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PubMed2000

An impressive therapeutic result of class III compression stockings in a patient with longstanding, extensive, combined leg ulcers.

BACKGROUND: Only a few publications are available in the literature concerning the treatment of venous leg ulcers by means of medical compression stockings. SUBJECT: A 59-year-old female patient with longstanding, extensive bilateral leg ulcers due to venous insufficiency, arteriolosclerosis and secondary lymphoedema, was treated successfully by flat-knitted medical compression stockings of compression-class III. CONCLUSION: The great advantage of this treatment is the fact that it is comfortable and easy to carry out at home. Furthermore, the costs of compression therapy with medical compression stockings are only a fraction of those of conventional therapy by means of compressive non-elastic bandages. Once or twice weekly visits of the patient to the hospital are not necessary and less specialized dermatological nurses are needed.

Bandages↗

PubMed2001

Injuries to the posterolateral aspect of the knee accompanied by compression fracture of the anterior part of the medial tibial plateau.

We present 12 cases of patients with injury to the posterolateral aspect of the knee accompanied by a compression fracture of the anterior part of the medial tibial plateau. There were 11 male patients and 1 female patient with an average age of 26 years (range, 17 to 44 years). There were 4 cases of posterolateral rotatory instability and 8 cases of straight lateral instability of the knee. The size of the compression fracture was classified into 2 types, small (8 cases) and large (4 cases). Although the mechanism of injury was considered to be hyperextension and varus force, the pattern of cruciate ligament injuries varied from case to case. The following 3 questions should be considered to determine which cruciate ligament is damaged: (1) Was the ipsilateral foot fixed to the ground? (2) Was forward inertia involved? (3) Was there a direct blow to the anteromedial aspect of the tibia or to the femur? Accompanied fractures of the medial tibial plateau were considered to have been compressed by the medial femoral condyle. The size of the accompanying compression fracture varied; 7 of 8 cases with a small-type fracture had posterior cruciate ligament injuries and 3 of 4 cases with a large-type fracture had anterior cruciate ligament injuries. The size of the fracture is determined by which point of the medial tibial plateau touched the medial femoral condyle. We propose that a compression fracture of the anterior part of the medial tibial plateau indicates a coexistent posterolateral aspect injury, and that especially a small compression fracture strongly suggests an accompanying posterior cruciate ligament injury, as well.

Adolescent↗

PubMed2000

Vascular tracheobronchial compression syndromes-- experience in surgical treatment and literature review.

Between January 1988 and December 1997 a total of 22 patients (age: 8 days-46 years) were operated for vascular airway compression syndromes with respiratory insufficiency. Vascular anomalies in tracheal compression were double aortic arch in 7 patients, (2 previously operated elsewhere), right aortic arch + left ligamentum arteriosum in 1, and pulmonary artery sling in 3. Three of these patients had secondary long-segment tracheomalacia. Compression of trachea and a main bronchus existed in 2 patients with right aortic arch + left ligamentum. Isolated main bronchus obstruction was present in 9 patients (abnormal insertion of ligamentum arteriosum in 1, status post (s.p.) previous operation for PDA in 4, s. p. surgery for coarctation in 1, right aortic arch + left ligamentum arteriosum in 2, and right lung aplasia + left ligamentum in 1). 3 of these cases had secondary long-segment bronchomalacia. All patients had a complex respiratory anamnesis [long-term intubation in 7, s.p. tracheostomy in 2 (over 3 months - 3 years), and progressive respiratory insufficiency in 13). In tracheal compression, surgical correction included transsection of the underlying ring or sling components (with additional anterior aortic arch translocation in 5 patients resection-reimplantation of left pulmonary artery in 3, segmental tracheal resection in 1, and external tracheal suspension in 2). In the 2 cases with compression of the trachea and a main bronchus, aortic "extension" by a prosthetic tube was necessary. In isolated main bronchus obstruction, surgical decompression basically consisted of transsection of the ligamentum arteriosum or resection of its scarry remnant forming the "corner point" of a compression between aorta and pulmonary artery. In 3 patients with secondary long-segment malacia, additional external bronchus suspension was performed. Effective decompression and re-expansion of the airway segment concerned was achieved, and was demonstrated by intraoperative endoscopy in all patients. There were 3 postoperative deaths (sepsis 2; massive, irreversible edema of the tracheal mucosa 1). Of the 19 surviving patients 16 could be extubated between the 1st and 17th (mean = 7.5) postoperative day. In 1 case the preoperative long-term tracheostomy had to be left in place for inoperable additional laryngeal stricture. 2 patients had to be reoperated (segmental cervical tracheal resection after 5 months for primary long-term intubation-related subglottic stenosis in 1, esophageal decompression for residual dysphagia after 57 months related to a traction phenomenon at the right descending aorta in the other), both with gratifying results. In all other patients clinical, endoscopic, and radiographic examinations (follow-up = 2 months - 6 years) demonstrate good results.

