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At least 1,765 records · Page 98Linked to original sources
PubMed1981

Digital scintigraphy: principles, design, and performance.

In a digital camera the position of a scintillation event is computed following analog-to-digital conversion of photomultiplier pulse charges. Digital position analysis is essentially a mathematical inversion procedure based upon calibrated responses of the photomultipliers to scintillations from a narrow-beamed source that maps a detector's field of view. Operationally, a camera's image characteristics are optimized by means of computer-generated inversion reference tables, individually tailored to the specific response characteristics of each detector. Design considerations indicate that cameras of varied configurations, e.g., linear, disc-shaped, rectangular, or cylindrical, can be analyzed by this method. Also, for any given electro-optical system, energy resolution, spatial characteristics, and event-rate performance can be made superior to analog systems. The measured performances of a one-dimensional test camera, although limited in its optical and electronic design, support this conclusion.

Analog-Digital Conversion↗
PubMed1978

[The value of radiotomographic examination in carcinomas of the larynx (author's transl)].

The autors compare the interpretation of radiotomographic films and the results of pathological examination of total laryngectomy specimens in 60 cases without contrast and in 15 cases with contrast. They study the value of the interpretation of X-ray films according to the site in terms of height, size, shape, the extent of the carcinoma and possible involvement of the pre-epiglottic space, the thyroid cartilage and the base of the tongue. With the aim of determining the true value of radiotomographic examination in carcinoma of the larynx, comparative tables were drawn up between the radiological interpretation and findings on macroscopic examination of total laryngectomy operative specimens. Radiological examination included standard lateral films, AP tomograms and, more recently, contrast laryngography.

Epiglottis↗
PubMed1997

[Carcinoma metastatic to the cervix: a study of 19 cases].

OBJECTIVES: To report the clinical features and to evaluate the treatment results of 19 cases of cervical metastatic carcinoma. METHODS: We analyzed retrospectively the 19 patients with carcinoma metastatic to the cervix treated during the period of 1959 to 1994 at Cancer Hospital, Chinese Academy of Medical Sciences. RESULTS: The average age of patients was 43.7. The main symptom was irregular vaginal discharge and (or) bleeding. In most patients, the primary cancers originated from digestive tract or ovary. The treatment methods included radiotherapy alone, radiotherapy combined with chemotherapy after operation, and surgery plus radiotherapy. The 1-, 2- and 5-years survival rates (life-time table were 68.5%, 47.3% and 26.2% respectively, and the longest period for survived patient with dysgerminoma has lived was more than 22 years. CONCLUSION: The active proper treatment of primary cancer can prolong the survival time of patients with carcinoma metastatic to the cervix. The patients whose metastatic lesions are limited to the cervix and sensitive to the radiation may be cured by radiotherapy and combination therapy.

Adolescent↗
PubMed1998

Building a nursing management analysis capacity in a teaching hospital.

The authors describe one institution's efforts to create the capacity to use standard hospital information systems to address clinical and operational nursing questions. This work involved not only technical aspects of information management system creation but also building the human currency to make the information available and useful. Because the information available to nursing comes from the same data sources that feed operational management and finance departments, nursing can now speak in the same language at the policy tables.

Budgets↗
PubMed1998

[A computerized database for managing otorhinolaryngologic oncology patients].

In recent years the management and interdisciplinary treatment of oncological patients has become extremely complex due to the progress made in diagnosis and therapy. As a result, the knowledge required to treat patients can no longer be simply memorized or manually filed. Computer technology provides the ideal instrument for organizing, saving and analyzing data from head and neck tumor patients. The authors have prepared a computerized database to meet the following needs: ease of use, even for non computer savvy users; minimal ambiguity for data entry; use for both clinical and scientific purposes; possibility to create a network with similar database at other Centers; possibility to expand to include image management. The archive is based on a personal computer with an INTEL 80486 microprocessor, 40 Mb RAM, DOS 6.0. and Windows 3.1. The software includes four main routines: a) formulation and management of tables where oncological data are gathered; b) entry and management of patient-related clinical data; c) statistical processing for epidemiological and oncological research and; d) management of basic computer services. In clinical practice the database allows the following: a) preparation of a monthly chart of check-ups, b) rapid tracking of patients lost to followup, c) printout of a summary of the clinical history of each patient at the time of check-up and rapid updating at the end of the examination, d) automatic production of forms such as discharge letters and reports to be shared with related services (i.e. medical oncology, radiotherapy). In addition, the database is a powerful, versatile research tool which can promptly provide all sorts of oncological data and can automatically prepare tables, diagrams, correlations, survival curves. The system was developed from 1993 to 1995 and has been operative, with a few minor modifications and updates, since 1995. Today the database contains more than 1200 oncological cases and the system is used daily by medical and paramedical personnel alike. Approximately 15 new cases are entered a month and 80 cases updated after follow-up.

