A new ground level neutron monitor for space weather assessment

We report on a new ground-level neutron monitor design for studying cosmic rays and fluxes of solar energetic particles at the Earth's surface. The first-of-its-kind instrument, named the NM-2023 after the year it was standardised and following convention, will be installed at a United Kingdom Meteorological Office observatory (expected completion mid 2024) and will reintroduce such monitoring in the UK for the first time since ca. 1984. Monte Carlo radiation transport code is used for the development and application of parameterised models to investigate alternative neutron detectors, their location and bulk material geometry in a realistic cosmic ray neutron field. Benchmarked against a model of the current and most widespread design standardised in 1964 (the NM-64), two main parameterisation studies are conducted; a simplified standard model and a concept slab parameterisation. We show that the NM-64 standard is well optimised for the intended large-diameter boron trifluoride (BF3 ) proportional counters but not for multiple smaller diameter counters. The new design (based on a novel slab arrangement) produces comparable counting efficiencies to an NM-64 with six BF3 counters and has the added advantage of being more compact, lower cost and avoids the use of highly toxic BF3 .

A GPS-enabled seabed sediment sampler: Recovery efficiency and efficacy

The design, manufacture, and commissioning of a global positioning system enabled sampler instrument conceived for the retrieval of seabed sediments are described. This system was designed for sampling in environmental assessment applications and, especially, those requirements that might include insoluble, anthropogenic radioactivity derived from the effluent from nuclear facilities. Once triggered, the sampler operates autonomously for the recovery of samples by settling in the sampling environment, and it is compatible with submersion in fresh water and also with an off-the-shelf, submersible, remotely operated vehicle. A number of tests have been carried out to determine the efficiency and efficacy of the sample recovery performed by the system and the extent to which the recovery of samples disturbs neighboring sediments.

Real-Time Avoidance of Ionising Radiation Using Layered Costmaps for Mobile Robots

Humans in hazardous environments take actions to reduce unnecessary risk, including limiting exposure to radioactive materials where ionising radiation can be a threat to human health. Robots can adopt the same approach of risk avoidance to minimise exposure to radiation, therefore limiting damage to electronics and materials. Reducing a robot’s exposure to radiation results in longer operational lifetime and better return on investment for nuclear sector stakeholders. This work achieves radiation avoidance through the use of layered costmaps, to inform path planning algorithms of this additional risk. Interpolation of radiation observations into the configuration space of the robot is accomplished using an inverse distance weighting approach. This technique was successfully demonstrated using an unmanned ground vehicle running the Robot Operating System equipped with compatible gamma radiation sensors, both in simulation and in real-world mock inspection missions, where the vehicle was exposed to radioactive materials in Lancaster University’s Neutron Laboratory. The addition of radiation avoidance functionality was shown to reduce total accumulated dose to background levels in real-world deployment and up to a factor of 10 in simulation.

Local and global trace plutonium contributions in fast breeder legacy soils

Trace-level plutonium in the environment often comprises local and global contributions, and is usually anthropogenic in origin. Here, we report estimates of local and global contributions to trace-level plutonium in soil from a former, fast-breeder reactor site. The measured ²⁴⁰Pu/²³⁹Pu ratio is anomalously low, as per the reduced ²⁴⁰Pu yield expected in plutonium bred with fast neutrons. Anomalies in plutonium concentration and isotopic ratio suggest forensic insight into specific activities on site, such as clean-up or structural change. Local and global ²³⁹Pu contributions on-site are estimated at (34 ± 1)% and (66 ± 3)%, respectively, with mass concentrations of (183 ± 6) fg g^-1 and (362 ± 13) fg g^-1. The latter is consistent with levels at undisturbed and distant sites, (384 ± 44) fg g^-1, where no local contribution is expected. The ²⁴⁰Pu/²³⁹Pu ratio for site-derived material is estimated at 0.05 ± 0.04. Our study demonstrates the multi-faceted potential of trace plutonium assay to inform clean-up strategies of fast breeder legacies.

