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PubMed1991

[The struggle toward a unified Europe in the area of veterinary medical education].

The recent years have been conspicuous by an unusually dynamic arrangement of political, social and economic relations among all European countries. Scientific community of nations on our continent concerns also our discipline-veterinary medicine-giving numerous examples of common aims, beginning from the 1st Veterinary Congress in 1863, Hamburg. The present changes occurring in Europe give priority to individual scientific, professional and productive integration also in our veterinary science and practice. It must be said, too, that international exchange of goods stimulates not only their standardization as for production conditions and assessment methods, but also the level of consciousness and objective knowledge of the parties warranting the quality of the product. This concerns particularly the food products as for which the parties interested take into account the technical and sanitary norms concerning the products at all stages of their production. Hence the tendency to unification of veterinary studies in all Europe has been approved by all four facilities in Poland. Accession of our faculties to the European Association of Veterinary Medicine Faculties direct by Prof. TOMA, as well as of Czechoslovak and Hungarian faculties, is a clear example of these countries being ready to integration. Similarly, the resolutions of the Association concerning standardization of diplomas and professional specializations of veterinary surgeons in European Community would inspire the veterinary education centres to comparing and following unified organization and programmes of studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Veterinary↗

PubMed1991

[The founding of the Association of Pharmacists 1783 to 1784].

The Czech Association of Pharmacists was established as a state-constituted professional organization by the decree of the Czech Government dated 11 March 1784, the initiator of the decree being Josef Gottfried Mikan (1742-1818), the then Dean of the Faculty of Medicine and Professor of Botany and Chemistry at Charles University. His correspondence with the government between 10 February and 16 May 1784, preserved in the State Central Archives, Prague, clearly demonstrates Mikan's main contribution to the issue of the decree. In his letter of 10 February 1784, he asked the government to order the establishment of a compulsory nation-wide association of pharmacists. Their meetings were to be presided by dean of the faculty in order to prevent disorders which he did not specify and evaluate at all. The pharmacists of Prague were acquainted with the governmental decree of 23 February, 1784, at the Carolinum Hall on 6 March, 1784. The decree included Mikan's requirements and the introduction of tests for pharmacists' apprentices (tirones) prior to the journeyman's examination and compulsory registration of employed pharmacists (subjecti) at the Faculty of Medicine. These supplements to education were added by the government. The Prague pharmacist Ignác Broz, the owner of the Golden Bear pharmacy since 1763, was appointed chairman of the Association. The governmental decree of 11 March 1784, including the above-mentioned regulations, was sent to all districts of Bohemia. The emperor was informed about the decision of the government by a letter dated as late as 17 June 1784.(ABSTRACT TRUNCATED AT 250 WORDS)

Czechoslovakia↗

PubMed1991

[Biomechanics of the normal and prosthetic knee].

The knee joint is characterized by particular kinetics due to asymmetry of the femoral condyles and to angulation of the extensor system. During flexion, this results in a rolling/sliding movement in which the upper surface of the tibia recoils under the femoral condyles, combined with an automatic movement of medial rotation from extension towards flexion of the tibia beneath the femur. The articular contact areas are very small, ranging from 10 to 20 cm2 for the femorotibial articulation and barely reaching 4 cm2 for the femoropatellar articulation. These areas are subjected to extremely strong pressures amounting to 7 times the body weight in the femorotibial articulation during walking, and up to 1500 N (20 times the body weight) during simple flexion. However, the most fundamental element of biomechanics is the instability of the knee joint which is dependent on its menisco-ligamentous system. In addition, the menisci increase the femorotibial contact area, thereby relieving some of the pressure. The knee prosthesis concept is based on the stability of the prosthetic knee. In patients with healthy ligaments, non-strained prosthesis can be used, in which case part of the forces proceeds directly from one bone to the other via the ligaments, and there are only minimal stresses between the two prosthetic pieces and at the prosthesis/bone interface. But when the ligamentous system is defective or incomplete, or when the axial alignment is so upset that ligaments must be severed, one must use prostheses that are partly or totally constrained.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗

PubMed1991

[Experimental acupuncturology and its role in acupuncture education--suggestion offering the course of experimental acupuncture in acupuncture education].