Head and Neck Neoplasms↗
PubMed1995

Factors predicting the recurrence of adhesive small-bowel obstruction.

BACKGROUND: A long-standing debate exists about whether stable patients who have adhesive small-bowel obstruction (ASBO) are best managed operatively or nonoperatively. In addition, the factors that predict recurrence have not been established. PATIENTS AND METHODS: We conducted a retrospective cohort study using medical records of 31 ASBO patients managed operatively and 59 managed nonoperatively. Follow-up data for up to 12.8 years after the index ASBO were collected from medical records. RESULTS: Life-table analyses found that ASBO recurred after 53% of initial episodes and 85% or more of second, third, or later episodes. Recurrence was much more rapid after third or later episodes than after first or second episodes. Recurrence occurred sooner and more frequently in patients managed nonoperatively than in patients managed operatively. These differences became statistically significant only after the second episode. CONCLUSIONS: The number of prior episodes is the strongest predictor of recurrence. The optimal management strategy is a function of the number of prior episodes a patient has experienced. Nonoperative management appears reasonable for stable patients who are having their first episode. Operative strategies appear best for those experiencing second episodes. Neither strategy yields acceptable outcomes in patients experiencing third or later episodes.

Adolescent↗
PubMed1993

Benefit of carotid endarterectomy after prior stroke.

PURPOSE: The benefit of carotid endarterectomy (CEA) in preventing recurrent stroke in patients who have sustained a previous stroke remains controversial. The purpose of this study was to evaluate the immediate results and long-term benefit of CEA after recovery from a prior ipsilateral stroke. METHODS: Between 1980 and 1990, 85 patients underwent CEA for prior stroke with an average follow up of 54 months (range 0.3 to 130). The interval from prior stroke to CEA averaged 19.8 months (range 0.1 to 158.3). Vascular risk factors included hypertension in 70.6%, diabetes in 20.0%, history of smoking in 80.0%, and associated coronary artery disease in 51.8% of the patients. RESULTS: There were no perioperative deaths. Four patients (4.7%) had an ipsilateral stroke within 30 days of operation. During the follow up 31 patients (36.5%) died. The leading cause of death was cardiac (54.8%) followed by cancer (16.1%). By life-table methods, the cumulative incidence of recurrent stroke at 9 years was 14% for strokes in the ipsilateral distribution, for an annual stroke risk of 1.6% per year. The cumulative incidence of stroke in other distributions was 5%, for an annual stroke risk of 2.1% per year for all strokes. When interval to operation, preoperative stroke severity, vascular risk factors, and neurologic symptoms were evaluated, no independent indicator of increased risk of recurrent postoperative stroke could be identified. CONCLUSION: These results demonstrate a marked improvement over the natural history and best medical therapy for these lesions as reoperated in the literature. We conclude that CEA is beneficial in preventing recurrent stroke in this group of patients and should be considered the appropriate management in this setting.

Adult↗
PubMed1987

[Nitrous oxide in combination anesthesia. Quantitative aspects of the effect of nitrous oxide].