Adolescent↗

PubMed1994

[Randomized use of an active compression-decompression technique within the scope of preclinical resuscitation].

INTRODUCTION: Despite its worldwide propagation, external chest compression is of limited efficacy. Recently a new method of cardiac resuscitation, active compression-decompression (ACD), was presented. In animals and a small series of patients resuscitated within the hospital ACD proved to augment blood flow during cardiac resuscitation as a result of greater intrathoracic pressure gradients. AIM OF THE STUDY: We investigated whether ACD does provide superior survival in patients suffering from out-of-hospital cardiac arrest. METHODS: Doctors and paramedics of the mobile intensive care unit at Mannheim University Hospital were trained in the new method. 56 patients were randomly assigned to either standard chest compression according to recommendations of the American Heart Association, AHA (Group I, 30 patients) or to ACD (Group II, 26 patients). ACD was performed by use of a hand-held suction device (CardioPump, Ambu Int.). Compression (30-50 kp) and decompression (10-15 kp) were alternately applied to the patients' chest with a frequency of 80/min. Duration of compression was 50% of the cycle. In both groups advanced life support was performed according to AHA standards. RESULTS: In Group I, 40% of the patients could be resuscitated; and 13.3% were discharged from hospital. In Group II, 38.5% of the patients regained spontaneous circulation, and 11.5% of the patients were discharged. (Group I vs. Group II: n.s.). One patient in each group survived with a severe neurological deficit. ACD caused greater physical efforts than standard chest compression. Furthermore ACD was difficult to perform in patients with ventricular fibrillation once electrode gel had been used. ACD was not feasible in five patients because of large breast (four women) and kyphoscoliosis (one patient). The rate of serious complications was lower in Group II. CONCLUSIONS: Methods to verify the efficacy of ACD in dummy training should be developed. Paramedics performing ACD should relieve each other every 5 minutes. In patients resuscitated by ACD self-adhesive defibrillation paddles instead of electrode gel should be used. Modifications in the design of the CardioPump are desirable to enhance the efficacy of ACD. With regard to future multicentre trials all paramedics should be skilled in the new technique to reach more patients in a shorter period of time.

Adult↗

PubMed2004

Monte Carlo simulations on the effect of substrate geometry on adsorption and compression.

Canonical Monte Carlo simulations were used to study the adsorption and compression of fluid layers on model substrates with cubic, (111) fcc, and graphite geometries. The effect of the relative size of the fluid and substrate molecules on adsorption was considered for strong molecule-surface interactions. In the case of monolayer formation, it was found that the surface geometry and the size of the adsorbate molecules had a significant effect on the structure of the adsorbed layer. These structures varied from well-ordered, commensurate layers to liquid-like structures. Lateral compression was observed for certain fluid to substrate molecule sizes. For the interactions studied in this work, it was found that maximum lateral compression occurred on the cubic surface when adsorbate molecules had a diameter approximately 15% larger than the substrate diameter. In the case of multilayer formation, it was found that second and higher adsorbed layers could compress into the adsorbed layers below them. For cubic substrates, the interlayer compression was predicted analytically with reasonable accuracy, with maximum interlayer compression found for fluid diameters approximately 90% the size of substrate molecule diameters.

Journal Article↗

PubMed2005

Evidence of PVT anomaly boundaries of water at high pressure from compression and NaCl.2H2O dehydration experiments.