DEVELOPMENT AND EXPERIMENTAL VALIDATION OF RESPONSE MODELLING FOR TIME-OF-FLIGHT NEUTRON DETECTION AND IMAGING SYSTEMS

The application and feasibility of a time-of-flight neutron detection system is explored for sources with time correlated gamma-ray and neutron emissions, such as the spontaneous fission emitter, Cf-252. For the emission of multiple gamma rays and neutrons from a single spontaneous fission event, a near instantaneous gamma-ray detection followed by a later neutron detection on a multi-detector array allows for an associated time-of-flight to be determined for a neutron arising from that event. Using a suite of purpose developed analysis tools, Monte-Carlo simulation and experimental data are compared for the Cf-252 water tank source facility at Lancaster University. Applying a bespoke time-of-flight imaging algorithm, vector-based optimisation (VBO), the true source location is determined within 21 cm by this approach.

An advanced blind-tube monitoring instrument to improve the characterization of subsurface radioactive plumes

This research presents a design of a resilient blind-tube radiometric logging probe, which satisfies key, operational site constraints, for direct in-situ characterization of subsurface radioactivity, particularly caesium-137 and strontium-90. The probe comprises a commercially-available Ø10 mm × 9.5 mm CeBr3 scintillator detector attached to a compact digitizer unit, in a resistant and waterproof housing. The probe is designed to be lowered down into metallic Ø 75 mm blind-tubes by means of a winch system.

Depicting corrosion-born defects in pipelines with combined neutron/γ ray backscatter: a biomimetic approach

The identification of corrosion, cracks and defects in pipelines used for transporting oil and gas can reduce the possibility of leaks, and consequently, it can limit the extent of an environmental disaster, public hazard and the associated financial impact of such events. Typically, corrosion in oil pipelines is measured with non-destructive ultrasonic or electromagnetic techniques, on the basis that corrosion and defects are often manifest as a change of thickness in the steel from which pipelines are made. However, such approaches are not practical for underground pipelines and their deployment can be complicated for the case of pipelines covered by insulation. In this paper, we present an innovative, non-destructive testing technique, which exploits the backscatter of a combination of fast-neutron and γ radiation from steel samples of a variety of thicknesses consistent with changes that might arise due to corrosion of a pipe wall. Our research demonstrates the potential to measure and characterise different steel thicknesses by detecting both the elastic, fast-neutron backscatter and the Compton-scattered γ radiations, simultaneously. Further, we demonstrate that the presence of insulation yields a consistent and separable influence on the experimental, wall-thickness measurements. The data from experimental measurements are supported by a comprehensive Monte Carlo computer simulation study.

Fast neutron and γ-ray backscatter radiography for the characterization of corrosion-born defects in oil pipelines

In this research, a combined fast-neutron/γ-raybackscatter imaging technique is described. The aim of this work is to understand corrosion defects in pipelines by measuring differences in the scattered radiation flux, generated when different steel thicknesses are irradiated by a neutron and γ-ray focused beam. A californium-252 radiation source is used to produce fast neutron and γ rays, exploiting its spontaneousfission. This mixed radiation field is collimated and directed towards the steel samples. Backscattered neutrons and γ rays aremeasured as a function of the steel thickness using 4 liquid organic scintillation detectors linked to a real-time, pulse-shape discrimination system, which separates and retains the neutron and γ-ray event data. In this paper, we describe how, using asingle radiation source and detection system, it is possible to perform and combine two complementary imaging modalities. This research is validated by an MCNP6 computer simulation study. The backscatter imaging system developed for this research and the experimental results of the measurements carried out using the National Physical Laboratory neutron low-scatter facility are also presented in this paper.

Investigating Artefacts and Repair Mechanisms Associated with α-particle Interactions in Charge Coupled Devices

Charge coupled devices (CCDs) have been shown to have potential for detecting charged particles and other forms of ionising radiation. In particular, the clusters in the pixel images produced are distinctive for α and β radiations, with α particles causing large, symmetrical clusters or long, vertical tracks often referred to as blooming, and β particles causing long, curved tracks. The size and shape of these tracks are also related to the energy of the incident radiation, giving the potential for spectroscopy of these types of radiation. This could be used, for example, to realise a hand-held, portable device for in-situ detection and identification of radioactive contamination. Images have been taken of exposures to a 210Po α-particle source using Sony ICX825AL interline transfer CCDs, covered with a thin, aluminised Mylar film to prevent inadvertent exposure to light. Both vertical streaks and round clusters have been observed in each of the three CCDs used. Increased levels of noise have been seen after several hours of exposure to the 210Po source, found to be caused by damage from α radiation. Three methods have been investigated to reduce this noise: 1) Annealing at 100°C for 24 hours repairs a significant proportion of the damage caused by the α radiation, though the effectiveness is reduced with each subsequent exposure and annealing cycle; 2) Cooling is performed during exposures by using a heat pipe to move heat away from the back of the CCD and a fan to cool the heat pipe and electronics associated with the CCD.This reduces the dark current during CCDmeasurements, and the method of cooling used allows thedevice to retain its small, hand-held size; 3) Anyremaining noise can be removed later using imageprocessing. These techniques are combined to extend thelifetime of the device. The rate of damage from the 210Posource is similar whether the device is cooled or not,however the noise evident in the images produced whencooled is significantly less, allowing the CCD to be usedfor a longer time between annealing operations.

