Haptic model fabrication for undergraduate and postgraduate teaching.

Three series of cone-beam computed tomography (CBCT) patient data sets were obtained. These data were exported into DICOM and MIMICS (Materialise's Interactive Medical Image Control System; Materialise, Leuven, Belgium) and were imported for differentiation of various tissues (bone, teeth, and nerve). After transferring the data to an additive manufacturing machine, three-dimensional (3D) haptic models were fabricated using clear and opaque materials. These models were integrated into phantom heads normally used for education in undergraduate dental education. 3D prototype CBCT-based haptic patient models can be used in undergraduate and postgraduate education. Students can simulate routine standard oral surgical procedures with supervision under 'dry conditions'. Residents can simulate advanced and complex cases before performing the real operation.

[Perforation of the sigmoid due to a duodeno-biliary stent displacement]. / Perforace sigmatu vycestovalým duodenobilárním stentem.

The aim of this presentation is demonstrate two case reports of very rare complications of migration of the duodenobiliar stent to the sigmoid colon area. Within two months last year we had 2 patients with bowel perforation by duodenobiliar stent. Both cases were treated using the Hartman operation.

Generation of three-dimensional prototype models based on cone beam computed tomography.

PURPOSE: The purpose of this study was to generate three-dimensional models based on digital volumetric data that can be used in basic and advanced education. METHODS: Four sets of digital volumetric data were established by cone beam computed tomography (CBCT) (Accuitomo, J. Morita, Kyoto, Japan). Datasets were exported as Dicom formats and imported into Mimics and Magic software programs to separate the different tissues such as nerve, tooth and bone. These data were transferred to a Polyjet 3D Printing machine (Eden 330, Object, Israel) to generate the models. RESULTS: Three-dimensional prototype models of certain limited anatomical structures as acquired volumetrically were fabricated. CONCLUSIONS: Generating three-dimensional models based on CBCT datasets is possible. Automated routine fabrication of these models, with the given infrastructure, is too time-consuming and therefore too expensive.

The effect of acidic beverages on the ultrastructure of the acquired pellicle--an in situ study.

AIM: The aim of the present in situ study was to investigate ultrastructural alterations as well as protective properties of the pellicle layer during consumption of acidic beverages. METHODS: Bovine enamel slabs were fixed on buccal and palatal aspects of individual splints and exposed in the oral cavities of three subjects for 120 min. In the following, the subjects drank orange juice, coke light or sprite light. Half of the specimens were removed afterwards, the others were exposed to the oral fluids for another 120 min. Erosive alterations of the bovine enamel slabs were measured by determination of the Knoop-micro-hardness. In addition, the ultrastructure of the pellicle was evaluated by transmission electron microscopy (TEM). RESULTS: Determination of Knoop-micro-hardness yielded only little reduction of the relative Knoop-hardness in situ during consumption of sprite light (-0.053+/-0.019) and coke light (-0.075+/-0.04). With orange juice nearly no change of the hardness was recorded. TEM-pictures showed that the globular outer layers of the pellicle were removed to a different extent according to the localisation of the specimens in the oral cavity, whereas the basal pellicle was not affected by the acidic beverages. On the specimens carried for another 120 min after the erosive attack, lacunae filled with organic structures were observed underneath the basal side of the pellicle. CONCLUSION: During fast consumption of acidic beverages in situ, the erosive effects on pellicle coated bovine enamel are moderate and juices seem to be less harmful as compared with low pH soft drinks. Pellicle proteins in eroded lacunae may impact the remineralization process.

Comparing alternative methods for composing community peer groups: a data warehouse application.

A method for assessing the health status of communities has been under development for a decade at the University of South Florida. Known as CATCH (Comprehensive Assessment for Tracking Community Health), the method utilizes health status indicators from multiple data sources. With federal grant support, a unique data warehouse has been created to automate CATCH assessments and to enhance online analytical processing for efficient data browsing, knowledge discovery, and model testing. A comparison of two peer grouping methods (population size versus predicted age-adjusted mortality) is reviewed to demonstrate the warehouse capabilities.

Rating the health status of U.S. communities.

Although the existence of small-area variation in health care utilization and quality had been acknowledged decades ago, and the public release of data about the performance of hospitals and physicians is no longer controversial, the wide range of variability in the health status of U.S. communities has received relatively little attention. The authors demonstrate (using Florida data) an empirically derived national system for rating the health status of communities, presented in a simplified consumer-type format, using a symbol-graded report card. This system is intended to keep the symbols of poor health status prominently in the minds and on the political agendas of community leaders.

Evaluating the evidence of effectiveness for preventive interventions: using a registry system to influence policy through science.