UNLABELLED: Minimal Alveolar Concentration (MAC) defines the anesthetic potency of nitrous oxide (N2O) combined with an inhalational anesthetic only for the moment of skin incision. For the complete operation, the proportional action of N2O is unknown. This prospective, randomized study reports the mean intraoperative concentration (MIC) of halothane with and without 70% N2O in combination with premedication, i.v. induction, and muscle relaxation for the duration of operation. METHODS: Forty ASA I-II patients scheduled for hysterectomies gave informed consent. All patients received atropine 0.5 mg, promethazine and pethidine 1 mg/kg i.m. 30-45 min prior to anesthesia, i.v. induction with thiopental, and neuromuscular blockade with alcuronium at the beginning of the operation. Post-induction, patients received randomized halothane in 30% O2/70% N2 (group 1, n = 20) or in 30% O2/70% N2O (group 2, n = 20). In the course of this observation (before induction and up to 15 min after extubation), the following parameters were measured (Table 1): arterial pressure (AP), heart rate (HR), plasma concentrations of growth hormone, prolactin, and cortisol in central venous blood, esophageal temperature, "train-of-four" ratio, and expiratory CO2 concentration. MIC had been computed from the integral of end-expiratory halothane concentration during the course of the operation. RESULTS: Biometric data and concomitant conditions were equivalent within the two groups (Table 2). MIC halothane was 0.72 +/- 0.014 vol% in group 1 (O2/N2) and 0.52 +/- 0.01 vol% in group 2 (O2/N2O).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1986

[Survey on subjective symptoms in VDT workers: complaint rate and years of service].

A questionnaire survey was conducted on 271 workers of microelectronics company. The questionnaire included such items as age, years of service, working conditions and subjective symptoms related to visual, musculoskeletal and general status. The following results were obtained: Of these workers, approximately 80% operated visual display terminals (VDT). The years of service for most were less than 4 to 5 years with the average being about 2 years (Fig. 1). The working hours per day on the VDT for most of them was less than 90 min, although some workers operated VDT for 3 or more hours per day (Fig. 2). A high incidence of complaints of visual function, i.e. eye strain and blurring of distant objects, was observed. Some also complained of musculoskeletal and general symptoms (Table 1). The rates of these subjective symptoms increased with years of service (Figs. 4 and 5), while the complaint rates decreased with age (Fig. 3). Significant positive correlations were found between most of these complaint rates and length of service (Table 2), although correlations between the complaint rates and age were generally non-significant but negative. The complaints tended to increase with working hours per day, although the operators who worked for longer period per day did not seem to complain as much as those who did not work so long (Fig. 6). In conclusion, the results of this questionnaire suggest that the effects of visual display terminals (VDT) work accumulate gradually over months and years.

Adult↗
PubMedDate not supplied

[Modern principles of endonasal surgery on the lacrimal duct].

Intranasal operations on the lacrimal duct developed in 1910 by G. West are rarely used now. The author analyzes his experience gained in 5000 endonasal dacryocystorhinostomies (96.7% of which were effective) and the advantages of intranasal approach to the lacrimal duct and presents a working classification of dacryocystitis. Indications for endonasal surgery on the lacrimal duct and contraindications precluding it are defined and a table for selecting the appropriate intranasal intervention in cases with abnormal discharge of tears offered. The author emphasizes the efficacy of endonasal operations and advocates wide use of this method in dacryology.

Adolescent↗
PubMed1985

Radiofrequency electromagnetic leakage fields from plastic welding machines. Measurements and reducing measures.

Operators of unshielded plastic welding machines are often exposed to radiofrequency (RF) electromagnetic leakage fields that substantially exceed all present occupational standards. Measurements show that the Swedish ceiling values (SE = SH = 250 W/m2) in many cases are exceeded at distances up to 1 meter from the electrode. To reduce the stray fields to an acceptable level at the location of the operator, RF field suppression devices should be fitted to the machine. We have studied the strength and the extent of the RF leakage field under various operating conditions and also investigated different methods for reducing the leakage field. The following measurements have been performed: E- and H-field strengths as a function of distance from the electrode, and as a function of load/tuning; the time dependence of [E]2 for various combinations of tuning and welding times producing a welding seam with the same strength; isopower density curves for SE and SH = 250 W/m2 with different types of RF emission control devices fitted to the machine; the RF voltage between the electrode and the welding table and the RF voltage on the machine casing. By decreasing the RF power and increasing the welding time the field strengths at the location of the operator can be reduced to levels below the ceiling values. The RF voltage between the electrode and the welding table ranged from 800 V up to 2100 V for the different plastic material that was welded. The RF voltage on certain parts on the chassis could be as high as 200 V. In order to reduce these voltages and the stray fields the machine should be equipped with a "large capacitive shield" in cases where this is possible.