Producing Useful Chemicals Using a Nuclear Reactor

In this paper, the irradiation of glycerol and ethylene glycol by either mixed (neutron-γ) or γ-only (γ) fields at the TRIGA reactor of the Jožef Stefan Institute is described. This is highly relevant to future applications of fission reactor systems to produce useful feedstock derivatives from organic waste, beyond the production of heat and power.

Samples of glycerol and ethyl glycol have been exposed to neutron-gamma radiation with fast neutron fluxes ranging from 7.7×1010 to 3×1012 cm−2s−1 and gamma-only irradiation at maximum dose-rates of 492 and 10 kGy hr−1, respectively. A study of the dependence of product yield versus absorbed dose has been conducted, for total dose ranges of 1 to 100 kGy. The products of these exposures have been identified through Gas Chromatography – Mass Spectrometry (GC-MS) techniques.

Analysis comparing neutron-gamma irradiated samples of ethylene glycol and glycerol with gamma-irradiated samples shows no detectable qualitative difference between either irradiation type. Although, additional radiolysis products were detected when compared with available literature; ethyl acetate from ethylene glycol and solketal from glycerol. Quantitatively, neutron-gamma irradiation seems to be less effective at producing acetaldehyde from ethylene glycol, compared with gamma-only which can be explained through neutron moderation and consequent heating effects due to the borosilicate vials.

Detection of Simulated Fukushima Daichii Fuel Debris Using a Remotely Operated Vehicle at the Naraha Test Facility

The use of robotics in harsh environments, such as nuclear decommissioning, has increased in recent years. Environments such as the Fukushima Daiichi accident site from 2011 and the Sellafield legacy ponds highlight the need for robotic systems capable of deployment in hazardous environments unsafe for human workers. To characterise these environments, it is important to develop robust and accurate localization systems that can be combined with mapping techniques to create 3D reconstructions of the unknown environment. This paper describes the development and experimental verification of a localization system for an underwater robot, which enabled the collection of sonar data to create 3D images of submerged simulated fuel debris. The system was demonstrated at the Naraha test facility, Fukushima prefecture, Japan. Using a camera with a bird’s-eye view of the simulated primary containment vessel, the 3D position and attitude of the robot was obtained using coloured LED markers (active markers) on the robot, landmarks on the test-rig (passive markers), and a depth sensor on the robot. The successful reconstruction of a 3D image has been created through use of a robot operating system (ROS) node in real-time.

Passive, non-intrusive assay of depleted uranium

The ability to detect neutrons from the spontaneous fission of ²³⁸U in samples of depleted uranium with organic liquid scintillation detectors is presented. In this paper we introduce a small modular organic liquid scintillator detector array that can detect changes in mass of ²³⁸U between 3.69 g and 14.46 g. To do this, 18-h assays of various masses of 0.3% wt. of depleted uranium dioxide were assessed using four EJ-309 detectors, a mixed field analyser operated in pulse gradient analysis mode, and associated counting components. We observe a background-corrected fast neutron count sensitivity of (2.0 ± 0.3) × 10^-4 n g^-1 s^-1 per detector. This research demonstrates a proof of concept for depleted uranium quantity to be assessed passively on a non-intrusive basis via its spontaneous fission decay.

A remotely triggered fast neutron detection instrument based on a plastic organic scintillator

A detector system for the characterization of radiation fields of both fast neutrons and γ rays is described comprising of a gated photomultiplier tube (PMT), an EJ299-33 solid organic scintillator detector, and an external trigger circuit. The objective of this development was to conceive a means by which the PMT in such a system can be actuated remotely during the high-intensity bursts of pulsed γ-ray contamination that can arise during active interrogation procedures. The system is used to detect neutrons and γ rays using established pulse-shape discrimination (PSD) techniques. The gating circuit enables the PMT to be switched off remotely. This is compatible with use during intense radiation transients to avoid saturation and the disruption of the operation of the PMT during the burst. Data are presented in the form of pulse-height spectra and PSD scatter plots for the system triggered with a strobed light source. These confirm that the gain of the system and the throughput for both triggered and un-triggered scenarios are as expected, given the duty cycle of the stimulating radiation. This demonstrates that the triggering function does not perturb the system response of the detector.