Experimental Acupuncturology is a new subject which probes the channel and principle of acupuncture with the help of modern scientific technique and experimental method. In channel research, the basic responsibility of Experimental Acupuncturology is to expand the essence of the channel. For nearly half a century, the research has been concentrated mainly on the channel detection, the phenomena of channels and the relationship between channel-point and viscera, etc. In the research on the principle of acupuncture, Experimental Acupuncturology has accumulated a lot of information to prove that therapeutic effect of acupuncture is credible. The effect of acupuncture is influenced by many factors. Thus, it is also one of the basic tasks for Experimental Acupuncturology to programme the experimental procedure according to the principles of diagnosis and treatment based on an overall analysis of symptoms and signs, so that the best wiring scheme can be chosen out. Summarily, Experimental Acupuncturology has, at beast, three important significances in training modern specialists of acupuncture medicine. Firstly, it can make it possible for students to get deeper understanding on the thought of traditional acupuncture and realize the advantage of acupuncture, thus, encourage their faith on this medical means. Secondly, it can enrich the contents of acupuncture medicine and broaden the outlook of students, because it introduces modern science, technology and experimental method into traditional theory. Finally, it can train students' ability in scientific researches through strengthening the practicability of acupuncture. Therefore, its active significance in acupuncture education has been granted by acupuncture specialists in our country. Nowadays, more and more colleges of TCM has offered this subject which were welcome widely.(ABSTRACT TRUNCATED AT 250 WORDS)

Acupuncture Therapy↗

PubMed1991

[The mechanism of taste quality discrimination in rat pontine parabrachial nucleus].

1. Cross-correlation analysis was made in the taste-sensitive neuron pairs recorded simultaneously from the parabrachial nucleus (PBN) of rats. Three indices were adopted to evaluate the activities of the taste neurons: 1) the spike response density (RD value), which is the net spike density with the 4 basic tastes. 2) the frequency of correlated discharges (FC value), which was determined by measuring the area of the peak appearing in the cross-correlogram (CC) during application of the test fluids. 3) the weight of correlated discharge (WC = FC/RD), which shows the relative importance of correlated discharges in the taste signals delivered by a component neuron of a given pair. 2. In 11 of the 23 pairs, the CCs exhibited peaks during stimulation with tastants. These 11 pairs, which were recorded in the pontine taste area, were composed of 18 NaCl-best (most sensitive to NaCl) and 4 HCl-best neurons. In 8 pairs, the best-taste of both of the component neurons was NaCl, and it was HCl in 1 pair (homo-type pairs). The remaining two pairs consisted of an NaCl-best and an HCl best neuron (hetero-type pairs). 3. In 8 homo-type pairs (7 NaCl-best and 1 HCl-best pair), each pair exhibited the maximal FC value during stimulation with the best-taste of the component neurons (2.3 less than or equal to maximal FC less than or equal to 26.6 Hz). In the remaining three pairs, the maximal FC values were low (0.8-1.9 Hz). Two of these pairs were hetero-type, and, in their cases, the maximal FC value was obtains during stimulation with a tastant which was different from the best-taste of the component neurons. 4. The peaks in the CCs usually straddled the origin, and their highest point was located at the origin or very close to it. The width of the peaks appearing in the CCs was broad (3-8 ms) in 7 pairs and narrow (0.5-2 ms) in 4 pairs. In all of the broad-peak pairs, the best-taste of both of the component neurons was identical (homo-type), NaCl or HCl. In six broad-peak pairs peaks also appeared during the application of distilled water. In the narrow-peak pairs, two were of homo-type (NaCl-best) and their maximal FC value was obtained during NaCl stimulation. Their maximal FC value was higher than that of the other two narrow-peak pairs, which were hetero-type and exhibited no peaks during water application.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMedDate not supplied

[Modern approaches to urinary incontinence in women].