In order to deal with the serious problems of drug use, delinquency, and mental health problems in this country, policy makers, communities, practitioners, and advocates need to identify prevention programs that have empirical support and at the same time meet their own community needs regarding acceptability, cost, and training, and supervision. An "evidence-based" approach to prevention, one that identifies the scientific knowledge about what prevention programs work, for whom, and under what circumstances, should play a critical part in this process. The premise of this evidence-based approach is that the wide adoption of prevention programs that have been found to be successful in rigorous evaluations, will lead to successful population-based prevention strategies. A web-based registry, or database that describes the available scientific information on individual preventive trials, would be of high potential use to policy makers engaged in prevention planning for their communities. This presentation describes a model registry based on descriptions of 167 preventive trials aimed at children aged 0-6. Empirical findings are presented regarding two critical components of the registry, the measurement of the quality of the trial and the strength of evidence for a beneficial effect produced by each intervention. Implications for the use of such a registry are also discussed.

CATCH/IT: a data warehouse to support comprehensive assessment for tracking community health.

A systematic methodology, Comprehensive Assessment for Tracking Community Health (CATCH), for analyzing the health status of communities has been under development at the University of South Florida since the early 1990s. CATCH draws 226 health status indicators from multiple data sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered list of community health problems. CATCH has been applied successfully in many Florida counties; focusing attention on high priority health issues and measuring the impact of health expenditures on community health status outcomes. Previously performed manually, we are using information technology (IT) to automate the CATCH methodology with a full-scale data warehouse, user-friendly forms and reports, and extended analysis and data mining capabilities. The automated system, CATCH/IT, will reduce the time to prepare community health status reports from months to days. In this paper, we present the current status of the project, along with the principal research and development issues and future directions of the project.

Visual acuity after topical application of proparacaine.

STUDY OBJECTIVE: To determine the effect of topical anesthetics on visual acuity (VA). METHODS: We studied 66 consecutive patients (73 afflicted eyes) who presented to a university hospital emergency department with the complaint of eye pain. VA was measured before and after patients were treated with proparacaine, a topical ocular anesthetic. RESULTS: After proparacaine instillation, VA was improved in 33 patients (45%), unchanged in 34 (47%), and worse in 6 (8%). CONCLUSION: Patients with eye pain often demonstrate improved VA after the instillation of a topical anesthetic.

A community health report card: comprehensive assessment for tracking community health (CATCH).

A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

[Transposition of the fallopian tube as a therapeutic possibility in special cases of tubal sterility]. / Die Transposition der Tube als Therapiemöglichkeit in besonderen Fällen von tubarer Sterilität.

This is a report on a new method of microsurgical transposition of the Fallopian tube. It was developed to deal with congenital malformations or with the different anatomic remnants after pelvic surgery or pelvic inflammatory diseases. The tube is mobilised by severing the mesosalpinx with the unipolar microelectrode without damaging the longitudinal vessels. After mobilisation, the bends of the tube disappear and the length increases almost doublefold. Then the tube can be laid to the contralateral ovary without any tension. The tube must be fixed to the ovary in such a way, that the fimbrial end is mobile enough to lay onto the ovary during ovulation. Up to now, six patients with longstanding tubal sterility were operated upon. Three of them became pregnant, one twice. There were no ectopic pregnancies and no abortions.

Photoreactions of riboflavin with spermine and their role in tryptophan photoconsumption induced by riboflavin.

The influence of spermine (Spr) on riboflavin (Rb) and riboflavin-tryptophan (Rb-Trp) solutions irradiated at 450 nm under aerobic and anaerobic conditions was studied. In both systems, it is shown that Spr interacts with 3Rb probably giving spermine-derived and flavin-derived radicals. In the presence of oxygen, modified Rb is regenerated with the simultaneous production of the active oxygen species O2.- and/or HO2.. The addition of Spr to the Rb-Trp system under aerobic conditions leads to a small protection of Trp consumption, although oxygen consumption is increased. This small protection arises as a consequence of competitive interaction of Trp and Spr with 3Rb. The competition of Spr and oxygen for 3Rb could also explain the autocatalytic oxygen consumption observed in the presence of the amine. Under anaerobic conditions Spr produces a larger protection of Trp consumption, which is compatible with the larger Rb triplet lifetime expected under these conditions.

Detection of tick-borne encephalitis virus RNA in ticks (Ixodes ricinus) by the polymerase chain reaction.

