A computerized decision support system for patient selection in dental education

A computerized decision support system is presented. The system is used to aid in the situation of patient selection for the purpose of dental education and utilizes the PERT/CPM methodology and decision tables. It runs on a microcomputer and written in Basic. The input is a list of patient's needs, and the output is a tentative treatment plan, the chair time needed to complete the treatment, its cost, and the probability that the student will finish it on time.     

Plasma catecholamines in hepatic coma and liver cirrhosis: Role of octopamine

Summary Plasma levels of adrenaline, noradrenaline and octopamine were estimated by a radioenzymatic method in nine cirrhotic outpatients with encephalopathy and in ten patients with hepatic coma (coma grade III–IV). In the cirrhotic outpatients normal as well as elevated plasma levels of noradrenaline were found. Octopamine could not be detected in the plasma of these patients as well as of ten healthy volunteers. Elevated noradrenaline levels were present in all patients with hepatic coma. Plasma noradrenaline remained elevated or even further increased during the course of hepatic coma, whereas adrenaline was elevated less frequently. In eight of the ten patients with hepatic coma octopamine was again not detectable in plasma. Only in two patients high levels of octopamine up to 59.5 ng/ml could be found in addition to increased noradrenaline concentrations. The infusion of the branched chain amino acid L-valine had no influence on the plasma level of either noradrenaline or octopamine.The data indicate that the sympathetic nervous system is activated during the course of hepatic coma. An accumulation of octopamine is not a common finding in chronic liver disease and hepatic coma. Since in the two patients with elevated octopamine levels the rise in octopamine occured concomitantly with a rise in noradrenaline, a displacement of noradrenaline by the false neurotransmitter octopamine in the noradrenergic neuron of the peripheral sympathetic nervous system seems unlikely. The results indicate that the development of hypotension in the course of liver cirrhosis and hepatic coma cannot be related to a deficiency of noradrenaline.Deeply moved we have to inform the readers about the sudden death of our colleague and teacher Professor Dr. F. Wewalka     

The use of a pretherapeutic, predictive score to determine inclusion criteria for the non-surgical treatment of ectopic pregnancy.

Non-surgical management of ectopic pregnancy has recently become an alternative to surgery. We have investigated a pretherapeutic score to define the indication for non-surgical and surgical treatment in 61 patients with ectopic pregnancy. The score was performed before the patients' inclusion in a nonsurgical management scheme. The score used six criteria which were evaluated on a scale from 1 to 3: gestational age, human chorionic gonadotrophin (HCG) level, progesterone level, abdominal pain, haemoperitoneum volume and haematosalpinx diameter (estimated by laparoscopy or transvaginal ultrasound). Three scores, 10, 11 and 12, were studied in order to define a threshold beyond which surgical treatment should be performed. For each one, sensitivity, specificity and positive and negative predictive values were analysed. The success rate of non-surgical treatment was 75% (46/61). For patients undergoing medical treatment with a score less than or equal to 12, the success rate was significantly higher compared with a success rate of 50% when the score was greater than 12. We conclude that a score less than or equal to 12 permits non-surgical management with a success rate of 82%. A score greater than 12 indicates that laparoscopic surgery may be more suitable. The choice between different non-surgical approaches, did not influence the success rate. When ultrasound reveals embryo heart activity, medical treatment is always possible if the score is less than or equal to 12.     

Follicular fluid renin concentration and IVF outcome

Total renin protein concentration (TRC) was measured in stored follicular fluid (FF) samples from 42 women. Samples were selected according to their origin from follicles either without recovered ova ('empty', n = 38) or fertilized but with failed implantation ('failed', n = 36) or successful deliveries ('deliveries', n = 71). Ratios of number of embryos transferred to number of infants delivered were 2:1, 3:1 or 4:2 but 1:1 was not available. Non-parametric testing was applied to FF-TRC, volume and outcome. TRC was significantly higher in the delivery than the failed (P = 0.001) or empty (P = 0.002) categories. Assuming that the range of renin in failed follicles can identify the sub-population of unsuccessful follicles in the delivery category, then elevated FF-TRC was clearly associated with successful outcome. For individual women, the odds of infant delivery increased 17-fold as a function of average FF-TRC between 10,000 and 25,000 microIU/ml. For failed and delivery but not empty follicles, higher renin levels occurred in the smaller follicles, consistent with a burst of renin synthesis associated with the presence of an oocyte. The results suggest that FF-TRC relates to ovum viability with ovarian hyperstimulation and may have predictive use in IVF programmes.     