Joint embryonic development from the front part of the urogenital sinus caused anatomic, topographic and to some degree functional interdependence of the urogenital system. This is the reason they have the same supporting system that if weak or impaired causes changes in both systems. Concretely, descensus uteri accompanied with descensus vaginae causes lowering of the base of the bladder, its neck and urethra. Due to such topographic change, residual volumes of urine remain in lowered base of the bladder and because of disturbed respective angles between the bladder and urethra, responsible for the function of urination, there is incontinence during every physical activity. Hippocrates mentioned that phenomenon, but the scientific identification of etiology and therapy of this disease dates from the very beginning of this century. The diagnostics was the past medical history and genital examination. In 1940 scientific interpretation begun in the field of uro-gynecology, it made progress during the World War II in Sweden and USA and after the war, somewhere earlier and somewhere later in other parts of the world. In our country the rudiment was noted in 1935 in Zagreb where it had developed after the war. There are different types of urinary incontinence, absolute and relative, all of them can be easily differentiated today. Since incontinence during physical activity (relative, orthostatic, stress, static) is most frequently found and that its consequences are most difficult, the emphasis is given to that type of urinary incontinence. The sophisticated clinical tests, roentgenoscopic and ultrasound examinations, urodynamics, electromyography, neurologic tests, vaginotonography, studies of urine flow make possible to obtain precise differential diagnosis of all types of urinary incontinence.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1991

[Immunohistochemistry of the prostate and prostate carcinomas].

1. The immature multilayered epithelium of the prostate glands and ducts reacts positively throughout the fetal period up to puberty for the following antigens: Acid prostate phosphatase (PAP), the prostate-specific antigen (PSA), keratins demonstrated by the broadly reacting keratin antibody "AE1 + AE3", keratins from stratum corneum, the keratins 7, 8, 18 and 19, binding sites for the peanut agglutinin (PNA) and carcinoembryonic antigen (CEA). The expression of PAP and PSA varies and can in individual cases even be nonexistent. Alpha-1-antichymotrypsin (ACT) is not demonstrable until birth. It is found only focally in two thirds of the cases. The prostate stroma proves positive for vimentin as well as desmin. In the prostate glands, vimentin may occur focally. Squamous cell metaplasias in the fetal prostate show positive for all antikeratin antisera as well as PNA and CEA. The epithelium of the ejaculatory ducts and seminal vesicles proves positive for all keratins investigated. Vimentin as well as PNA-binding sites are found on a general basis. The urothelium of the prostate urethra also contains all keratins and, in addition, PNA and CEA. Endocrine cells, positive for serotonin, are sparse in the prostate glands, in the prostatic ducts and in the urothelium. 2. The onset of the androgen effect during puberty leads very probably to the morphological differentiation of the immature glandular epithelium into the two cell types, basal cell and secretory cylindric epithelium which differ with regard to their immunohistochemical behavior. The glands of benign nodular hyperplasia, including special forms, as well as epithelial alterations with nuclear atypia behave immunohistochemically exactly like normal prostate glands. The markers PAP, PSA, CEA, ACT, the keratins 8 and 18 and focally occurring vimentin are expressed exclusively in the secretory epithelium of the prostate glands and ducts, and not in the basal cells. In contrast, antisera against the following antigens stain only the basal cells and basal cell hyperplasia: Keratins from stratum corneum, a common epitope of the keratins 4, 5 and 6 (antibody KA1) and both the estrogen and progesterone receptor. Squamous cell metaplasias behave immunohistochemically like the basal cells. The keratins 7 and 19, desmoplakin, PNA as well as the patients' own blood group antigens are found in both the basal cells and the secretory epithelium. Keratin 7 and the blood group antigens are always only found focally. PNA-binding sites are secreted by the cylindric epithelium. Atrophic glands and the glands in postatrophic hyperplasia share immunohistochemical features with both the basal cells and the secretory epithelium.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗

PubMed1991

[Hygiene barriers in the hospital--psychological aspects].