Remediation of 137Cs contaminated concrete using electrokinetic phenomena and ionic salt washes in nuclear energy contexts

This work describes the first known the use of electrokinetic treatments and ionic salt washes to remediate concrete contaminated with ¹³⁷Cs. A series of experiments were performed on concrete samples, contaminated with K⁺ and ¹³⁷Cs, using a bespoke migration cell and an applied electric field (60V potential gradient and current limit of 35mA). Additionally, two samples were treated with an ionic salt wash (≤400molm^-3 of KCl) alongside the electrokinetic treatment. The results show that the combined treatment produces removal efficiencies three times higher (>60%) than the electrokinetic treatment alone and that the decontamination efficiency appears to be proportional to the initial degree of contamination. Furthermore, the decontamination efficiencies are equivalent to previous electrokinetic studies that utilised hazardous chemical enhancement agents demonstrating the potential of the technique for use on nuclear licensed site. The results highlight the relationship between the initial contamination concentration within the concrete and achievable removal efficiency of electrokinetic treatment and other treatments. This information would be useful when selecting the most appropriate decontamination techniques for particular contamination scenarios.

Characterisation of the TRIUMF neutron facility using a Monte Carlo simulation code

Here, the characterisation of the high-energy neutron field at TRIUMF (The Tri Universities Meson Facility, Vancouver, British Columbia) with Monte Carlo simulation software is described. The package used is MCNPX version 2.6.0, with the neutron fluence rate determined at three locations within the TRIUMF Thermal Neutron Facility (TNF), including the exit of the neutron channel where users of the facility can test devices that may be susceptible to the effects of this form of radiation. The facility is often used to roughly emulate the field likely to be encountered at high altitudes due to radiation of galactic origin and thus the simulated information is compared with the energy spectrum calculated to be due to neutron radiation of cosmic origin at typical aircraft altitudes. The calculated values were also compared with neutron flux measurements that were estimated using the activation of various foils by the staff of the facility, showing agreement within an order of magnitude.

The analysis of complex mixed-radiation fields using near real-time imaging

A new mixed-field imaging system has been constructed at Lancaster University using the principles of collimation and back projection to passively locate and assess sources of neutron and gamma-ray radiation. The system was set up at the University of Manchester where three radiation sources: (252)Cf, a lead-shielded (241)Am/Be and a (22)Na source were imaged. Real-time discrimination was used to find the respective components of the neutron and gamma-ray fields detected by a single EJ-301 liquid scintillator, allowing separate images of neutron and gamma-ray emitters to be formed. (252)Cf and (22)Na were successfully observed and located in the gamma-ray image; however, the (241)Am/Be was not seen owing to surrounding lead shielding. The (252)Cf and (241)Am/Be neutron sources were seen clearly in the neutron image, demonstrating the advantage of this mixed-field technique over a gamma-ray-only image where the (241)Am/Be source would have gone undetected.

Repeat endocarditis: analysis of risk factors based on the International Collaboration on Endocarditis - Prospective Cohort Study

Repeat episodes of infective endocarditis (IE) can occur in patients who survive an initial episode. We analysed risk factors and 1-year mortality of patients with repeat IE. We considered 1874 patients enrolled in the International Collaboration on Endocarditis - Prospective Cohort Study between January 2000 and December 2006 (ICE-PCS) who had definite native or prosthetic valve IE and 1-year follow-up. Multivariable analysis was used to determine risk factors for repeat IE and 1-year mortality. Of 1874 patients, 1783 (95.2%) had single-episode IE and 91 (4.8%) had repeat IE: 74/91 (81%) with new infection and 17/91 (19%) with presumed relapse. On bivariate analysis, repeat IE was associated with haemodialysis (p 0.002), HIV (p 0.009), injection drug use (IDU) (p < 0.001), Staphylococcus aureus IE (p 0.003), healthcare acquisition (p 0.006) and previous IE before ICE enrolment (p 0.001). On adjusted analysis, independent risk factors were haemodialysis (OR, 2.5; 95% CI, 1.2-5.3), IDU (OR, 2.9; 95% CI, 1.6-5.4), previous IE (OR, 2.8; 95% CI, 1.5-5.1) and living in the North American region (OR, 1.9; 95% CI, 1.1-3.4). Patients with repeat IE had higher 1-year mortality than those with single-episode IE (p 0.003). Repeat IE is associated with IDU, previous IE and haemodialysis. Clinicians should be aware of these risk factors in order to recognize patients who are at risk of repeat IE.

