Objective: To investigate the association between the practice of radiation safety principles (PRSP) and participation in radiation safety refresher courses among Mongolian radiology professionals.

Methods: This cross-sectional questionnaire-based study was conducted in Ulaanbaatar, Mongolia. The questionnaire was distributed to 250 participants, and 156 questionnaires were analyzed.

Results: Only 59.6％ of radiologists and 59.8％ of technicians used lead aprons regularly. Less than half of the professionals tried to minimize the time of the procedure (28.8％ and 28.3％) and to distance themselves from the X-ray source (42.9％ and 37.0％). The professionals who participated in radiation safety refresher courses had practiced the safety principles better than those who had not (p＝0.028).

Conclusion: In Mongolia, many radiology professionals did not practice proper radiation protection, but participation in radiation safety refresher courses was effective. Besides the importance of personal protective equipment supplies, further education and training for radiation safety for the professionals are required.

Background & Aims: This study evaluated the construct validity of the Indonesian version of WHODAS 2.0 among persons with physical impairment.

Methods: WHODAS 2.0 was self-administered to 212 participants with physical impairment in Bandung, Indonesia. The Rasch model was used to analyse the instrument’s construct validity.

Results: Data of 212 participants were analysed. The average outfit mean-square (MnSq) of the 36-item and 32-item versions of WHODAS 2.0 satisfied the Rasch model expectations (0.99±0.28 vs 0.99±0.24). Item D2.5 ‘walking a long distance such as a kilometre’ and item D4.5 ‘sexual activity’ were identified as misfitting items in both versions (infit or outfit MnSq >1.4). The variance explained by measures of the 32-item version was 56.7％, and the 36-item version was 49.0％. Both versions’ reliability and separation index were excellent, with Cronbach’s alpha >0.90 and a separation index >2. The response category function and targeting did not fully satisfy the Rasch model expectations. A strong correlation between both versions of WHODAS 2.0 and WHOQOL BREF (r>0.60) established the convergent validity.

Conclusions: The Indonesian version of the 32-item version of WHODAS 2.0 has acceptable construct validity in a physical impairment sample in Bandung, Indonesia.

Background & Aims: Spontaneous hemopneumothorax (SHP) is a rare condition that can result in shock due to extensive bleeding. However, the optimal timing of surgery remains controversial.

Methods: Twenty-six patients who underwent surgery for SHP between July 1999 and December 2017 at our institution were retrospectively investigated.

Results: Nineteen patients underwent emergent surgery (ES) and 7 underwent sub-emergent surgery (sub-ES). The ES group exhibited significantly higher drainage volume before surgery compared to the sub-ES group (blood loss; 512 ml vs. 258 ml, p＝0.019), and higher total hemorrhage volume (1,056 ml vs. 458 ml, p＝0.022). One sub-ES group patient, whose preoperative blood loss measured 150 ml, went into shock prior to surgery. His chest roentgenograms did not indicate significant hemorrhage in the thorax; however, his total blood loss measured 1,100 ml.

Conclusions: The optimal timing of surgical intervention for SHP may depend on the extent of preoperative blood loss. However, preoperative drainage volume is not an accurate indicator of total blood loss, and chest radiographic findings are not reliable in some cases. Therefore, patients with SHP must be carefully monitored, and surgical treatment should proceed smoothly from conservative management as necessary.

Objectives: The aim of this study was to evaluate the influence of professional values on attitudes toward collaborative practice.

Methods: Questionnaires were gathered from 151 health and social care workers. A multiple regression analysis was performed with the factors in the modified Attitudes Towards Health Care Teams Scale (“Quality of Care”, “Team efficiency” and “Patient-centered care”) as the dependent variables, and participant characteristics and “Career Anchors” subcategory scores as explanatory variables.

Results: The Multiple regression analysis revealed that “Quality of Care” could be predicted by “Pure Challenge” and “Lifestyle”; “Team efficiency” by “Security (negative)” and “Service”; and “Patient-centered care” by “Service”, and “Security (negative)”.

Conclusions: Our results suggested that multiple professional values have effects on the attitudes toward collaborative practice.

　　We treated two patients from foreign countries who had cervical tuberculous lymphadenitis. On CT, findings were strongly suggestive of this disease, although we could not detect Mycobacterium Tuberculosis (TB) itself in the lymph node by microscopic examination or culture. Definitive diagnosis was made by a combination of image evaluation, serological tests, pathological examination, and PCR test. The incidence of TB in Japan is gradually decreasing, but TB in resident aliens is increasing. Presently, almost 380,000 young foreigners work in Japan as technical intern trainees. Nearly all of these young people are in their twenties and come from countries where TB is highly prevalent. TB rarely presents as cervical tuberculous lymphadenitis, but it is common in young foreigners living in Japan.

An 85-year-old woman was rushed to our hospital with chest and back pain. She was diagnosed with an acute dissecting aortic aneurysm and treated with conservative therapy, but re-dissection was observed. On the sixth hospitalization day, she underwent emergency ascending aortic artery replacement. On the third postoperative day, she developed extensive cerebral infarction. Thereafter, on the fourth postoperative day, platelets were markedly reduced and heparin-induced thrombocytopenia (HIT) was suspected. After close examination, the diagnosis of HIT was confirmed. Argatroban administration was started; no new thrombosis developed, and the patient was transferred to another hospital for rehabilitation on the 49^th postoperative day. The interval between heparin exposure and thrombocytopenia suggests that the HIT was triggered by heparin flush at CVC insertion.