The potentially best stereographic presentation of the plastinated anatomical specimen.

Volumegraph, which is an improved version of the parallax panoramagram, has been studied as a method of stereophotography of a plastinated human body specimen. The volumegraph provides a steric view of the specimen in a natural color appearance. The potential advantages in using the volumegraph for the presentation of anatomical specimens are discussed taking account of its technical details.

Patient-nurse collaboration: a comparison of patients' and nurses' attitudes in Finland, Japan, Norway, and the U.S.A.

While there has been an increasing emphasis on patients' participation in decisions concerning health care and nursing in the literature as an ideal, it is not clear to what extent patients and nurses assume the consumerist attitude regarding health-care decision making. With the view that attitudes people hold regarding their role in health care and nursing will primarily affect the way they behave in health-care situations, a multinational study was carried out to examine five sets of attitudes regarding consumerism held by patients in acute-care hospitals and nurses working in them. The findings from the surveys in Finland, Japan, Norway, and the U.S.A. indicate that while the patients and the nurses in these countries tend to lean toward the consumerist perspective in their attitudes, there were significant differences in the acculturation of these attitudes among the countries and between the patients and nurses. Two different models for the explanation of attitude regarding collaborative decision making in nursing practice emerged for the patients and the nurses as groups. For both groups, however, age and the more general consumerist attitudes have a bearing on their attitudes regarding collaboration in nursing.

Intraarterial digital subtraction angiography in the diagnosis and treatment of gastrointestinal disorders.

During a period of 18 months, intraarterial digital subtraction angiography (IADSA) was performed in 360 patients with various gastrointestinal disorders. This technique was useful both in diagnostic and interventional procedures. Due to increased contrast resolution, hepatic tumors and portal vein systems were better visualized than with the use of conventional angiography. Also, a significant reduction in the dosage of contrast medium resulted in markedly reduced patient discomfort. Small pancreatobiliary tumors were better evaluated on conventional angiograms due to the decreased spatial resolution of IADSA.

[Role of angiography in the diagnosis of pancreatic cancer].

Endoscopic Retrograde Choledocho-Pancreatography, Ultrasonography and Computer Tomography can show dilated pancreatic duct in the patients with small resectable pancreatic carcinoma. However they can not predict the size of the tumor. Angiography is a complementary examination, being able to demonstrate the size of the tumor and predict its resectability.

Integrated approach to the diagnosis of pancreatic carcinoma.

A prospective comparison of sensitivity, specificity and predictive value of ultrasonography (US), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP) and angiography was performed in 112 patients with proven pancreatic carcinoma. ERCP had the highest sensitivity and specificity in evaluation of pancreatic carcinoma. CT was the least sensitive in detecting pancreatic malignancy. Angiography had the highest positive predictive value. US and ERCP had a high negative predictive value. The initial examination of a patient with suspected pancreatic carcinoma is by US. Should this produce an abnormal result, CT is then used to confirm a lesion. A diagnosis of unresectable pancreatic carcinoma could be made by US and CT without the need for additional imaging procedures. If not, ERCP is indicated when there is some distinct reason to suspect pancreatic carcinoma. If ERCP reveals an abnormality, then angiography is performed to determine whether the lesion is benign or malignant, and if malignant whether it is resectable or not.

[Double contrast examination of the bile ducts (author's transl)]. / Die Doppelkontraströntgendarstellung der Gallenwege.

Efficacy of double contrast X-ray study of the bile duct was studied. Using barium sulfate it was possible to demonstrate fine mucosal pattern (FMP) of the bile duct in the surgical specimen. Utilizing decompression catheter in 44 patients with extrahepatic jaundice, double contrast study was clinically performed. It was also possible to demonstrate FMP of the bile duct mucosa. Mucosal and intramural spread of bile duct carcinoma were revealed preoperatively. It was also useful in the differential diagnosis of the biliary tract diseases.

[A critical comparison of methods for diagnosing carcinoma of the pancreas (author's transl)]. / Kritischer Vergleich der Untersuchungsmethoden bei der Frage nach einem Pankreaskarzinom.

Our investigations have shown that only those carcinomas of the pancreas of less than 3 cm. can be cured. In our experience the only way to diagnose such tumours preoperatively is a combination of angiography, ERCP and/or percutaneous transhepatic cholangiography.

[Transhepatic biliary drainage for obstructive jaundice (author's transl)]. / Transhepatische Gallengangsdrainage bei Verschlussikterus.

Sixty-five patients with obstructive jaundice out of a total of 71 patients, were treated successfully by PTCD. The markedly elevated total bilirubin and alkaline phosphatase in the serum were reduced significantly and the general condition of the patient improved rapidly. On the other hand, severe obstructive jaundice which had persisted for several weeks was not amenable to treatment in this way. Occlusion of the extrahepatic bile ducts by tumour was treated by internal PTCD; this provided satisfactory flow of bile into the duodenum for at least six months. PTCD is simpler for the patient than surgery and is therefore the method of choice in obstructive jaundice. Finally, PTCD can be used for the introduction of antibiotics for the treatment of suppurative cholangitis or liver abscesses. This rapidly leads to reduction in fever and absorption of the abscesses.