[Benzodiazepine addition, our iatrogenic epidemic--157 cases of benzodiazepine dependence].
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Biomedical subjects
Publications and source records attributed to W Binder.
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A simple device for localisation of non-palpable lesions of the breast has been developed. It consists of two metal grids which facilitate mammographic fine needle puncture and preoperative marking of small lesions. The instrument is easy to handle and can be used at any mammographic unit without special adjustments.
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A critical analysis of the latest results in the treatment of epithelial ovarian carcinomas indicates significant progress. Postoperative radiotherapy using the moving-strip technique is the treatment of choice in stages I a (grade 2 and 3 lesions and/or tumour rupture), Ib, II and III (asymptomatic) with residual tumours less than 2 cm in size. In the stages Ic, IIc and III (symptomatic) with residual tumours larger than 2 cm, radiotherapy may be curative following successful initial combination chemotherapy. This combined modality treatment is being investigated in our department in a prospective trial. The importance of prognostically significant factors (completeness of operation, age, histology, histological grade and adequate treatment) is discussed. The moving-strip technique is described in particular with regard to its practical application as basis of the modern therapeutic regimen for ovarian cancer.
With regard to 16 cases of testicle tumors and Hodgkin disease which are well proved by X-ray diagnosis, the mono-axial and bisectorial pendulum movement over 100 degrees is submitted to a critical consideration. The authors resume that the big lymph nodes are not always covered in an optimal manner, however, the radiation exposure of the kidneys is often relatively high. The values of different alternative methods are discussed on the basis of computer isodoses relating to a constant phantom cross-section. In view of tumor covering as well as kidney and spinal marrow exposure, the most favourable dose distribution is reached by a mono-axial and bisectorial pendulum movement combined with a contralaterial irradiation method. This method seems to be specially suited for the routine therapy of lymphomas requiring an irradiation with 5,000 rd or more because of their bigness or their low radiosensitivity.
Modern techniques in brachyradiotherapy using moulds are described for various tumours of the head and neck. The ideal dose distribution can be calculated by the use of computers and practical examples are shown. The radiobiological and also economical advantages of this method of treatment are discussed.
Rhinoplasty is one of the most challenging surgical procedures. Surgeons should strive to obtain maximum aesthetic and functional results with minimal operative intervention. Excessive surgery often results in unwarranted impairment of nasal function. The obstructive or sensory complications of rhinoplasty can occur in the early or late postoperative periods. The most common functional sequelae of rhinoplasty, and their causes, prevention and therapy, are discussed.
The concept of the integral dose, being correlated with the system of immunity, has got an increased bearing on radiation therapy. Experimental determination of integral doses in a tissue-equivalent body-phantom by means of ferrosulfate dosimetry and potentiometric analysis is described. The results are discussed and compared considering X and Y irradiation techniques and different units for irradiation.
A comparison is made between five irradiation methods, the dose distribution and volume doses of which had been ascertained by means of two phantoms presupposed differently large. Of the two methods of small-angle pendulum irradiation, the bisectorial monaxial pendulum technique turns out to be a practicalbe alternative to fixed-field and rotation irradiations. Similarly to fixed-field irradiation with two opposed fields, to which, after all, this technique is superior in every respect, it makes possible a relatively simple spatial irradiation planning. In this regard it is also more favorable than the rotation irradiations, though they give security of a more homogeneous load to axially parallel focuses; but an oblique position of the focal axis can be compensated only by an extension of the target volume and consequently augmentation of the volume dose. The necessity of confining to a certain extent the sum of absorbed energy is accentuated.
The value of computerized radiotherapeutic planning is illustrated by the case report of a patient with an extensive pelvic wall metastasis of a carcinoma of the uterine cervix diagnosed by conventional methods. The exact topography is delineated by computer tomography and enables optimum dosimetric radiotherapeutic planning.
Profile correction of cosmetically deforming micrognathia in patients with functional occlusion may be attained by the foreshifting of multple horizontal oblique osteotomy segments of the anterior mandible. We discuss the development, limitations, advantages, preoperative evaluation, and surgical technique of this method.
The fundamental requirements of irradiation planning are discussed delimitating the minimum and maximum demands of planning. Different possibilities to represent the topographic relations within the irradiation plane of the patient's cross-section are described. The computer-assisted system for irradiation planning, installed at our hospital by means of MAT construction, is discussed. A pathway is shown which leads to individual treatment planning and considers dosimetrically the actual conditions of the patient who will undergo radiation therapy. The possibilities and limits of ultrasonic cross-sectional imaging are demonstrated.
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The use of bolus materials for a tissue-equivalent field compensation is discussed and the application of compensation filters for high-energic radiation is stressed. The properties of "Super Stuff", which is a collodial, tissue-equivalent bolus, are described and compared with those of other materials such as polystyrene, plexiglas and water. The universal possibilities of applying "Super Stuff" as field compensating material are demonstrated on a practical example in the field of the kV therapy.
A report is given on the utilization of computer tomography for the irradiation planning. Owing to international cooperation it was possible to use the obtained pictures as a basis for a computerized irradiation planning. The authors give some practical examples of optimized isodose plans for individual cases which have been elaborated by using the computer-tomographic cross-section pictures and the computerized system for irradiation planning and which give a good idea of the efficiency of the system.
In order to obtain a homogeneous distribution of the dose over extended fields in radiotherapy of Hodgkin's disease, for an exact dosage within the irradiated region it is necessary to consider the topography of the patient. The skin protective build-up effect due to the use of bolus materials would be lost with telecobalt irradiation, and therefore tissue compensating filters with a large surface are to be preferred. A simple method of making such filters by means of the moirétopography is described. The way to obtain a compensation filter for extended areas is demonstrated by an example showing how to construct it from lead plates correct in scale and layerwise.
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