Depth profiling 137Cs and 60Co non-intrusively for a suite of industrial shielding materials and at depths beyond 50 mm

A phantom has been used to position two radiation sources, separately, when buried under dry-silica sand at depths between 5 and 50 mm. A γ-ray energy spectrum was then measured at every 1 mm depth. Principal component analysis has been conducted, which has led to a non-linear fit being established, allowing the depth of entrainment to be accurately inferred. The technique has been expanded for additional shielding media: water, aggregate and both wet and dry soil. The technique has also been expanded beyond the previous depth constraint of 50 mm.

A digital approach to neutron-γ imaging with a narrow tungsten collimator aperture and a fast organic liquid scintillator detector

A digital neutron-γ imaging technique for mixed radiation field is described. The imaging system is based upon an organic liquid scintillator detector, a narrow tungsten collimator, fast digitiser and adjustable equatorial mount. Radioactive sources have been attached to a vertical plane and the digitiser has been used to digitise neutron and γ events. The digitised events have been discriminated using pulse gradient analysis and images have been generated of the count distribution in the source plane.

Determination of the depth of localized radioactive contamination by 137Cs and 60Co in sand with principal component analysis

A method to determine the depth of buried localized radioactive contamination nonintrusively and nondestructively using principal component analysis is described. The γ-ray spectra from two radionuclides, cesium-137 and cobalt-60, have been analyzed to derive the two principal components that change most significantly as a result of varying the depth of the sources in a bespoke sand-filled phantom. The relationship between depth (d) and the angle (θ) between the first two principal component coefficients has been derived for both cases, viz. d(Φ) = x + y log(e) Φ where x and y are constants dependent on the shielding material and the γ-ray energy spectrum of the radioactivity in question, and φ is a function of θ. The technique enables the depth of a localized radioactive source to be determined nonintrusively in the range 5 to 50 mm with an accuracy of ±1 mm.

A portable energy-sensitive cosmic neutron detection instrument

The construction and testing of a portable energy-sensitive neutron instrument are described. This instrument has been designed and constructed for the primary purpose of characterizing cosmic-ray neutron fields in the upper atmosphere and in cosmic reference field facilities. The instrument comprises a helium-3 proportional counter surrounded by 15 mm of lead and 140 mm of polyethylene creating a spherical structure with a diameter of 34 cm. The instrument also incorporates 12 boron-coated diodes, six on the outside of the polyethylene layer with six placed within the structure. The dimensions, materials, and arrangement of these in the instrument have previously been optimized with the MCNPX Monte Carlo simulation software to provide a compromise between the requirements of portability and spectral response. Testing took place at several locations and experimental data from the instrument's operation at the high-altitude Jungfraujoch laboratory in the Swiss alps are presented.

Time-Dependent Rheology of Starch Thickeners and the Clinical Implications for Dysphagia Therapy

The viscosity of nonsolid foods and the stability of their viscosity over time is critical in managing dysphagia. The time-dependent viscosity of liquids thickened with starch-based thickeners was measured at constant temperature and shear rate. Viscosity was measured between 30-min intervals of rest (zero shear) over a period of 17 h at 20.0 degrees C. Two common types of thickeners were evaluated: maize-based and maltodextrin-based (the latter commonly used in pediatrics). The maize-based thickeners undergo a significant decrease in viscosity over the initial 1-4 h following preparation. The maltodextrin-based thickener's viscosity increases significantly 30 min following preparation and is then more stable over time than its maize-based equivalent. These findings suggest that the success of current dysphagia therapies that use thickeners could be influenced by the time-dependent nature of thickened fluid viscosity. Acknowledgment and appropriate selection of the thickener type is shown to be of great importance.