Isothermal compression experiments on water have been performed between 0 to 80 degrees C and up to 1.3 GPa pressure. The compressibilities derived from the water compression experiments reveal a nonsmooth PVT behavior forming two anomaly boundaries. These boundaries originate at the melting line of ice III at about 0.25 GPa/-20 degrees C, and of ice VI at about 0.8 GPa/13 degrees C. Both boundaries have a positive sloped course separating three areas of different PVT properties of water. However, this P-T topology is obscured by an unresolved complication in the temperature range of 40-60 degrees C, which allows different topological interpretations of the data. As a cross-check for the compression experiment the dehydration boundary of sodium chloride-dihydrate (NaCl.2H2O) has been determined up to 1.5 GPa. The dehydration curve of NaCl.2H2O which traverses the two anomaly boundaries shows two inflections at the intersection, at 0.27 GPa/12 degrees C and at 0.77 GPa/22 degrees C, respectively. While the isothermal compressibility curves as well as the dP/dT course of the two anomaly boundaries give evidence of two densifications of water, the slope analysis of the inflections of the NaCl-2H2O dehydration curve suggests that the entropy change plays an important role. A recent model of water at high pressure conditions proposes a gradual structural transition from a low density water (LDW) at low pressures to a high density water (HDW) at high pressures. The compression data as well as the inflections of the dehydration boundary indicate, however, two discrete structural changes of water. Data comparison with that model suggests that the anomaly boundary at lower pressure corresponds to a volume fraction [V(HDW)/(V(LDW)+V(HDW))] of 0.8, while the upper one approaches a volume fraction of 1.

Journal Article↗

PubMed2001

Operator-induced compressive axial forces during implant gold screw fastening.

STATEMENT OF PROBLEM: The gold screw of an implant is put under tension during fastening. An increase in operator-induced compressive axial force during fastening may diminish screw tension, lower the friction between the screw threads, and allow for increased tightening torque. PURPOSE: This study was undertaken to assess and compare the compressive axial forces and torques placed simultaneously on implant gold screws by persons with varying degrees of expertise. MATERIAL AND METHODS: A calibrated electric torque driver was used to fasten implant gold screws. Three groups of operators with various levels of implant experience (faculty [F; n = 4], prosthodontic residents [R; n = 4], and undergraduate dental students [S; n = 6]) were asked to repeatedly tighten and loosen a new gold abutment screw into a standard 3.75-mm diameter Branemark abutment. Compressive axial forces during torquing were assessed over the tightening time by means of a miniature load cell adapted to the electric torque driver. Each operator repeated the experiment 3 times after calibration. Within operator and between operator reliability were evaluated. RESULTS: Loosening compressive axial forces were always higher than tightening compressive axial forces, and peak torque was less on loosening than tightening. Faculty placed a smaller range of forces on the screws (mean = 3.29 N, SD +/- 1.45 N) than did the residents (mean = 2.74 N, SD +/- 1.96) or the students (mean = 3.01 N, SD +/- 2.54). CONCLUSION: The clinical experience of operators seems to influence their application of compressive axial force during gold screw tightening. Less torque during unfastening of gold screws seems to be related to increased axial loading.

Analysis of Variance↗

PubMed2000

Prevention of venous ulceration by use of compression after deep vein thrombosis.

Venous ulcers may result from damage to the lining of the veins after an occurrence of deep vein thrombosis (DVT). As the pressure in the damaged venous system remains pathologically high, a result of DVT, swelling develops, hemosiderin staining develops around the ankle area, and varicosities often develop. These symptoms are part of the postphlebitic syndrome and are a precursor to formation of the chronic venous ulcer. The mainstay of treatment or prevention for venous ulcers remains compression therapy. In spite of the evidence that compression is necessary to reduce edema and allow the ulcer to heal, many patients still are not using compression after DVT to prevent ulcer formation. This article describes the prevalence, cost, etiology, and pathophysiology of postphlebitic syndrome and presents the nursing intervention of compression therapy as an ulcer prevention strategy for the patient with DVT. A variety of compression strategies are discussed. A case study of a patient in need of compression therapy is presented.

Bandages↗

PubMed2004

Mechanical compression of cartilage explants induces multiple time-dependent gene expression patterns and involves intracellular calcium and cyclic AMP.