This study was made necessary due to the great extent of hospital infections (720,000 cases) in the Federal Republic of Germany and the fact that the nosocomial infection is the most common infectious disease. Starting with a theoretical explanatory model of hygiene behaviour in clinics, 25 senior physicians, 38 assistant doctors, 31 members of the nursing staff and 20 members of the cleaning personnel and domestic staff in university clinics (surgery, orthopaedics, anaesthesia, gynaecology, paediatrics) were examined in a two-stage sociopsychological investigation. To be checked was the hypothesis that the quality and intensity of hygiene behaviour in clinics rises with the extent of personal hygiene sensitivity, knowledge about hygiene essentials, hygiene risks, causes of infection and possibilities of prophylaxis, exemplary and supervisory behaviour on the part of principals and staff in the clinic, as well as the absoluteness, succinctness, clinic-specificity and compulsoriness of rules of hygiene. General findings: (1) During training hygiene was a subject which did not arouse much interest; 57% admit big deficiencies in training; 60.4% of all those asked saw a big lack of information concerning basic knowledge of hospital hygiene, use of non-reusable materials, disinfection of endoscopes, laser probes etc., antibiotic therapy and strategy, development of resistant germs and their disinfection, ways and chains of infection, asepsis in the operating theatre, disposal of contaminated material, rules of hygiene in dealing with HIV-patients, sterilization of implants etc. (2) Doctors and nursing staff assume a relatively high incidence of hospital infections in their own clinic and in their wake an increase in psychological strain on the part of the patients, as well as higher costs in the health service. The most common hygiene deficiencies are lack of space and storage rooms, no separation of septic and aseptic patients, deficiencies in toilets and bathrooms, inadequate personal hygiene behaviour of staff, lack of protective clothing or no regular change of clothing, shortcomings in disinfection, incorrect use of syringes, stethoscopes, etc., no sterile dressings for wounds, no systematic hygiene control and no official consequences for wrong behaviour.(ABSTRACT TRUNCATED AT 400 WORDS)

Cross Infection↗

PubMed1990

[Experimental reconstruction of the trachea with free jejunal graft].

To evaluate experimentally the usefulness of the jejunum in the correction of extensive tracheal defect, circumferential tracheal defect was surgically created in 31 mongrel dogs and primarily reconstructed with microsurgical free tissue transfer of autogenous jejunal segment. A silicone T tube was inserted to maintain the lumen of the grafted jejunal segment. First, defect of 7 cervical tracheal rings was repaired with untreated 5 cm free jejunal segment in 12 dogs (group 1). Next, a pilot experiment to examine the quantity of intestinal juices from jejunal segments revealed that abrasion and cauterization of the mucosal surface decreased the secretion of intestinal juices, so defect of 7 cervical tracheal rings was repaired with 5 cm free jejunal segment the surface of whose mucosa was abraded and cauterized in 11 dogs (group 2). In all the dogs except two, primary healing was accomplished without air leakage or infection, and gross pathological examination of the trachea and graft revealed no evidence of disruption, infection or granulation. In group 1, 6 of the 12 dogs died of pneumonia or air way obstruction caused by intestinal juices from free jejunal segment within 20 days after the operation. On the other hand, only one of the 11 dogs died of pneumonia at 9 days in group 2. One of the dogs died of air way obstruction caused by mucus at 3 months. Three dogs died of filariasis at 4 weeks, 3 and 7 months, and 5 dogs were sacrificed at 2, 4, 8 weeks and 3 months. Microscopic examination of the graft demonstrated thin jejunal mucosa. The anastomosis was already covered with epithelium by the end of 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1990

[Progress in ophthalmology in the last 25 years].

UNLABELLED: In the last 25 years, ophthalmology has: 1. seen great changes, more in surgical and diagnostic aspects, less in pharmacology. SURGERY: General introduction of the operating microscope and improvements in microsurgial techniques; replacement of the opacified crystalline lens with a plastic intraocular implant; vitreal surgery for treating advanced diabetic vitreo-retinopathy and complicated retinal detachments; thermal, photodisruptive, and photoablative application of laser light for treatment of diabetic retinopathy, of glaucoma, and of post-cataract capsular membrane formation; improvements in keratoplasty; radiation therapy of choroidal malignant melanomas. DIAGNOSTICS: Fluorescein angiography, automated computer perimetry; echography; improved electro-physiological examinations; new imaging techniques [CT and NMR]. Medical treatment: Introduction of beta blockers in the treatment of glaucoma, virostatics for corneal herpes [Iodoxyuridine, Vidarabine, Trifluorthymidine, Acyclovir], Cyclosporine-A for keratoplasty--these are most of the landmarks. 2. witnessed a breakthrough in clinical therapeutical trials with controlled, randomized, multi-center studies, particularly in the USA to answer the question concerning the efficacy of therapy in disease entities having poor prognosis, e.g. of diabetic retinopathy or of senile macular degeneration. 3. experienced a change in its structure through an enormous increase in knowledge and in diagnostic and therapeutic possibilities with subspecialization in research and clinic, through an increase in the number of permanent and training positions in the clinics with a corresponding increase in privately practicing ophthalmologists, and through improvements in surgery, permitting drastically reduced hospitalization periods or even partial transfer of surgery from the clinic to the private practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Eye Diseases↗

PubMedDate not supplied

[The present status of treatment of splenic injuries in children].