Electrodes↗
PubMed2005

[Plasma concentration of endothelin-1 after myocutaneous latissimus dorsi-transplantation -- role in reperfusion injury].

The success of a free flap transplantation is based on a sufficient microanastomosis which meets the following requirements: a pedicle placed without kinking or twisting, a good drainage, a well defined recipient vessel and integrity of the endothelium. The aim of this study was to determine whether operation-related ischaemia through flap transplantation and tourniquet induces an increase of Endothelin-1 plasma levels as one cause of vasospasm during microvascular procedures. We focused our attention in particular on the reperfusion period which is often limited to an irreversible perfusion failure of microcirculation due to free radicals, interleukin and Endothelin-1. Twenty-one patients with tissue injury of the lower leg were included in our study, fourteen underwent a latissimus dorsi muscle transplantation with a combined ischaemia, seven patients had a tourniquet ischaemia for tumour resection, debridement and local flap transfer. The duration of ischaemia varied due to the course of operation. The withdrawal of venous blood via central vein catheter, flap vein and wound bed followed a fixed time table pre- and post-reperfusion (T1: preoperative day via cubital vein, T2: 6th postoperative day, T3: 5 min, T4: 10 min, T5: 15 min, T6: 1 h post-declamping and after tourniquet ischaemia via central vein catheter and T7: within 5 min from the flap vein immediate after recharging the flap). The vessel anastomosis determined the withdrawal from the local wound bed. ET-1 in venous blood samples were measured with ELISA. The duration of ischaemia in the tourniquet group ranged from 22 min up to 210 min with a mean of 76.58 min and in the latissimus group from 87 min up to 203 min with a mean of 139.21 min. The mean ET-1 plasma concentration measured systemically before operation in the 21 patients was 0.51 +/- 0.08 pg/ml (Mean +/- SD). This result corresponds with data published in literature. The locally measured plasma levels of ET-1 after tourniquet and flap ischaemia were increased with 0.34 up to 3.90 pg/ml (0.95 +/- 0.79 pg/ml [Mean +/- SD]) for the tourniquet group and with 0.34 up to 14.87 pg/ml (1.85 +/- 3.64 pg/ml [Mean +/- SD]) for the latissimus group. This is an increase compared to systemically measured values as 0.75 +/- 0.06 pg/ml (Mean +/- SD) for the tourniquet group and 0.58 +/- 0.21 pg/ml (Mean +/- SD) for the latissimus group. We conclude that Endothelin-1 is increased locally in the early reperfusion period after free latissimus dorsi-transplantation.

Adult↗
PubMedDate not supplied

[Validation of the Short Cognitive Battery (B2C). Value in screening for Alzheimer's disease and depressive disorders in psychiatric practice].

