity of iodinated contrast agents is essentially related to the spatial accessibilty of lipophilic and polarizable iodine atoms. This accessibility was examined in iobitridol by HPLC and 1H- and 13C-NMR spectroscopy,taking into account both the static distribution of the hydrophilic groups around the triiodinated benzene ring and in particular the dynamic modulation of this distribution. The aim of this latter parameter is to prevent distortion of the hydrophilic sphere of nonionic agents when faced with a hydrophobic environment. Iobitridol is characterized by 2 tertiary carbamoyl substituents whose high rotation barriers (deltaG*353=27.6 kcal for E/Z-rotation and deltaG*345=17.3 kcal for syn/anti-rotation) stabilize the hydrophilic sphere. The 3rd dihydroxylated anilide substituent does not undergo SMILES rearrangement and provides iobitridol with its even hydrophilic distribution. Iobitridol presents remarkable chemical solubility (>140% m/v) and stability. The iobitridol molecule was specifically designed with the aim of stabilizing the hydrophilic sphere around the triiodinated benzene ring, therefore permanently masking access to the iodine atoms. This new concept represents a further step forward towards the synthesis of new iodinated contrast agents which should be totally inert vis-a-vis biological membranes and proteins.

碘造影剂的化学毒性本质上与亲脂性和极化性碘原子的空间可及性有关。考虑到三碘化苯环周围亲水性基团的静态分布,特别是这种分布的动态调制,通过HPLC和1H- nmr和13C-NMR对碘腈醇的可及性进行了研究。后一个参数的目的是防止在面对疏水环境时,非离子试剂的亲水性球体发生畸变。Iobitridol具有2个叔胺基取代基,其高的旋转势垒(deltaG*353=27.6 kcal, deltaG*345=17.3 kcal)稳定了亲水性球。第3个二羟基苯胺取代基不发生SMILES重排,使碘腈醇具有均匀的亲水性分布。碘腈醇具有显著的化学溶解度(>140% m/v)和稳定性。碘腈醇分子是专门为稳定三碘苯环周围的亲水球而设计的,因此永久地屏蔽了碘原子的接触。这个新概念代表了合成新的碘化造影剂的又一步,这种造影剂对生物膜和蛋白质应该是完全惰性的。
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引用次数: 0
期刊
Acta radiologica. Supplementum
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