A new coated bipolar coagulator: technical note

BACKGROUND: Sometimes charring or popping occurs and the bipolar blades get stuck to the vessel. METHODS: The tips of one of the many commercially available bipolar forceps were coated in a striped manner with Teflon--50 micro in thickness. RESULTS: The new bipolar coagulator coated with Teflon reduced the incidence of tissue sticking. CONCLUSIONS: Experience with this instrument was still quite limited, but preliminary results were promising.     

The everting suture: A new technical aid for ureteral nipple construction

PURPOSE: A new technique using an everting suture to construct a ureteral nipple is described. MATERIALS AND METHODS: The method was used to create 28 ureteral nipples. A 2-zero silk suture is passed through the ureteral wall, transfixing the lumen, and is tied 5 cm. away from the ureteral wall. The ends are cut 10 cm. long. The suture is grasped within the ureteral lumen and with traction the ureter is everted in 1 step without trauma. RESULTS: The suture in smooth 1-step atraumatic eversion of the ureter in all cases. CONCLUSIONS: With this technique a well formed nipple of the desired length can be constructed.     

A new forceps for the safe and easier insertion of subdural catheter: technical note

A new forceps suitable for the safe and easier insertion of a silicon catheter into the subdural space is described. The use of this new tool has two advantages: Firstly, the insertion of the silicon subdural catheter is parallel to the brain surface and secondly, the movement of the catheter's end in the subdural space is controlled with greater accuracy. Thus, the surgeon has the opportunity to direct the catheter to the right position avoiding penetration or injury of the brain.     

A new method for strengthening palatal closure defects of the hard palate

Closure of minor defects in the hard palate can be done with local flaps. There is often a risk of perforation of the reconstructed area. In the case reported this complication was obvious due to a large, thin, flap-covered area. In strengthening the reconstruction fascia lata and Surgicel was used. The postoperative result was excellent and the rehabilitation of the patient was without complications.     

一种新型环保铜箔表面钝化处理工艺研究

为了取代现有铜箔钝化工艺中有毒物质六价铬的使用,以钼酸钠、植酸等作为新型添加剂,对经过“粗化-固化”处理后的铜箔直接进行钝化实验,探讨了钼酸钠、磷酸钠、氧化锌等添加剂含量和电流密度、钝化时间及植酸存在等单因素条件变化对钝化膜的影响,得出最佳工艺参数为:钼酸钠8 g/L,磷酸钠4 g/L,氧化锌3 g/L,植酸2 mL/L,钝化时间10 s,电流密度0.2 A/dm2.在最佳工艺下,得到的铜箔钝化膜表面平整均匀、质量较好,通过抗氧化试验和盐雾试验后,该铜箔表面无任何缺陷,未出现氧化、腐蚀现象,表现出较理想的抗氧化能力和抗腐蚀能力,具有良好的应用前景.      

The guru and therapist: Goals and techniques in regard to the question of the chela and patient.

Attempts to clarify the goals of nondualistic religious traditions using Buddhism as an example. It is argued that since the therapist and guru hold entirely different views on human existence, they differ remarkably in their goals and techniques and in what they consider to be a legitimate question on the part of the patient and chela (disciple). A comparison is made between how the therapist and guru interact with their respective "patients." (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Words hard to say and hard to hear: "May I give you some feedback?"

Long-term favourable effects of a treatment with both cyclosporin A and coumarin in a 35 year old Caucasian female patient with Beh?et's disease, presenting with haemoptysis caused by pulmonary thromboemboli and a single major pulmonary artery aneurysm, are reported. All disease activity and complications were well controlled during 9 years of follow-up.     

Designing preemployment training for the hard to employ: A cross-cultural psychological approach.

A review of reports concerning the effects of training of the hard-to-employ suggest that the training is ineffective. One major factor responsible for the lack of success may be the neglect of cultural variables. A theoretical framework is presented which helps in the design of training programs that take cultural variables into account. (69 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early memories: A technical aid to focusing in time-limited dynamic psychotherapy.

The key to successful time-limited therapy, whatever model is being used, is to rapidly develop a problem focus. A focus makes the work meaningful to the patient and guides the therapist's interventions. A technical aid to focusing involves the therapist collecting a small number of early memories during the evaluation. The psychological function of these memories is similar to that of dreams in that they express important feelings, fantasies, and defenses. However, early memories more purely reflect central and enduring life themes. In addition, it is proposed that the particular memories patients choose to share with their therapist reflect their experience of present needs and stresses. Early memories can be used during the course of treatment to reinforce interpretations of maladaptive relationship patterns and their genetic antecedents. Vignettes are presented to illustrate this use. Clinical implications developing from the use of early memories in time-limited psychotherapy are discussed, and a proposal is made for greater emphasis on the systematic teaching of time-limited therapy in the training of psychotherapists. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fraud and abuse provisions in the Health Insurance Portability and Accountability Act: a guide to the new act for physicians

The Health Insurance Portability and Accountability Act, many provisions of which became effective on January 1, 1997, will have a significant impact in the area of health care fraud and abuse. This article examines the fraud and abuse provisions of the new act from the point of view of the practicing physician. The greatest impact on the health care provider will come from the increased enforcement resources which will be available as a result of the act. The act also contains some particular substantive additions to health care fraud and abuse law which will be applicable to physicians, including provisions penalizing health care fraud, wrongful disclosure of individually identifiable health information, false certification for home care, and false statement to a health benefit program.     

On the ability to inhibit thought and action: A theory of an act of control.

Presents a theory of the inhibition of thought and action to account for people's performance in situations that require them to stop or change their current thoughts and actions. The theory proposes that a control signal, such as an external stop signal or an error during performance, starts a stopping process that races against the processes underlying ongoing thought and action. If the stopping process wins, thought and action are inhibited; if the ongoing process wins, thought and action run on to completion. The theory is formally developed to account for many aspects of performance in situations with explicit stop signals, and it is applied to data obtained from 3 adult observers in a series of RT tasks. The relation between response inhibition and other acts of control in motor performance and in cognition is discussed, and the implications of the theory are considered in terms of current thinking about attentional control and automaticity. (69 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new method of endoscopic mucosal resection of neoplastic lesions in the stomach: its technical features and results

BACKGROUND/AIMS: In gastric cancer, endoscopic treatment can be expected to provide an absolute cure only if the lesion is mucosal and not accompanied by metastatic lymph nodes. To further evaluate such possibly curable lesions, we retrospectively reviewed 208 cases of early gastric cancer surgically resected over the past 20 years. METHODOLOGY: Our new method of endoscopic mucosal resection using a cap-fitted panendoscope, which is called EMRC, has been employed in the treatment of 73 gastric neoplastic lesions. RESULTS: It was found that curable lesions would, as the primary condition, be histologically well-differentiated carcinomas and measure 2 cm or less of the elevated type and less than 1 cm of the depressed type. The lesions were consequently identified as 49 early cancers (46 mucosal, 3 submucosal), 23 adenomas and 1 carcinoid. Although resection was completed in a single session of EMRC treatment in all cases, approximately 40% of them required fractionated resection, leaving an ulcer measuring 3 cm or more in approximately 30%. Bleeding or muscle resection occurred in 7 patients, in whom conservative treatment was effective. No recurrence has been found in any of the 73 lesions, demonstrating a favorable outcome. CONCLUSIONS: This method is advantageous in that it is simple and relatively easily applied at almost any location within the stomach. In addition, the size of the specimen obtained by en bloc resection is approximately 2 cm. The method is thus fairly likely to come into widespread use.