Efferent projections of the pretectum in the cat

Summary Direct projections from the pretectum in the cat were investigated by means of the Nauta-Gygax and the Fink-Heimer method in an attempt to identify the morphological substrates subserving possible neural mechanisms involved in visual behaviour and reflexes.Degeneration in the diencephalon was found ipsilaterally in the nucleus limitans, lateral pulvinar nucleus, lateral posterior nucleus, lateral dorsal nucleus, dorsal and ventral lateral geniculate nuclei, centre medianparafascicular complex, central medial nucleus, paracentral nucleus, central lateral nucleus, ventroanterior and ventrolateral nuclear complex, zona incerta, H field of Forel and the reticular nucleus. The pretectal fibers projecting to the ventral lateral geniculate nucleus appeared to be topically organized.In the midbrain, the pretectal fibers were observed to terminate ipsilaterally within the superior colliculus, nucleus of Darkschewitsch, dorsolateral portion of the red nucleus, lateral terminal nucleus of the accessory optic tract and the reticular formation, and bilaterally within the central gray, interstitial nucleus of Cajal and the rostral portion of the nucleus of Edinger-Westphal. Degeneration in the superior colliculus was marked in laminae II, III and IV. The fibers arising from more anterior part of the pretectum appeared to be distributed more medially in laminae II and III.The pretectopontine fibers terminated ipsilaterally in the paramedial and the dorsolateral pontine nuclei as well as the reticular formation. In the inferior olivary complex, degeneration was found in caudal levels of the dorsal cap and -nucleus, and additionally in the rostral portion of the dorsal accessory olive.     

基于自由变形法的多模态医学图像的配准与融合

本研究提出了一种自动识别颈部PET-CT图像特征点的算法，它应用自由变形（FFD）方法以CT图像的特征点为参考使PET图像产生变形，再结合最大互信息法对颈部PET与CT图像进行非刚体配准，最后用改进的小波图像融合法把两者进行融合得出视觉效果比较理想的融合图像。经实际计算得出的变形PET图像与对应CT图像的互信息量大于原始PET图像，并且最后用改进的小波图像融合法得出的融合图像的信息量比一般小波融合大，由此证明本研究所用方法是有效的。     

Modulation of rodent cortical motor excitability by somatosensory input

It is assumed that somatosensory input is required for motor learning and recovery from focal brain injury. In rodents and other mammals, corticocortical projections between somatosensory and motor cortices are modified by patterned input. Whether and how motor cortex function is modulated by somatosensory input to support motor learning is largely unknown. Recent human evidence suggests that input changes motor excitability. Using transcranial magnetic stimulation (TMS), this study tested whether motor cortex excitability is affected by patterned somatosensory stimulation in rodents. Motor potentials evoked in gastrocnemius muscles in response to TMS (MEP(TMS)) and to cervical electrical stimulation (MEP(CES)) were recorded bilaterally. Initially, the first negative peak of the MEP(TMS) was identified as a cortical component because it disappeared after decortication in three animals. Subsequently, we studied the effects of 2 h of electrical stimulation of one sciatic nerve on the cortical component of the MEP(TMS), i.e., on motor cortex excitability. After stimulation, its amplitude increased by 117 +/- 45% ( P<0.01) in the stimulated limb. A significantly smaller effect was found in the unstimulated limb ( P<0.02) and no effect was observed in unstimulated control animals. The subcortically evoked MEP(CES) were not affected by stimulation. It is concluded that somatosensory input increases motor excitability in rat. This increase outlasts the stimulation period and is mediated by supraspinal structures, likely motor cortex. Modulation of motor cortex excitability by somatosensory input may play a role in motor learning and recovery from lesion.     

男医学生在妇产科实习的素质能力培养

21世纪需要高素质人才，素质教育是关键。从一定意义上说素质教育就是因材施教，妇产科作为一门比较特殊的学科，在实践教学工作中女患者不愿意示教的情况越来越严重，尤其对于男医学生。本文对男医学生在妇产科实习的素质能力培养进行实践与研究，提出以素质教育为中心，培养出具备高尚的医德、扎实的专业本领和丰富的人文知识的新型人才。     

我院基于XML异构数据集成的开发应用及研究

基于XML的数据集成，Web Services中间件能够较容易地实现对各数据源的描述以及数据源之间的数据转换，它在应用程序和数据库之间起着接口的作用．本文结合实际医院信息工作，运用VFP9 COM模型，作了有效性的研究及应用，并对标准数据集的二次开发进行了讨论。结果表明，该方法用于医院跨网络平台、跨应用系统、异构信息集成是有效的和易于操作的。