A polymerase chain reaction for the detection of tick-borne encephalitis virus (TBEV) RNA in ticks was developed. Two pairs of primers for nested PCR were selected from the 5'-NCR and the 5'-terminus of the C protein coding region, which are highly conserved among the TBEV isolates sequenced so far. The sensitivity of the nested PCR was tested by dilution experiments of a TBEV positive brain suspension. The specificity of the PCR products was confirmed by Southern blotting. In a pilot study, 60 homogenates of 7200 ticks (I. ricinus) were examined by PCR. Two homogenates were found positive. The PCR for TBEV RNA appears to be a valuable method to define endemic areas of TBE.

Epidemiology and ecology of tick-borne encephalitis in the eastern part of Germany between 1960 and 1990 and studies on the dynamics of a natural focus of tick-borne encephalitis.

From 1960 to 1990, attempts to isolate TBE virus from ticks and small mammals were made and investigations to detect TBE antibody in small mammals, game and humans were performed in the five new federal Länder of Germany. The confirmed TBE cases for which the site of exposure could be determined were also registered. As a result of these epidemiological and ecological investigations, a map is presented showing the natural foci of TBE which are primarily located in the subatlantic and mountainous climatic regions. TBE was endemic in the area of investigation from 1960 to 1990 showing a morbidity of up to 0.7 per 100,000 inhabitants which decreased in recent years to 0.02 per 100,000 inhabitants. The natural foci of TBE virus in eastern Germany showed a high activity between 1960 and 1970. Since that time, there have hardly been any cases of human disease and TBE virus could no longer be detected, neither in ticks nor in small mammals. Taking the natural focus on the Island of Usedom as an example, attempts have been made to elucidate whether such foci have become extinct or whether they have persisted. From 1983 to 1989, a surveillance programme was performed to detect antibodies to TBE virus in small mammals and game and to attempt to culture virus from ticks and small mammals. The attempts to isolate virus from a total of 8200 ticks were negative. Attempts to isolate virus from the brains of small mammals were also negative. Antibody prevalence in 446 small mammals and 500 animals of game was ca. 1%. At one site, the sero-positive reactions converted from 0% (1983-1988) to 4.5% (1989) among small mammals population. The investigations performed on the Island of Usedom have shown that this natural focus has not disappeared but is in a state of endemic latency. Moreover, the seroconversion observed in the small mammals population shows that further surveillance of such foci is necessary. This becomes obvious by the sporadic occurrence of single TBE cases as well as by a low antibody prevalence of 1% in small mammals and game. The epidemiological situation in eastern Germany is thus completely different from that in western Germany where an average of 70-120 TBE cases per year are registered, occurring mainly in Bavaria and Baden-Württemberg.

Development of a self-report measure of adherence for children and adolescents with insulin-dependent diabetes.

Two samples of insulin-dependent diabetic youths were studies in successive attempts to refine a brief patient self-report measure of general long-term adherence to a diabetic regimen. Validity and reliability were assessed for both samples by measuring a number of related variables: locus of control, stressful life events, knowledge of diabetes, parent report, and glycosylated hemoglobin. Initial evidence of validity was demonstrated in a variety of criterion areas. Both reliability and validity were replicated on the second sample. Adherence is discussed as a complex multidimensional variable, the measurement of which requires several different methods, including the selfreport measure described here. Warnings about social desirability as a confounding factor were discussed, as were suggestions for other adherence measures.

Psychosocial childbearing stress and metabolic control in pregnant diabetics.

The authors tested the relationship between psychosocial childbearing stress factors and metabolic control in a research sample of 39 pregnant insulin-dependent diabetic women. Subjects were selected using rigorous exclusion criteria from a population of more than 200 pregnant diabetic patients assessed in a University National Institutes of Health Center. Metabolic control was determined by plasma levels of preprandial day, night, and early morning fasting glucose, urinary ketones, and glycosylation of hemoglobin. Differences in plasma glucose concentrations and urinary ketone levels at several times during the day and night were associated with psychosocial stress factors. A similar relationship between stress and levels of diabetic control could not be demonstrated by hemoglobin A1 assay, a result contradicting most prior studies of adolescent populations. These findings are compatible with a biopsychosocial model of diabetes mellitus and emphasize the importance of using several different measures of diabetic control to determine stress-control relationships.

Multidimensional assessment of depression.

A brief version of the Multiscore Depression Inventory was evaluated. Good coefficient alpha and test-retest reliabilities were obtained for the total score and the subscales. Two factor analyses were reported which appear to justify the use of a multiscore approach for at least 8 of the 9 subscales: helplessness, energy level, guilt, social introversion, cognitive difficulty, irritability, pessimism, and low self-esteem. Sad mood apparently overlapped with energy level on one analysis (replicating findings with the 118-item Multiscore Depression Inventory), and with self-esteem on the second analysis. Normative data are provided on diverse samples totaling 849 subjects.