UNLABELLED: Alzheimer's disease (AD) is a major healthcare challenge due to the increasing longevity of the population. Clinically prominent neuropsychological and neurological impairments, together with behavioral disorders characterize Alzheimer's disease (AD). In the past, behavioural and emotional disturbances received less attention than cognitive symptoms in studies of dementia. The association between cognitive and behavioural symptoms is complicated by the fact that such association could also occur with different patterns during depressive episode without dementia. Because Alzheimer's disease (AD) tends to be under diagnosed, there is an increasing need for accurate neuropsychological screening tools that are easy to administer by psychiatrists. The aim of the present study was to validate, in French, a sensitive and specific screening battery (B2C) designed to improve the discrimination between patients with AD, patients with depression, and healthy elderly subjects. POPULATION AND METHOD: The B2C was administered to 123 ambulatory subjects (mean age 76.4 2.3 years): divided in three groups of subjects. AD subjects were included (n=49) with a Mini-Mental Status Examination (MMSE) score of between 18 and 26, and a confirmed diagnosis (DSM IV) of mild to moderate AD. Subjects were not included if they were receiving treatment with an acetylcholinesterase inhibitor. The depressive group comprised elderly subjects (n=27) with at least two DSM IV criteria for a major depressive episode including the depressive mood criterion and a score of more than 17 on the Montgomery-Asberg Depression Rating Scale (MADRS). The healthy control group (n=47) comprised age-matched subjects with no neurological or psychiatric pathology. The B2C consists of four individual tasks derived from classical neuropsychological tests. Tasks were presented in the following order: temporal orientation test (knowledge of month, date, year, day of the week and time of day), 5 word test (task is originally derived from the Enhanced Cued Recall test), clock drawing test (In this widely used test, the subject had to draw a clock with all the numbers and then draw the clock hands at twenty minutes to four), and the semantic verbal fluency test (the subject was asked to generate as many words as possible from a given category in a fixed time period of 60 seconds). During the pre-study investigator meeting, the test procedure was adapted to ensure uniformity of practice in all centres. The B2C was administered one week to one month after the study inclusion date by a psychologist blinded to the patient groups and who had not participated in the subject's inclusion. Multivariate analysis was performed using a forced model of all four tests. Due to the nature of the dependent variable (AD vs controls and depressive vs control), the chosen discrimination model was a binary logistical regression model. Explanatory variables were limited to the variables of the test battery, and the dependent variable was the subject's status (AD, depressive or control). RESULTS: The mean results for each test are presented in Table II. The time taken to perform the tests was significantly higher (p=0.0001) for the AD group (11.2 minutes) when compared with both the control (7.6 minutes) and depressive group (8.2 minutes). In each of the four subtests, the AD subjects were significantly more impaired than the two other groups. Multivariate analysis was performed using a forced model of all four tests which provided correct classification of a high percentage of subjects (88.5%). The analysis followed a normal distribution and demonstrated that the AD patients were significantly impaired in all four tests of the B2C compared with controls. Depressive, elderly subjects were only impaired in verbal fluency. Multivariate analysis showed that, compared with controls, patients with mild AD were significantly impaired for all four tests. Response operating characteristics (ROC) analysis of the B2C showed: 93.8% sensitivity and 85% specificity for discriminating AD from control patients (table III), and 63% sensitivity and 96% specificity for discriminating AD from depressive patients (table IV). DISCUSSION: The main objective of this study was to demonstrate that the Short Cognitive Evaluation Battery developed in the French language is able to discriminate between patients suffering from AD and healthy elderly subjects. The results clearly demonstrate that AD patients were significantly impaired in all four tests of the B2C compared with the control group. The present study also supports the use of the screening battery for discriminating between AD and depressive subjects. The SCEB was less discriminatory for AD versus depressive patients than for AD versus controls. This could be due to the limited size of the depressive group. The verbal fluency test was the most sensitive for discriminating between AD and depression but this was at the expense of specificity. Other brief screening tests have already been developed in English speaking countries, In French language, the B2C appears to be a highly sensitive and specific tool for discriminating between patients with mild AD and healthy elderly individuals. Furthermore, in combination with clinical evaluation, the B2C could improve the specificity of the difficult discrimination between mild AD and depression. The next step of the validation process will include concurrent validity study and inclusion of a higher number of subjects with depressive symptoms.

Aged↗
PubMed2006

Patient's age and extent of coronal and root destruction predict root canal treatment subsequent to after a full-cast crown.

DESIGN: A case-control study was carried out at the University of North Carolina School of Dentistry in the US. PARTICIPANT SELECTION: Dental charts from the university's dental clinical were audited for patients who had a single-cast crown between 1 January 1998 and 31 December 2002. Cases were defined as individuals who underwent root canal treatment at some time after the insertion of a single-cast crown up to 1 July 2004. The control group consisted of people who did not have root canal treatment after the insertion of a full-cast crown. DATA ANALYSIS: A list of 24 clinical factors was compared between groups (Table 1). Multiple logistic regression analysis was used to determine which preoperative nonprocedural factors were predictive of root canal treatment subsequent to a full-cast crown. RESULTS: A total of 6612 single-cast crowns (cast metal or porcelain fused to metal) were inserted during the 5-year period of interest. Of these, 5743 crowns, identified from 3357 patients' records (ie, the study subjects), were determined not to have undergone root-canal treatment prior to full-cast crown restorative treatment. Ninety-two subjects were initially determined to be eligible cases; ninety-two subjects were also therefore randomly selected from the remaining 3265 subjects to make up the control group. Twenty-six of the cases and 21 members of the control group were excluded because of incomplete records. The final case and control groups comprised 66 and 71 subjects respectively. Only subjects' age at the time of restorative treatment and their post-cementation tooth sensitivity was statistically significantly different between the two groups (P<0.05). Multiple logistic regression determined the statistically significant (P<0.05 ) predictors of case status: these were a patient's age and also the subgroup to which they were allocated according to the extent of pre-operative coronal and root destruction, on the basis of the restorative core size (more than three restored surfaces; Table 2). CONCLUSION: The age of a patient and the extent of coronal and root destruction can be used to predict the future need for root canal treatment on teeth for which a single-cast crown is planned.