Chondrocytes are influenced by mechanical forces to remodel cartilage extracellular matrix. Previous studies have demonstrated the effects of mechanical forces on changes in biosynthesis and mRNA levels of particular extracellular matrix molecules, and have identified certain signaling pathways that may be involved. However, the broad extent and kinetics of mechano-regulation of gene transcription has not been studied in depth. We applied static compressive strains to bovine cartilage explants for periods between 1 and 24 h and measured the response of 28 genes using real time PCR. Compression time courses were also performed in the presence of an intracellular calcium chelator or an inhibitor of cyclic AMP-activated protein kinase A. Cluster analysis of the data revealed four main expression patterns: two groups containing either transiently up-regulated or duration-enhanced expression profiles could each be subdivided into genes that did or did not require intracellular calcium release and cyclic AMP-activated protein kinase A for their mechano-regulation. Transcription levels for aggrecan, type II collagen, and link protein were up-regulated approximately 2-3-fold during the first 8 h of 50% compression and subsequently down-regulated to levels below that of free-swelling controls by 24 h. Transcription levels of matrix metalloproteinases-3, -9, and -13, aggrecanase-1, and the matrix protease regulator cyclooxygenase-2 increased with the duration of 50% compression 2-16-fold by 24 h. Thus, transcription of proteins involved in matrix remodeling and catabolism dominated over anabolic matrix proteins as the duration of static compression increased. Immediate early genes c-fos and c-jun were dramatically up-regulated 6-30-fold, respectively, during the first 8 h of 50% compression and remained up-regulated after 24 h.

ADAM Proteins↗

PubMed1996

A simple polynomial that predicts low-back compression during complex 3-D tasks.

While most existing models that predict loads on the low back for occupational risk analysis are restricted to assessing moments in the sagittal plan, a few have the ability to determine spine compression from three-dimensional (3-D) loading. The objective of this work was to find a method to estimate low-back compression forces during 3-D loading tasks from a model that contains as much biological content validity as the authors could incorporate, such as the effects of muscle co-contraction, but was simple enough to be implemented into a model appropriate for industrial use. The problem that had to be solved was how to represent the anatomical reality that a given muscle force vector contributes simultaneously to all three moments, flexion or extension, lateral bend and axial twist. Simply summing the compression components of independent equivalent muscles in each plane unrealistically assumes that muscles are uncoupled (i.e. each one works independently to support only one moment). In this study, loads in the various tissues of the low back that resulted from the simultaneous generation of moments about the three orthopaedic axes during 3-D tasks were estimated by an anatomically detailed 90 muscle model. A four-dimensional regression equation was developed to predict low-back compression from the three moments generated about the three axes (R2 = 0.94). Comparison of compression estimates from an uncoupled model showed that accounting for muscle coupling reduces compression by 22% on average. The predictive equation is presented to simplify analysis of complex 3-D industrial tasks for those who would like to incorporate it into their own models that produce moments of force in three plans of the L4/L5 level of the lumbar spine.

Adult↗

PubMed2001

Effects of slow- and fast-acting compression on the detection of gaps in narrow bands of noise.

The inherent amplitude fluctuations in narrow bands of noise may limit the ability to detect gaps in the noise; 'dips' in the noise may be confused with the gap to be detected. For people with cochlear hearing loss, loudness recruitment may effectively magnify the fluctuations and this could partly account for the reduced ability to detect gaps in noise bands that is usually found for such people. Previously, we tested these ideas by processing the envelopes of noise bands to alter the amount of envelope fluctuation. We showed that instantaneous compression, implemented via processing of the Hilbert envelope, led to smaller (that is, better) gap detection thresholds for subjects with cochlear hearing loss. In the present experiment, we determined whether fast-acting compression of the type sometimes used in hearing aids could also lead to improved gap detection. A behind-the-ear (BTE) digital hearing aid was programmed to implement multi-band compression, either fast-acting or slow-acting (control condition). A reference condition using unaided listening was also used. Stimuli were delivered via an earphone placed over the hearing aid. Overall stimulus levels at the output of the hearing aid were similar across conditions. Thresholds for detecting gaps in noise bands centred at 4 kHz were measured as a function of noise bandwidth (10-500 Hz). To prevent the detection of spectral changes introduced by the gap, stimuli were presented in a broad-band background noise. Three normally hearing subjects and three subjects with bilateral cochlear hearing loss were tested. Gap thresholds varied non-monotonically with noise bandwidth, being maximal around 50 Hz. Gap thresholds were generally higher for the hearing-impaired than for the normally hearing subjects. For the latter, gap thresholds were similar for the three conditions. For the hearing-impaired subjects, gap thresholds were similar for the unaided condition and the condition using slow compression. However, fast compression led to smaller gap thresholds, especially for noise bandwidths up to 50 Hz. The results show that fast compression can improve the ability of hearing-impaired subjects to detect gaps in sounds with slowly fluctuating envelopes.