Small but very dangerous risk of postsplenectomic sepses gave rise to the examination of surgical attitudes of medical treatment of damaged and ruptured spleen. Some new ideas of immunology revealed the importance of the spleen in the protection of the host and serious defect of immunologic system if the spleen is removed. According to those ideas, ruptured spleen is to be retained by all means. Some minor lesions and hemorrhages that are easily controlled by conservative measures, are not to be operated. In case of serious ruptures and massive hemorrhages necessitating more than 20 ml/kg of fresh blood to replace lost volume, penetrated abdominal injuries and with polytraumatic patients, laparotomy, surgical hemostasis and preservation of the spleen are indicated if possible. In the period of the last eight years, 90 children were treated because of the possibility they had injured spleen. Thirty-eight patients (42%) were under observation. Hemodynamic indicators were normal, so we did not make any aggressive diagnostic examinations. Other 47 patients had splenic scintigraphy, computed tomography (CT) of the abdomen or ultrasound examination. The findings were positive with 32 (69%) patients. Of those patients, 14 (44%) were immediately operated since serious rupture of the spleen was diagnosed and clinical signs suggested the presence of severe abdominal bleeding. To this number of operated patients, four polytraumatic patients and one suffering from penetrated injury are to be added. They were indicated the exploration of the abdomen without previous diagnostics. There were 19 surgical treatments of ruptured spleen; three of them included splenectomy while the other patients underwent splenic preservation.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

PubMed1989

[Morphological observation on 6th-week development of human kidneys and gonads].

The development of kidney and gonad of 3-6th-week human embryos were studied. Their positions at different developing stages were measured in terms of the sequence of neural ganglion according to Felix's method. The 9.5 mm embryo: Pronephrons are seen as 2 epithelial blind tubules on the right side and 1 on the left at the 6th cervical ganglion level. The lateral tubule on the right side and the left one are pronephric ducts, whereas the medial one on the right side is the pronephric tubule. The cranial ends of mesonephrons on both sides level at the 1st thoracic ganglia and run caudally to the 11th thoracic ganglia, their total number amount to 62. The mesonephric ducts on both sides firstly appear opposite to the 1st thoracic ganglia and open caudally into the cloaca. The metanephrons, the ureteric buds are unbranched yet and the metanephric mesoderm appears as clusters of cells on both sides. The gonads are indifferent. The 11 mm embryo: Pronephrons degenerated. The cranial ends of mesonephric tubules locate at the 3rd thoracic ganglia level on both sides and extend caudally to the level of the 11th ganglion in the right side and 12th in the left, their total number amounts to 65. Mesonephric ducts appear opposite to the 4th thoracic ganglia on both sides, running caudally, and open into the cloaca. Metanephrons, the ureteric buds give off 1st grade branches on both sides and metanephric mesoderm remain as clusters of cells. The gonads are indifferent. The 12 mm embryo: Pronephrons degenerated.(ABSTRACT TRUNCATED AT 250 WORDS)

Gonads↗

PubMed1989

[Light and electron microscopic studies on experimental oral precancerous lesions. Wounding and Trp-P-2 application].

