Ulcus terebrans: an unusual cause of paraparesis.
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Basal Cell Carcinoma↗
Biomedical subjects
T Birbilis
Publications and source records attributed to T Birbilis.
A pair of clamps for a safe removing and repositioning of beta and gamma angular settings of Brown-Roberts-Wells stereotactic system during operation.
The Brown-Roberts-Wells arc system is a non-target-centered design, i.e., without an independent approach angle. The approach angle of this system strictly depends on precalculated values (entry and target point). Therefore, some components of the system used sometimes prevent a direct insight into the operation field. Once the entry point has been set, the arc system normally has to be taken off to permit an unimpeded approach to the burr hole. To facilitate rotation and return to the primary beta and gamma angular settings during stereotactic craniotomy and other surgery, a pair of clamps was designed for the BRW arc system. These clamps help the approach to the entry point in such a way that some components of the arc (e.g., the guide block holder) are removed from the surgical field, thus giving wide visual access for the stereotactic approach. Consequently, it is no longer necessary to remove the entire arc system, resulting in an increased operation safety and shorter operation times.
Equipment Design↗
Scalp marking for a craniotomy using a laser pointer during preoperative computed tomographic imaging: technical note.
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Brain↗
A new forceps for the safe and easier insertion of subdural catheter: technical note.
A new forceps suitable for the safe and easier insertion of a silicon catheter into the subdural space is described. The use of this new tool has two advantages: Firstly, the insertion of the silicon subdural catheter is parallel to the brain surface and secondly, the movement of the catheter's end in the subdural space is controlled with greater accuracy. Thus, the surgeon has the opportunity to direct the catheter to the right position avoiding penetration or injury of the brain.
Catheters, Indwelling↗
MiniMATCH: a simple method for local data transfer between MRI and CT scan sets.
A comparison of the spatial position of distinct locations within cranial MRI and CT scan sets can easily be done with a simple algorithm designed as a computer program. After determination of a basic system formed by the coordinates of anatomical landmarks in CT and MRI, arbitrary points can be identified on one scan set and transferred quantitatively to the other. Pros and cons of the method are discussed and opposed to the properties of specifically designed image processing systems.
Algorithms↗
Optimized evaluation of a pulsed 2.09 microns holmium:YAG laser impact on the rat brain and 3 D-histomorphometry of the collateral damage.
Since more than 20 years CO2 and Nd:YAG lasers are established in the microsurgery of the nervous system. CO2 lasers can be used handheld, but may be focused on the target area by mirror optics and sideports of the operating microscope's micromanipulator. Nd:YAG lasers have the disadvantage of deep penetration into the brain and provocation of a large collateral damage. The need is for a fibre conducted solid system for surgery in delicate areas as for brain stem surgery. Fibre conduction of near infrared lasers allows better exposure of the target area compared to hollow wave guides or mirror equipment. Fibres can be tapered and modified according to the purpose. The holmium:YAG (Ho:YAG) laser has acquired interest by introducing the system into microsurgery of parenchymal tissue. They have not been proven yet sufficiently for neurosurgical tasks. The effort to minimalize the collateral tissue damage has to be maximalized in the surgery of nervous tissue and functional low redundant brain stem or spinal cord tissue. Volumetric data may be more precise in comparison to depth and width data of the laser lesion even when the different levels of the tissue interaction have to be analyzed for estimation of the real side effects in nervous tissue. We have used 50-800 ml delivered Ho:YAG single pulses in cortical areas of Sprague-Dawley rats and investigated the different lesion zones by volumetric data. The functional lesion zone was detected and measured by immunohistological staining of the heat shock protein HSP 72. For further reduction of the focus area, we have used tapered 400 to 200 microns fibres.
Animals↗
Determination of the burr hole-site using the Brown-Roberts-Wells stereotactic system. A simple marking technique: technical note.
The authors describe a new tool-set with which the determination of the burr hole-site using the BRW-stereotactic system can be done on a non-sterile-washed head. The described attainment permits an increased security, not only reducing exposure of the operative field to a minimum but also shortening the operative length. The use of this tool-set for marking smaller superficial cortical processes is also possible.
Computer Simulation↗
Greek physicians' and dentists' compliance with the British society for antimicrobial chemotherapy (BSAC) guidelines for preventing bacterial endocarditis.
Two thousand questionnaires inquiring about applied prophylaxis for bacterial endocarditis were sent to practicing doctors in Greece. Two hundred and ninety-nine questionnaires were completed and returned (15% response rate) and were subsequently divided into two groups: Group A (163) consisting of responses from dentists, chest physicians and ear, nose and throat (ENT) specialists and group B (136) including responses from gastroenterologists, gynecologists, urologists and radiologists. The percentage of correct answers given in response by clinicians in Groups A and B to the main questions and in accordance with the 1992 guidelines of the British Society for Antimicrobial Chemotherapy (BSAC) were respectively: (a) 53% vs 35% asked patients their previous history pertaining to valve disease, rheumatic fever or prosthetic valve surgery; (b) 55% vs 33% administered prophylaxis to patients with relevant history prior to medical procedures; (c) 67% vs 0% of prescribing doctors administered the appropriate antibacterials; (d) 33% vs 31% initiated prophylaxis in proper timing prior to medical procedure; (e) 14% vs 13% administered antibiotics in correct time/route/duration of infusion where applicable, prior to medical procedure; (f) 7% of group A doctors administering recommended antibiotics, implemented prophylaxis with correct time/route/dosage while, although none of group B doctors administered recommended antibiotics, 7% implemented prophylaxis with correct time/route recommendations; (g) an overall 2% of doctors from both groups met the BSAC recommendations. In conclusion, it is imperative that the appropriate training of doctors in all subspecialties regarding prophylaxis of bacterial endocarditis and according to current recommendations be carried out.
Anti-Bacterial Agents↗
A preliminary report on the use of relon mesh in the repair of eventrations with large parietal defects. An experimental study in rats.
This experimental study in rats was designed to investigate the tolerability and the mode of healing when commercial relon mesh is used in the repair of large abdominal-wall defects. A defect was created to simulate anatomical derangement of the abdominal wall and a surgical correction was performed using relon mesh. The mesh was implanted intraperitoneally in 18 Wistar albino rats. The animals were killed under anaesthesia 4, 6, 8, 12, 15 or 30 days later and the intra-abdominal viscera were examined macroscopically for adhesions and other evidence of inflammatory reactions. Skin healing usually occurred within 7-8 days of surgery. Microscopic studies were used to confirm the gross findings and showed that maturation of granulation tissue, fibrocyte invasion with encapsulation of the mesh and the appearance of newly formed vessels occurred 2 weeks after surgery. Within 4 weeks a strong layer of connective tissue was present. The relon mesh was tolerated well. These results indicate that the use of relon mesh may provide a cheap alternative means of repairing large abdominal-wall defects.
Abdominal Muscles↗