The patient with respiratory problems

Despite improvements in operative and anesthesiological techniques, respiratory problems in surgical patients have been minimized but not eliminated. In addition to risks which are typical for the individual patient, the perioperative respiratory morbidity is affected by anesthesiological manipulations as well as the operation and the nature of the operation (elective versus emergency). In this paper, after describing anesthesia-associated disturbances of the respiratory situation together with worsening due to the disease in patients with COLD, techniques and methods for therapy, prophylaxis, and prognostic assessment are delineated. Two examples are given for patients with respiratory problems (abdomino-thoracic esophageal resection as a example of local trauma in patients with numerous preoperative risk factors and acute necrotizing pancreatitis to describe the sequelae of a toxic process). The essence of our discussion is that, prognostically, preoperative diagnosis is of reduced value. Only a synopsis of clinical findings together with spirometry and blood gas analysis appears to be relevant. Early mobilization in conjunction with excellent postoperative pain therapy is of utmost importance, which is equivalent to the almost routine placement of a patient controllable epidural analgesia technique. These concepts have shown in the two patient groups described that respiratory morbidity may be reduced significantly. Cooperation between surgeons and anesthesiologists, which is characterized by complete and mutually high competence on both sides, is essential for successfully managing patients at increased respiratory risk.     

Non-pigmented extrabulbar sarcomas of the eye-region (author's transl)

The authors report on 30 cases with non-pigmented extrabulbar sarcomas of the eye-region which occurred in our clinic within the period of 1955 till 1975. The primary sarcomas of the orbit predominate with 11 cases over the secondary involvement with 9 cases. More seldom (5 cases) is the involvement of the lids and the epibulbar space. The various groups of lymphosarcoma predominate with 16 cases over the spindle-cell sarcoma with 6 cases. The age distribution shows that these tumors prefer the first three decades and the fifth and the following decennia. The prognosis is bad for the conservation of the eye as well as for the preservation of life. With reference to the localisation the distribution at the time of the beginning of the therapy as well as the histological findings an intensive therapy (operation, radiation, chemo-therapy) has to be accomplished.     

Hypochondriasis in the elderly: a reaction to social stress

Hypochondriasis in the elderly is often a preventable or reversible syndrome. It can become chronic if the patient finds no relief from social stress or becomes dependent upon medical services as a source of support. When this is recognized, psychotherapeutic intervention is necessary. Although no socioeconomic group is exempt, hypochondriasis in the elderly occurs more often among the lower social classes. Its higher prevalence in this group is attributable to the frequency and severity of social stress and the loss of alternative social opportunities. If psychotherapeutic intervention is necessary, the elderly hypochondriac patient should be helped to recognize social stress as a major source of the problem and to develop a realistic method of coping with it. Apparently the precipitating factors are often in the socioeconomic sphere; hence, social planners should be aware of this fact if the demands on the health care system are to be reduced.     

Intraocular pressure during operations using the heart-lung machine (author's transl)

The results of the investigations reported here show that contrary to expectations, the drop in mean arterial blood pressure (up to 57 mm Hg) during extracorporal circulation does not result in a simultaneous drop in intra-ocular pressure. Other factors, affect intra-ocular pressure during extracorporal circulation, causing it to rise. Postoperative studies of vision led to the conclusion that the elevations of intraocular pressure measured during extracorporal circulation with the heart-lung machine do not adversely affect ocular function.     

A Theoretical Model for the Measurement of Fiber Orientation with Thermal Waves

Abstract

It is an important task of nondestructive testing to determine the fiber orientation of reinforced polymers. One appropriate method, especially for carbon fibers, is phase-sensitive modulated thermography, where images of the phase angle and the amplitude of thermal waves at the surface of the sample are obtained. The anisotropy induced by the fibers results in elliptical contour lines whose direction and excentricity are correlated with the orientation of the fibers and the corresponding degree of thermal anisotropy, respectively.

To correctly interpret the measurements one needs a theoretical model. Such a model is developed for layered media with different orientations in different depths. Using a Fourier transform one can reduce the heat conduction in three dimensions to a one-dimensional problem that can be solved analytically. Because the FFT algorithm is used for the numerical evaluation, the calculation of phase and amplitude images is very fast, with the computation time being approximately equal to the measurement time. The comparison with experiments for a test sample shows a good agreement between theory and measurement.     

Thermal Waves for Imaging of Defects with Lockin-Speckle Interferometry

ABSTRACT:  A temporal modulated deformation field was monitored by a phase shifted out-of-plane interferometer. The periodical deformation was generated by exposure to intensity modulated light which produces a thermal wave by absorption at the surface of the object. From the recorded sequence of speckle-interferograms time-varying absolute displacement maps are derived by an unwrapping process. The transformation in the frequency domain and the evaluation at the modulation frequency (lockin-technique) allows to improve the signal-to-noise ratio and to investigate the depth where the defects are located. The measuring time for depth localisation can be reduced when the object is simultaneously excited and evaluated at several frequencies. The potential of this new method is shown on different model samples.     

Methodological examination of videotape-assisted reviews in brief therapy: Helpfulness ratings, therapist intentions, client reactions, mood, and session evaluation.

Evaluations of sessions and videotape-assisted reviews in 24 cases were studied to better understand methods and measures used in therapy process research. Results show that helpfulness ratings, intentions, and reactions were consistent across sessions and reviews. Positive mood increased after sessions but decreased after reviews. Therapists evaluated sessions less positively after reviews than after sessions; Stability, predictive validity, and concurrent validity were found for helpfulness ratings, and stability was found for intentions and reactions. Presession mood was related to process judgments. Thus, using videotape-assisted reviews, helpfulness ratings, intentions, and reactions to study process seems justified, but researchers should be aware that mood may influence judgments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)