The purpose of this study was to investigate histologically and ultrastructurally the changes of epithelial cells in the tongue which was wounded twice and treated with Trp-P-2 (3-amino-1-methyl-5H-pyrido [4,3-b] indole). Light Microscopy. Hamsters were divided into 10 groups (Groups A-J). In all 10 groups, the tip (2 mm) of the tongue was excised with scissors. In Groups A and F, the wound was painted trice weekly with DMSO (dimethyl sulfoxide) for 8 weeks. In Groups B, C, D, G, H and I, the wound was painted trice weekly with a 0.5% solution of Trp-P-2 in DMSO for 8 weeks. In Groups E and J, the wound was not treated for 8 weeks. At the end of 8 weeks, in Groups A, B, C, D and E, the tip of the tongue was again excised, while in Groups F, G, H, I and J, the tip was not excised. In Groups A, C, F and H, the tongue was painted daily with DMSO until the animals were killed. In Groups B and G, the animals received no treatment until they were killed. In Groups D, E, I and J, the tongue was painted daily with Trp-P-2 until the animals were killed. Animals of all groups were killed at 11 and 15 days after the second excision or after the end of 8 weeks. The tongue was examined histologically. Electron Microscopy. In Groups a, c and d, the animals received the same treatment as those of Groups A, C and D, respectively. The animals were killed at 15 days after the second excision. The tongue was examined ultrastructurally. 1. Light Microscopic Observation. 1) In Group A, at 11 and 15 days, the tongue showed only hyperkeratosis. 2) In Group B, at 11 and 15 days, the tongue showed the changes of the mild epithelial dysplasia. 3) In Groups C and D, at 11 and 15 days, the tongue showed the changes of the marked epithelial dysplasia. These changes were disorientation of cells, cellular and nuclear pleomorphisms, nuclear hyperchromatism, increased number of mitotic figures, abnormal keratinization and elongation of epithelial projection. 4) In Group E, at 11 and 15 days, the tongue showed the changes of the mild epithelial dysplasia. 5) In Groups F, G, H, I and J, the tongue showed only hyperkeratosis. 2. Electron Microscopic Observation. 1) In Group a, the cells in the basal cell layer were round or ovoid in shape with large centrally-located nuclei.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1989

[Fechner's paradox, a binocular vision test].

Fechner's paradox is a visual phenomenon which may be summarized as follows: a subject looks at an illuminated screen in binocular vision; one of the eyes is provided with a photometric neutral filter (density 1,3), the other eye remaining uncovered. When the uncovered eye is covered by means of a cover-test, the apparent luminosity of the viewing screen seems to decrease; but when the eye with the filter is covered by the cover-test, the apparent luminosity of the screen seems to increase: this fact is apparently paradoxical, since a part of the luminous stimulus of the eyes was suppressed: this is Fechner's paradox. The exact mechanism of this phenomenon is not yet clear; nevertheless, it is a primordial phenomenon of binocular vision, is easy to use in clinical strabological practice. Our present study was an application of Fechner's paradox in 119 strabismic subjects, 5 kinds of responses were obtained: 2 normal kinds of responses: Fechner's paradox symmetrical (41 subjects) or asymmetrical (29 subjects), i.e. 60% normal responses; and 3 kinds of pathological responses: mononuclear abolition (34 subjects), binocular abolition (10 subjects) and inversion of Fechner's paradox (5 subjects). The comparison between these responses and the clinical features was as follows: 1) Fechner's paradox was normal in 78% of subjects when the difference between the visual acuities of the two eyes was below 5/10, i.e. without true ambylopia; Fechner's paradox was abnormal in 74% of subjects when the difference was greater than 5/10; unilateral abolition of Fechner's paradox was not clearly related to the differences in visual acuity, but bilateral abolition and inversion of the phenomenon was related to ambylopia of one eye.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1989

[Digital radiography: fundamentals and future potentials].

Digital radiography consists of four major steps which include X-ray detection, digitization, image processing and display. Important parameters in digitization process is the pixel size and the number of grey levels which affect the quality of digitized images. A number of digital radiographic systems have been or are being developed which include the point-beam, line-beam, slot-beam and multiple slit-beam systems as well as conventional wide-beam systems such as image intensifier-TV system, storage phosphor system and film-based system. Important physical properties of digital radiographic systems are the sensitivity, resolution, noise, system response, scatter rejection, contrast sensitivity and image acquisition time. The resolution property is affected by the pixel size, sampling distance, display pixel size, image processing, detector response and X-ray beam characteristics. From ROC studies on chest images, the pixel size of approximately 0.2 mm and the corresponding image matrix of about 2,000 x 2,000 is considered optimal choice of these parameters. Future potentials of digital radiography are likely to be in the areas of computer-aided diagnosis (CAD) and PACS. Preliminary results obtained from recent studies on quantitative analysis of digital radiographic images are promising. The rms variation and the first moment of the texture of abnormal lungs with various interstitial diseases were clearly different from those of normal lungs. Automated detection scheme of nodules in chest images indicated approximately 70% true positive rates and a few false positives in each lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1989

[Hemostatic requirements for the performance of regional anesthesia. Workshop on hemostatic problems in regional anesthesia].