The design of a portable cosmic ray three-band neutron detector

The design of a portable three-band cosmic-ray neutron detector is reported in this article. This instrument has been designed to characterise cosmic ray neutron fields in the upper atmosphere and in cosmic reference field facilities. The design utilises a spherical moderator with a layer of spallation material covering a central (3)He proportional counter. The instrument incorporates twelve lithium-coated diodes, six on the outside of the polyethylene layer and six placed within the structure. The dimensions, materials and arrangement of these in the instrument have been optimised with MCNPX to provide a compromise between the requirements of portability and spectral response.

Multicenter evaluation of a Candida albicans peptide nucleic acid fluorescent in situ hybridization probe for characterization of yeast isolates from blood cultures

We evaluated aliquots from 244 clinical blood culture bottles that demonstrated yeasts on Gram stain using a Candida albicans peptide nucleic acid (PNA) fluorescent in situ hybridization (FISH) probe. The sensitivity, specificity, positive predictive value, and negative predictive value of the C. albicans PNA FISH test in this study were 99%, 100%, 100%, and 99.3%, respectively.

Radiation-induced statistical uncertainty in the threshold voltage measurement of MOSFET dosimeters

The results of a recent study on the limiting uncertainties in the measurement of photon radiation dose with MOSFET dosimeters are reported. The statistical uncertainty in dose measurement from a single device has been measured before and after irradiation. The resulting increase in 1/f noise with radiation dose has been investigated via various analytical models. The limit of uncertainty in the ubiquitous linear trend of threshold voltage with dose has been measured and compared to two nonlinear models. Inter-device uncertainty has been investigated in a group of 40 devices, and preliminary evidence for kurtosis and skewness in the distributions for devices without external bias has been observed.

Novel developments in the MOSFET dosemeter for neutron dosimetry applications

The feasibility of large-geometry Metal Oxide Semiconductor Field Effect Transistor (MOSFET) devices has been assessed for both active and passive neutron dosimetry and use in radiotherapy environments. Neutron sensitivity has been enhanced with the use of polymeric cement surrounding the gate region. Neutron activation via nuclear interaction processes is a potential problem with conventionally packaged and fabricated devices. To overcome this problem, a unique low-activation device design is described. Standard Dual in-Line devices, modified with polymeric cement and boron loaded cement have been exposed to gamma rays (60Co) and neutrons (gamma-ray shielded 252Cf) to provide neutron sensitivity estimates. The results show that the neutron sensitivity can be increased by a factor of approximately three by the use of a thin layer of polymeric cement over the gate region. Essentially zero activation is observed in the activation-reduced design compared with 1000 cps in the conventional design MOSFET when both are exposed under identical conditions to a neutron field from a gamma-ray shielded 252Cf isotopic source.

American association of tissue banks: a historical reflection upon entering the 21st century

The American Association of Tissue Banks (AATB) is a scientific, not-for-profit, peer-group organization founded in 1976 to facilitate the provision of transplantable tissues of uniform high quality in quantities sufficient to meet national needs. The Association was created well before there was governmental oversight of tissue banking. The organization consists of individuals involved in tissue banking, medical users, and scientists in the field. Current structure consists of a 13-member Board of Governors with specific subgroups including Musculoskeletal, Reproductive, Skin, Tissue Bank Councils and Council of Accredited Tissue Banks. A historical review shows the evolution from development of guidelines to publication of standards, and from an inspection conducted by peers to one conducted by an independent, trained professional inspector. Association growth and historical accomplishments are highlighted.

Paraarticular osteochondroma of the knee: report of 2 cases and review of the literature

Paraarticular osteochondromas are unusual osteocartilaginous tumors that arise in the soft tissue adjacent to a joint. Their pathogenesis and classification are controversial, and worrisome histologic features make the distinction from chondrosarcoma difficult on morphologic grounds alone. Two cases of paraarticular osteochondroma of the knee arising in patients 66 and 75 years of age are reported in this study. Although the exact biologic nature of these tumors is not well characterized, limited data suggest that they will behave in benign fashion, similar to soft tissue chondromas. Paraarticular osteochondromas should be recognized to avoid unnecessarily aggressive surgical management.

