Biomedical subjects
Publications and source records attributed to A Hemprich.
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An 8-year-old boy was admitted with a pain-full swelling at the right mandible and symptoms of septicemia. The illness was caused by a dental infection due to Streptococcus constellatus proved by isolation from blood culture, the origin was a decayed tooth. Treatment comprised suitable antibiotics, extraction of the tooth and local irrigations with chlorhexidine solution. General condition improved rapidly, the local situation rather slowly, however.
In the treatment of adenoid cystic carcinomas, certain situations such as inoperable tumors, macroscopic tumor residues following surgery and recurrences occurring with the previous therapeutic strategies (surgery and/or photon radiotherapy) are afflicted with frequent local recurrences. In these situations the use of radiotherapy with fast neutrons (densely ionizing radiation with high energy transfer) results in absence of recurrences in approx. 70% of the cases, according to data in the literature. The advantage of using neutrons lies in their greater biological effect on slowly growing tumors. In the Hospital for Radiotherapy of the Münster University neutron therapy has been applied since 1986 for these indications using a DT neutron generator (14 MeV). Based on the results obtained in the treatment of 8 patients and a review of the literature, indications for, treatment planning and implementing of neutron therapy is illustrated. Particular consideration is given to CT and MRT. Neutron therapy offers an alternative to previously existing treatment methods for locally advanced adenoid cystic carcinomas or highly differentiated malignomas of the salivary glands. Its effectiveness should be verified by studies involving larger numbers of patients and longer observation periods.
History taking and careful clinical examination reveal alcohol addiction in a great number of the patients with tumors of the lips, oral cavity and oral pharynx. Alcohol, as a cocancerogenic, is not only an important factor in the development of tumors of the upper digestive tube and the respiratory tract, but, as a habit-forming agent, may also present considerable problems for the affected patients. Hence the treatment plan was extended to include additional psychological aspects of the management of the disease and the problems of addiction. The psychological objectives are described and first results of this extended treatment concept are reported.
In 1984 a first diagnosis and treatment code was developed for the computer documentation of patient data at the clinical department for oral and maxillofacial surgery of the Münster University Hospital. After a long time of testing and improving in day-by-day practical use, it today includes a total of 126 diagnoses and 169 forms of treatment. When in 1986 the Federal Ordinance for Hospitalization Cost Rates came into power, this documentation system had to be re-coded to comply with ICD 9 and, at the same time, a documentation sheet had to be developed that would meet both the necessary scientific standards and the given administrative criteria. In this paper a documentation sheet is presented that fulfills both requirements and, by virtue of its simplicity, avoids almost any loss of data.
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