Adult↗

PubMed1990

Cerebral blood flow in experimental intracranial mass lesions. Part I: The compression phase.

We have shown that a rebound of intracranial pressure (ICP) occurring after decompression of an intracranial mass lesion is a threshold phenomenon dependent upon the cerebral perfusion pressure (CPP) during compression and the duration of the compression. In the present study regional cerebral blood flow (rCBF) was measured during balloon compression of a degree critical for the development of a postdecompression rebound. The effects were compared with those of hydrostatically raised pressure which under similar conditions rarely produces a rebound of ICP. Disproportionately marked reductions in flow occurred in the hemisphere ipsilateral to the balloon, especially in white matter and in cortex adjacent to the balloon with flow values of, respectively, 1.1 +/- 0.9 and 6.4 +/- 3.4 ml 100 g-1 min-1. The differences in flow between balloon and hydrostatic compression were found to be due to an increased cerebrovascular resistance (CVR) caused by a direct compressive effect by the balloon overriding the generalized vasodilation which occurs in response to the raised ICP. Thus the increase in CVR attributable to compression by the balloon added to the reduction in CPP caused by the diffuse increase in ICP. As a consequence flow in large regions of the brain was reduced below the thresholds for structural infarction and for ischaemic damage to the blood-brain barrier.

Animals↗

PubMed2003

Evaluation of a lower-body compression garment.

The aims of this study were to determine how custom-fit compression shorts affect athletic performance and to examine the mechanical properties of the shorts. Ten male and 10 female track athletes on a university's nationally competitive track team, specializing in sprint or jump events, participated in the study. Testing utilized the compression shorts with loose-fitting gym shorts as the control garment. Several significant effects were revealed for the custom-fit compressive garment. Although 60 m sprint time was not affected, hip flexion angle was reduced. Skin temperature increased more and at a faster rate during a warm-up protocol. Muscle oscillation was decreased during vertical jump landing. Countermovement vertical jump height increased when the participants were wearing the custom-fit compression garment. In materials testing, the elasticity of the compressive garment provides increased flexion and extension torque at the end range of extension and flexion, respectively, and may assist the hamstrings in controlling the leg at the end of the swing phase in sprinting. The compressive garment significantly reduced impact force by 27% compared with American football pants alone. Through various mechanisms, these findings may translate into an effect on athletic performance and a reduction in injuries.

Adult↗

PubMed2001

Effects of JPEG and wavelet compression of spiral low-dose ct images on detection of small lung cancers.

PURPOSE: To compare the effect of compression of spiral low-dose CT images by the Joint Photographic Experts Group (JPEG) and wavelet algorithms on detection of small lung cancers. MATERIAL AND METHODS: Low-dose spiral CT images of 104 individuals (52 with peripheral lung cancers smaller than 20 mm and 52 control subjects) were used. The original images were compressed using JPEG or wavelet algorithms at a ratio of 10:1 or 20:1. Five radiologists interpreted these images and evaluated the image quality on a high-resolution CRT monitor. Observer performance was studied by receiver operating characteristic (ROC) analysis. RESULTS: There was no significant difference in the detection of cancers measuring 6 to 15 mm in uncompressed images and in those compressed by either of the algorithms, although the quality of images compressed at 20:1 with the wavelet algorithm was somewhat inferior. A lower diagnostic accuracy was noted using images compressed by the JPEG or wavelet algorithms at 20:1 in detecting lung cancers measuring 6 to 10 mm and cancers measuring from 6 to 15 mm with ground-glass opacity. CONCLUSION: Compression of low-dose CT images at a ratio of 10:1 using JPEG and wavelet algorithms does not compromise the detection rate of small lung cancers.

Algorithms↗

PubMed2006

Frequency-compression outcomes in listeners with steeply sloping audiograms.

