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[Phantom experiments and early clinical experience with a mammogram apparatus using a grid (author's transl)].

The effect of a grid on film quality and dose was investigated in a newly developed mammographic apparatus (Mammo Diagnost U--C. H. F. Müller). It was shown that available film-screen combinations used with a grid produced practically the same picture quality as Definix Medical used without screen or grid. Although the dose required is almost doubled by the use of the grid, the latter, nevertheless, produces a reduction of surface dose to about a quarter (4 cm. plexiglass phantom). Using a film-screen combination not at present commercially available, there was some improvement in the demonstration of microcalcification, but the improvement resulted in an increase in the required radiation dose.

Humans↗

The TramEC "double cross" mesh: a new experience for repairing groin hernia. Our experience with 280 patients.

AIM: The purpose of this work is to provide a detailed account of a new technique for open prosthesis hernioplasty, a technique that makes use of a pre-shaped TramEC mesh made of polypropylene monofilament and created by the author. Specific descriptions are offered in regard to the shape of the mesh, the hernioplasty technique and the physiopathologic characteristics. METHODS: From 2000 to 2001, a total of 280 hernioplasties were performed with the TramEC technique. A follow-up of these patients was done after 1 week, after 3 months and after 1 year. An ecography of the groin was executed on all patients after 1 week in order to verify the presence of seromas. RESULTS: No recurrence was observed in 55.7% of patients examined after 1 year. Two patients (1.2%) experienced chronic but not debilitating pain. CONCLUSION: The author believes that with the TramEC mesh a precise overlap is formed between the mesh itself and the floor of the groin canal, thus creating the conditions required for avoiding empty spaces in order to favour the fibroplasias and amalgamation of tissues: basic parameters in avoiding recurrences. In addition, the mesh not only repairs the hernial defect but also strengthens the internal inguinal ring by virtue of its "double cross" structure. Because of the device's anatomical shape and the simplicity of the technique, we optimise the operation in terms of time and reproducibility.

Adolescent↗

Nine years experience with chemically dependent physicians: the New Jersey experience.

Few studies have been able to retroactively evaluate the effectiveness of treating chemically dependent physicians. This paper provides an overview of the Physicians' Health Program of the Medical Society of New Jersey; details the current status of physicians treated for chemical dependency from 1982 to 1990; lists the perceived reasons for successful recovery; and identifies the needs for the future.

Alcoholism↗

[Long-term experience of immediate implant loading using DenTi implants. Part 1. Material, methods and experience in immediate loading of DenTi implants].

Immediate loading of dental implants have been widely used to retain and support crossarch partial dentures. Normally 3-6 months after implantation complete osseointegration is established, this period may be shortened with immediate loading of implants. The purpose of this study was to evaluate the factors that may influence the long-term success of immediate implant loading. The immediate loading technique with DenTi implants was introduced 12 years ago, and during this period the clinical results have been followed up on 257 DenTi implants in 83 patients. 62 patients and with 263 implants placed with submerged technique were recruited into the control group. The retrospective long-term follow-up examination has revealed that the success rate of DenTi implants with traditional two stage surgery was 97.4%. The success rate of DenTi implants with immediate loading was 95.71%. According to the date of the success rata and prognosis of immediate loaded implants are comparable to the traditional two stage submerged implants.

Adult↗

Experience with standardized protocols in hypothermia, boom or bane? The Alaska experience.

The geography, climate and population of Alaska place practitioners with a variety of skills in the position of initially caring for sick or injured people. The state of Alaska has developed an Emergency Medical Services (EMS) system which is responsible for the training of personnel, equipment, and other aspects of pre-hospital care. In 1982, the EMS produced protocols for the treatment of hypothermia (1). These protocols recommend the specific treatment preferred for each level of skill--from the lay public and first responders through physicians. Revised in 1989, they have been well accepted throughout the state. The protocols have clarified what can be a somewhat confusing subject. The result has been treatment in the field, in smaller clinics, and in hospitals that conforms more to an accepted standard of care-relieving people from having to resolve certain debated aspects of care. A recent survey of prehospital personnel and physicians involved in prehospital care confirmed the usefulness of the protocols.

Alaska↗

Experience with upper extremity burns. The Mount Vernon experience.

History and clinical examination remain the mainstay in assessing burn depth. There is no satisfactory objective test for burn depth. Silicone oil in loose bags is the dressing of choice for the conservative management of superficial burns. Deep dermal burns of the dorsum of the hand should be shaved and grafted within the first 5 days. Full-thickness burns of the dorsum without exposure of deep structures should be excised and grafted within the first 5 days. K-wires may be used to stabilize metacarpophalangeal and PIP joints to prevent secondary deformity while grafts heal, but should not be left longer than 6 weeks. Flaps used to repair full-thickness burns with exposure of deep structures should be planned to permit elevation and movement. Primary reconstruction of extensor mechanisms should be performed at the time of flap cover.

Burn Units↗

[Personal experience with segmental corporo-caudal allotransplantation of the pancreas in an experiment on dogs].

In the Institute for Surgery, its Experimental Centre, has already several years an experimental transplantations of pancreas been carried out with the aim of learning surgery technique and performing a clinical transplantation of that organ. In our work we have used a technique of corporacaudal allotransplatation of pancreas with vascular anastomosis. As the blood vessels of the graft we have used the arteria and vena lienalis with parts of aorta and portal vein, which have been anastomosed with a. and v. iliaca communis of the pancretotomized recipient. We have used techniques of the open pancreatic duct, ligated pancreatic duct, our own technique of permanent bleeding of the pancreatic graft during the transplantation pancreaticojejunostomy and pancreatico-vesicular anastomosis. As the parameters of function of allograft we are using: glycaemia, i.v. GT test, K constant, insulinaemia, amylasaemia, length of survival of animals and pathohistological finding. The average term of survival of experimental animals was 28 days. During the function of alograft the experimental animals shown some signs of laboratory subclinical diabetes. Refusal of transplant was followed by sudden increase of glycaemia, without any clinical or laboratory sign of anticipation of the refusal.

Animals↗