There is uncertainty as to which preoperative examinations are necessary before performing regional anesthesia. Therefore an interdisciplinary consensus conference was established to obtain recommendations on some of the open questions related to this topic. Preoperative laboratory examinations are not necessary prior to peripheral nerve blocks near large vessels if these are easy to compress. In patients on anticoagulant therapy direct puncture of the vessel should be avoided. Prior to spinal or epidural anesthesia, no preoperative laboratory examinations are necessary if no anamnestic or clinical evidence of coagulation disorders exists. Otherwise the following examinations are useful: clotting time, prothrombin time, partial thromboplastin time (PTT), and thrombocyte count. Low-dose heparin prophylaxis is no contraindication to spinal or epidural anesthesia. However, in patients at increased risk of bleeding or with low body weight, PTT and thrombocyte count are necessary. Since at present no definite data exist as to the bleeding risk in patients treated with low-molecular-weight heparin prophylaxis, spinal/epidural anesthesia should be performed in controlled studies only under these conditions. This particular precaution seems to be necessary because low-molecular-weight heparin increases levels of plasminogen activators (t-PA) and therefore has fibrinolytic activity. If plasma expanders are administered perioperatively, the highest bleeding risk exists after dextran infusions. There is also an increased bleeding risk if nonsteroidal anti-inflammatory drugs, especially acetylsalicylic acid, are administered repeatedly within 5 days prior to spinal/epidural anesthesia. In these patients preoperative determination of the clotting time appears necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Conduction↗

PubMed1989

[Management of patients with varicose veins presenting with a history of deep venous thrombosis].

The notion of a history of deep venous thrombosis in patients with varicose veins has often been at the origin of a contemplative attitude toward this pathology. What used to be an act of vigilance has now become plain negligence, if not a therapeutic error. Indeed, the difficulty in diagnosing an acute episode explains the many false positive results obtained; moreover, the variability of the evolution of true venous thrombosis should no longer cause one to adopt a monolithic attitude. In this indication, noninvasive investigating procedures allow distinguishing quite different situations occurring in these patients. In a substantial number of cases, no deep vein circulatory abnormality can be found. Treatment should address primary varicose veins. For those patients with deep venous thrombosis sequelae, such studies allow us to differentiate between occlusion/restriction states from devalvulation, and to detect the precise location of such sequelae, as well as their impact on circulatory function. When occlusion is found, varicose veins, which may be supplementary veins, are left untouched. When devalvulation occurs as an isolated phenomenon, superficial vein insufficiency is of primary importance. Treatment is the more complete that deep reflux will promote relapse through all existing leakage points. If, regardless of this treatment, deep reflux causes significant disturbances, surgical revalvulation should be recommended. More complex cases combining persisting occlusion with devalvulation call for a graded attitude. Noninvasive investigating procedures coupled with phlebography allow us to assess the part played by the various anomalies in causing the disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1987

[The lipid profile in 1987. Where to start and where to end?].

In 1987, the lipid work-up forms now an integral part of a rational policy of prevention of often dramatic and unfortunately often fatal clinical accidents of atherosclerosis, especially coronary atherosclerosis coronary atherosclerosis where an extremely high mortality, around 60,000 par year, requires that all prevention efforts be mobilized, as everything seems to indicate that it will be quickly rewarding and will substantially reduce this main scourge of mortality and morbidity in this country. It is desirable that every french person, in a relatively near future, with the new simplified techniques of cholesterol and triglycerides controls, be aware of his/her cholesterol level when prevention is effective: i.e. at a relatively early age, if possible around the age of 30, before the warnings of common atherosclerosis in the fifth or sixth decade. If the lipid work-up is normal, limited in a known patient without any personal or familial risk factor, to a simple dosage of fasting blood cholesterol and triglycerides, and costing merely 45 French Francs, it is not necessary to repeat that test in these patients, except every 5 years approximately. The cost to the national community is extremely low. On the contrary, in all cases where the first dosage indicate abnormalities, or are found in a family with major cardio-vascular risk in several of its members, or in case of familial hyperlipidemia, this work-up must be improved, associated with the dosage of HDL cholesterol by the precipitation technique enabling to recover the computed dosage of LWDL cholesterol, and the dosage of apoprotein B, currently rather well standardized and if possible, in the near future, the dosage of apoprotein Al.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