[Clinical guidelines as part of total quality management. Analysis of heterogenous treatment concepts of sepsis in various clinics with computer assisted generation, logical testing and complexity assessment of clinical algorithms]. / Klinische Leitlinien als Teil eines umfassenden Qualitätsmanagements. Analyse heterogener Behandlungskonzepte der Sepsis verschiedener Kliniken mit Hilfe computerunterstützter Erstellung, logischer Uberprüfung und Komplexitätsbewertung klinischer Algorithmen.

Generation, local tailoring, implementation and evaluation of clinical guidelines is an integral part of quality management. Clinical guidelines are intimately related to the independency of physicians' decisions. By this the physicians should be responsible for guideline development and guarantee the use of adequate methods of total quality management and outcome assessment. Formal consensus finding and transparency of evidence are necessary to guarantee the use of guidelines. Clinical algorithms are highly formalized and they are well suited for generation and analysis by the software ALGO. Determination of complexity and comparison of the clinical contents of algorithms is done by the scores CASA (Clinical Algorithm Structural Analysis) and CAPA (Clinical Algorithm Patient Abstraction). In a study of 22 clinical departments on treatment management concepts in sepsis following anastomotic insufFiciency in colorectal carcinoma a considerable heterogeneity was shown using this program.

[Testing metal/acrylic bonds for shear strength, axial tensile strength and maximum bending stress]. / Prüfung von Metall-Kunststoff-Verbundsystemen durch Scher-, Biege- und axialen Zugversuch.

The effects of thermocycling and water penetration on the bond strength of resin-metal-systems and improvements using bonding agents have been tested by shear, bending and tensile tests. After 10,000 cycles within 10 days in different water-baths with 5-37-55 degrees C, there is a decrease in bond strength by 40 to 60%. The use of bonding agents increases the adhesion of the resin to the metal by more than 100%. No significant differences were found between the three bonding agents Silicoater, Sebond MKV and OVS.