Targets and endpoints in ablation therapy for atrial fibrillation in the light of pathophysiological mechanisms

Atrial fibrillation (AF), an important public health problem is a complex and multifactorial arrhythmia. Non-pharmacological treatment for symptomatic patients is of increasing importance. The different catheter ablation techniques in AF treatment developed during recent years, all based on different pathophysiological insights, are discussed. The non-standardized use of different follow-up methods after ablation make interpretation and comparison of results difficult.     

Congenital fibrosis of the liver: diagnostic possibilities of peritoneoscopy and splenoportography.

Congenital fibrosis of the liver can be tentatively diagnosed by direct-vision peritoneoscopy, and this diagnosis can be verified without difficulty by a liver puncture under peritoneoscopic control. In addition, peritoneoscopy makes it possible to determine portal pressure in the spleen under optical control of the puncture site, and to make a splenoportogram at minimum risk. The splenoportogram supplies information on the luminal width of the splenic and portal veins, which is important if a shunt operation is contemplated. Besides, information can be obtained on the extent of the collateral circulation, and the features of the portal branches in the liver can in turn corroborate the diagnosis.     

MR imaging of blood vessels using three-dimensional reconstruction: methodology

Multisection, dual-echo magnetic resonance (MR) transaxial images of blood vessels contain both anatomic and qualitative information about flow. Even so, the images are produced as a series of two-dimensional tomographic sections from which full visualization of connected structures is difficult. A computer algorithm was developed that automatically detects flowing blood based on pixel intensity and calculated T2 and provides reconstructed views of vessels while analyzing and displaying flow characteristics. Images of abdominal vessels, aortic aneurysms, and the heart were encoded by flow and color to demonstrate depth. In addition, these data were reconstructed to derive a more accurate assessment of patency. With this technique, transaxial images can be used to analyze flow patterns, determine patent areas, and visualize all levels of vessels in a single image.     

论我国医疗美容产业的可持续发展

目的探讨我国医疗美容事业的产业化属性、经济学地位,以及如何达到全面、协调和可持续发展的大目标。方法逻辑论证。结果认识到医疗美容产业是“医疗美容经济”系统的核心要素;揭示了医疗美容产业具有“人本经济”的特征,民营医疗美容产业是发展医疗美容事业的重要力量,医疗美容产业的发展是当代中国医学美学与美容医学整体学科建设和发展的社会基础和经济基础。结论医疗美容产业的形成是医疗美容事业在社会主义市场经济条件下发展的必然趋势,同时提出了医疗美容产业健康发展的三大措施：增强产业意识;加强行业规范;实行人本管理。最终的结论是：医疗美容事业利用产业化机制,走产业化发展的道路,促进了整个社会医疗美容事业的全面、协调和可持续发展。     

The integration of medical specialists in hospitals. Dutch hospitals and medical specialists on the road to joint regulation

Medical specialists have--notwithstanding governmental policy--acquired a firmly established position in policy-making in Dutch hospitals. In all general hospitals the Executive Board and the Staff Executive frequently and systematically negotiate their interests. Three conclusions may be drawn on the basis of the research reported on in this article. In the first place, it is the primary objective of the medical staff executive to protect the interests of the medical domain against managerial dominance. In the second place, developments suggest that the parties are slowly but surely switching to the joint regulation of overlapping interests. Finally, the trend towards joint regulation is an enormous challenge for medical staff governance.