Journal Article↗
PubMedDate not supplied

[Surgical treatment of pulmonary metastases (author's transl)].

From April 1954 till February 1976, pulmonary resections for metastases of primary extrapulmonary malignancies have been done on 35 patients, 21 men and 14 women with average age of 49 years 7 months. In about half of the cases the lung opacities were discovered occasionally. Three patients have undergone a second thoracotomy for a recurrent metastasis. Of the 48 resected metastatic lesions, 31 were located in the right and 17 in the left lung. Thirty were on resection unilateral and solitary. There was no operative mortality and the postoperative morbidity was neglectable. The cumulative 3- and 5-years survival percentages as obtained by the life-table method were 44.6 and 31.2. Better survival rates were found in the age group of 0-40 years and in the group of the sarcomas. Worse results were obtained when the primary tumor was invasive or associated with regional metastases. Resection of metastatic lung lesions larger than 5 cm diameter and especially the resection of multiple lesions gave poorer results. The time-interval between the primary operation and the pulmonary resection had no clear prognostic value. The factors determinating the palliative character of the pulmonary resection had a negative influence on the survival. None of the 9 patients with pulmonary metastasis and secondary intrathoracic lymphatic metastases did survive longer than 3 years. All these patients had a primary carcinoma. Out of this study no conclusions can be made as to the extension of the pulmonary resection.

Adolescent↗
PubMed1992

[The special aspects in the planning and use of an electron linear accelerator facility for intraoperative radiotherapy (IORT)].

Limiting conditions for the planning of the installation of an electron linear accelerator in an operating theatre are described taking into account the radiotherapeutical and surgical requirements based on the example of the Essen facility for intraoperative radiotherapy (IORT) with electrons. Special features of the facility like a non-contact electron applicator system with television monitoring, table-top trolley, which is used also during irradiation, are explained in detail. Measured isodose curves for all tubes and all electron energies serve for the radiotherapist as criteria for decision on tube size and electron energy selection during surgical operation. The influence of misalignments of the tube on dose distributions is investigated. Limit values of alignment tolerances are deduced. Daily constancy tests for monitor calibration, electron energy, and tube alignment system are to be performed for quality assurance. Tables of the planned and realized treatments and of a representative time schedule of an IORT give a survey on the indications and the necessary time effort and staff. Completion of the set of tubes as well as optimization of the tube fixation accessory and of the table-top trolley are main subjects for future developments.

Anesthesiology↗
PubMed1996

Results of the surgical treatment for thoracic outlet syndrome.

Excellent and good results following different operations for TOS are close to 80%, using simple statistics, where results included many patients followed up for only a few months. Using life-table methods, the success rate is 6% to 9% less, close to 70%, at 5 years. The results were virtually identical for anterior and middle scalenectomy, transaxillary first rib resection, and combined supraclavicular scalenectomy and first rib resection. Secondary success, the results of reoperation on patients in whom the first operation failed, improved the results of the primary operation 15% and 17%, respectively, for transaxillary rib resection and anterior and middle scalenectomy. When the initial operation was combined rib resection and scalenectomy, fewer patients underwent reoperation, as only neurolysis could be performed, and the results improved only 3%. A significant variable in results was etiology: Work-related injuries versus non-work-related accidents, usually auto accidents. Results of three independent studies showed better success rates by 13% to 15%, in patients who had non-work-related auto accidents, as compared with work-related injuries.

Humans↗