Soft tissue for allograft reconstruction of the human knee: a survey of the American Association of Tissue Banks

With increasing use and availability of musculoskeletal soft tissue allografts, orthopaedic surgeons need current knowledge about allograft processing, costs, and availability. In conjunction with the American Association of Tissue Banks, a comprehensive survey consisting of specific questions on several topics in tissue banking was sent to 42 member banks or banks undergoing accreditation review that distribute musculoskeletal tissues. Donors came from organ procurement organizations, coroners' offices, hospital morgues, and donations; the average age of the donors was 35. Most of the 36 tissue banks responding to the questionnaire harvest patellar and Achilles tendons. Patellar tendon demand exceeded supply. Tissue processing was done by outside organizations approximately 50% of the time. Of the four types of tissue sterilization processes performed, gamma irradiation was the most common. Doses of sterilizing gamma irradiation varied from 1 to 3.5 mrad. The average approximate costs of fresh-frozen tissue were $800 for patellar tendon allograft, $615 for Achilles tendon, and $640 for menisci. There was no consensus of opinion of how to size or sterilize meniscal allografts. As demand increases for soft tissue allografts, it is essential that the orthopaedic surgeon is knowledgeable about the clinical impact of tissue banking.

Dedifferentiated chondrosarcoma with rhabdomyosarcomatous differentiation

Dedifferentiated chondrosarcomas are primary bone tumors characterized by the presence of both low-grade cartilaginous and high-grade sarcomatous components. The high-grade component usually shows histologic features of either malignant fibrous histiocytoma or fibrosarcoma. We are aware of only 10 published cases in which the high-grade component showed rhabdomyosarcomatous differentiation. To further clarify the clinical, radiographic, and pathologic features of this unusual variant, we report three additional cases of dedifferentiated chondrosarcoma with rhabdomyosarcomatous differentiation. The patients included two men and one woman; their mean age was 63 years. Tumors originated in the pelvis (ilium), scapula, and tibia. Two patients presented with radiographic findings typical of dedifferentiated chondrosarcoma, including a geographic, lytic lesion with areas of mineralization suggestive of cartilage in close association with a permeative component. The third patient presented with a primarily lytic, destructive lesion of the right iliac wing. Histologically, the tumors contained lobules of well-differentiated chondrosarcoma associated with a high-grade sarcoma with prominent rhabdomyoblasts. Immunohistochemical stains for actin and desmin were positive in all three tumors, and electron microscopy revealed evidence of skeletal muscle differentiation. All three patients died with metastatic disease, 1, 6, and 12 months postoperatively. This histologic variant of dedifferentiated chondrosarcoma is rare, but it shows radiographic and clinical features similar to "conventional" dedifferentiated chondrosarcoma, including a very poor prognosis.

Open tibial fractures with severe soft-tissue loss. Limb salvage compared with below-the-knee amputation

The long-term outcomes and the quality of life were studied in patients who had had an open fracture of the tibial shaft with severe soft-tissue loss. Limb salvage with a free flap was attempted in twenty-seven patients (sixteen of whom had a successful procedure and were examined personally by us), while eighteen patients were managed concurrently with an early below-the-knee amputation. Soft-tissue coverage was successful in all but one patient in whom limb salvage had been attempted. Ultimately, however, five extremities were amputated, with an infection at the site of a non-union being the most common reason for amputation. The patients who had had limb salvage had more complications (p < 0.001), more operative procedures (p < 0.001), and a longer stay in the hospital (p < 0.05) than the patients who had had an early below-the-knee amputation. The long-term functional results for sixteen patients who had had a successful limb-salvage procedure (average duration of follow-up, thirty-five months) were compared with those for eighteen patients who had had a below-the-knee amputation (average duration of follow-up, forty-four months). The patients who had had a successful limb-salvage procedure took significantly more time to achieve full weight-bearing (p < 0.05), were less willing or able to work (p < 0.01), and had higher hospital charges (p < 0.006) than the patients who had been managed with an early below-the-knee amputation. They also had a significant decrease in motion at the ankle and subtalar joint in the injured leg compared with the contralateral leg (p < 0.001). A quality-of-life evaluation was possible for only thirteen of the patients who had had a successful limb-salvage procedure and for sixteen of the patients who had had a below-the-knee amputation. The two groups were similar in terms of their responses, but significantly more patients who had had limb salvage considered themselves severely disabled (p < 0.05). They also had more problems with the performance of occupational and recreational activities (p < 0.05). This study confirmed the reliability of modern microvascular free tissue techniques for the coverage of large soft-tissue defects associated with tibial fractures. It also showed that complications and difficulties in the restoration of osseous union are common and may be directly related to the less satisfactory functional, occupational, recreational, and quality-of-life outcomes that are seen in many patients who have had limb salvage.(ABSTRACT TRUNCATED AT 400 WORDS)