Previous investigation of an experimental, wearable frequency-compression hearing aid revealed improvements in speech perception for a group of listeners with moderately sloping audiograms (Simpson et al, 2005). In the frequency-compression hearing aid, high frequencies (above 1600 Hz) were amplified in addition to being lowered in frequency. Lower frequencies were amplified without frequency shifting. In the present study, an identical frequency-compression scheme was evaluated in a group of seven subjects, all of whom had steeply sloping hearing losses. No significant differences in group mean scores were found between the frequency-compression device and a conventional hearing instrument for understanding speech in quiet. Testing in noise showed improvements for the frequency-compression scheme for only one of the five subjects tested. Subjectively, all but one of the subjects preferred the sound quality of the conventional hearing instruments. In conclusion, the experimental frequency-compression scheme provided only limited benefit to these listeners with steeply sloping hearing losses.

Adult↗

PubMed1988

Tension and compression in the cytoskeleton of PC-12 neurites. II: Quantitative measurements.

We assessed the mechanical properties of PC-12 neurites by applying a force with calibrated glass needles and measured resulting changes in neurite length and deflection of the needle. We observed a linear relationship between force and length change that was not affected by multiple distensions and were thus able to determine neurite spring constants and initial, nondistended, rest tensions. 81 out of 82 neurites showed positive rest tensions ranging over three orders of magnitude with most values clustering around 30-40 mu dynes. Treatment with cytochalasin D significantly reduced neurite rest tensions to an average compression equal to 14% of the former tension and spring constants to an average of 17% of resting values. Treatment with nocodazole increased neurite rest tensions to an average of 282% of resting values but produced no change in spring constant. These observations suggest a particular type of complementary force interaction underlying axonal shape; the neurite actin network under tension and neurite microtubules under compression. Thermodynamics suggests that microtubule (MT) assembly may be regulated by changes in compressive load. We tested this effect by releasing neurite attachment to a polylysine-coated surface with polyaspartate, thus shifting external compressive support onto internal elements, and measuring the relative change in MT polymerization using quantitative Western blotting. Neurons grown on polylysine or collagen without further treatment had a 1:2 ratio of soluble to polymerized tubulin. When neurites grown on polylysine were treated with 1% polyaspartate for 15-30 min, 80% of neurites retracted, shifting the soluble: polymerized tubulin ratio to 1:1. Polyaspartate treatment of cells grown on collagen, or grown on polylysine but treated with cytochalasin to reduce tension, caused neither retraction nor a change in the soluble:polymerized tubulin ratio. We suggest that the release of adhesion to the dish shifted the compressive load formerly borne by the dish onto Mts causing their partial depolymerization. Our observations are consistent with the possibility that alterations in MT compression during growth cone advance integrates MT assembly with the advance.

Adrenal Gland Neoplasms↗

PubMed2002

An ultrasonic measurement for in vitro depth-dependent equilibrium strains of articular cartilage in compression.

The equilibrium depth-dependent biomechanical properties of articular cartilage were measured using an ultrasound-compression method. Ten cylindrical bovine patella cartilage-bone specimens were tested in compression followed by a period of force-relaxation. A 50 MHz focused ultrasound beam was transmitted into the cartilage specimen through a remaining bone layer and a small hole at the centre of a specimen platform. The ultrasound echoes reflected or scattered within the articularcartilage were collected using the same transducer. The displacements of the tissues at different depths of the articular cartilage were derived from the ultrasound echo signals recorded during the compression and the subsequent force-relaxation. For two steps of 0.1 mm compression, the average strain at the superficial 0.2 mm thick layer (0.35 +/- 0.09) was significantly (p < 0.05) larger than that at the subsequent 0.2 mm thick layer (0.05 +/- 0.07) and that at deeper layers (0.01 +/- 0.02). It was demonstrated that the compressive biomechanical properties of cartilage were highly depth-dependent. The results suggested that the ultrasound-compression method could be a useful tool for the study of the depth-dependent biomechanical properties of articular cartilage.

Animals↗

PubMed1989

An instrument for monitoring the force applied by breast compression devices on mammography x-ray sets.

Automatic breast compression devices are commonly fitted to mammographic x-ray sets. The force exerted by these compression devices should be limited and periodically checked. This article describes the design and construction of an instrument for the routine assessment of the force applied by breast compression devices on mammography x-ray sets. Results obtained on four different mammography x-ray units are presented. In addition, data on the effect of compression plate design on compression force is given for one unit. The instrument has proved to be a simple and quick method of monitoring the force applied by the compression plates on mammographic x-ray units.

Female↗