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  • 1
    ISSN: 1432-0932
    Keywords: Sciatique ; Chimionucléolyse ; Chymopapaine ; Lombalgie ; Sciatica ; Chemonucleolysis ; Chymopapain ; Back pain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In the 11-year period from 1978 and 1988, myelography was performed on 624 patients with suspected herniated lumbar discs. Positive findings, defined as an indentation of the contrast-filled dural sac and/or lack of contrast filling of the nerve roots, were found in 508 (81.4%) patients. Patients with suspected spinal stenosis were excluded from the study. The choice of treatment was determined by the preference of the consultant in charge. In all, 146 patients were treated by chemonucleolysis, 152 patients underwent surgical excision of the disc via laminectomy/fenestration, while 210 patients were listed for further treatment (albeit chemonucleolysis or laminectomy) but sustained relief of symptoms whilst waiting for admission or refused further intervention and consequently continued conservative treatments (such as physiotherapy, manipulations under anaesthetic, epidural or local injections). Following a repetitive questionnaire and clinical review, 78% of those patients that had undergone chemonucleolysis were satisfied with their treatment (i.e. symptoms were either ‘gone’, ‘much better’ or ‘better’). Significantly fewer patients were satisfied after surgical disc excision or conservative treatments (71% and 61%, respectively; P〈0.001). Whereas patients with a short duration of symptoms (less than 1 year) achieved the best outcome after chemonucleolysis and laminectomy, patients with a prolonged history (greater than 2 years) benefitted most from conservative methods. Of those patients in whom symptoms were considered to be worse or the same following treatment, 46%, 51% and 42% were still working following chemonucleolysis, surgery and conservative treatment, respectively. The outcome did not depend upon the size of the disc involved. Although this is a retrospective study, it is the first report to compare the outcome following chemonucleolysis, surgery and conservative methods in patients with disc prolapse confirmed by myelography.
    Notes: Résumé Au cours des onze années allant de 1978 à 1988, 624 patients présentant une suspicion de hernie discale ont été explorés par saccoradiculographie. Des signes positifs comme une encoche d'imprégnation et/ou un défaut de remplissage des gaines radiculaires ont été retrouvés chez 508 patients (81.4%). Les patients présentant une suspicion de sténose lombaire ont été exclus de l'étude. Le traitement a été choisi selon les préférences du praticien responsable. 146 patients ont été traités par chimionucléolyse, 152 ont subi un traitement chirurgical avec laminectomie/fenestration et discectomie. 210 patients en attente d'un traitement complémentaire (bien qu'initialement traités par chimionucléolyse ou laminectomie), ont éprouvé une amélioration de leur symptomatologie alors qu'ils attendaient une réhospitalisation ou ont refusé l'opération et de ce fait ont continué les traitements conservateurs (comme la physiothérapie, les manipulations sous anesthésie et les injections épidurales ou locales). Selon les données du questionnaire et des examens cliniques répétés, 78% des patients traités par chimionucléolyse étaint satisfaits de leur traitement (soit que les symptômes aient disparu, soit qu'ils aient été nettement améliorés ou améliorés). Le nombre de patients satisfaits après discectomie chirurgicale, ou traitement conservateur était significativement moins élevé (respectivement 71% et 61%; P〈0.001). Les patients souffrant depuis moins d'un an ont présenté de meilleurs résultats après nucléolyse et laminectomie, alors que ceux qui présentaient une évolution plus longue (plus de deux ans) ont tiré plus d'avantages des méthodes conservatives. Chez les patients présentant une aggravation ou une persistance des symptômes après le traitement, 46% avaient repris le travail, 51% après chirurgie et 42% après un traitement conservateur. Le résultat était indépendant de la taille de la hernie. Bien que ce travail soit une étude rétrospective, c'est le premier rapport comparant les résultats à la suite de la chimionucléolyse, de la chirurgie et des traitements conservateurs chez des patients présentant une hernie discale confirmée par saccoradiculographie.
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  • 2
    ISSN: 1432-2315
    Keywords: Ray tracing ; Space subdivision ; Rendering
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science
    Notes: Abstract Ray tracing is becoming popular as the best method of rendering high quality images from three dimensional models. Unfortunately, the computational cost is high. Recently, a number of authors have reported on ways to speed up this process by means of space subdivision which is used to minimize the number of intersection calculations. We describe such an algorithm together with an analysis of the factors which affect its performance. The critical operation of skipping an empty space subdivision can be done very quickly, using only integer addition and comparison. A theoretical analysis of the algorithm is developed. It shows how the space and time requirements vary with the number of objects in the scene.
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  • 3
    ISSN: 1432-0932
    Keywords: Key words Chemonucleolysis ; Lumbar disc herniation ; Manipulation ; Osteopathy ; Randomised controlled trial ; Sciatica
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This single-blind randomised clinical trial compared osteopathic manipulative treatment with chemonucleolysis (used as a control of known efficacy) for symptomatic lumbar disc herniation. Forty patients with sciatica due to this diagnosis (confirmed by imaging) were treated either by chemonucleolysis or manipulation. Outcomes (leg pain, back pain and self-reported disability) were measured at 2 weeks, 6 weeks and 12 months. The mean values for all outcomes improved in both groups. By 12 months, there was no statistically significant difference in outcome between the treatments, but manipulation produced a statistically significant greater improvement for back pain and disability in the first few weeks. A similar number from both groups required additional orthopaedic intervention; there were no serious complications. Crude cost analysis suggested an overall financial advantage from manipulation. Because osteopathic manipulation produced a 12-month outcome that was equivalent to chemonucleolysis, it can be considered as an option for the treatment of symptomatic lumbar disc herniation, at least in the absence of clear indications for surgery. Further study into the value of manipulation at a more acute stage is warranted.
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  • 4
    ISSN: 1546-1718
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Medicine
    Notes: [Auszug] The mechanism of disease-associated trinucleotide repeat instability involves cis-acting factors (cis-elements) in the vicinity of the repeat, but the nature of these elements is unknown. One cis-element may be the location of the replication origin relative to the repeat. We have used an SV40 DNA ...
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  • 5
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature Publishing Group
    Nature 211 (1966), S. 954-954 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Despite the scatter common to all amplitude studies, the data clearly show a sharp decrease in amplitude between 92 and 93. It is unlikely that this marks the shadow boundary of the core, especially as studies of PcP from nuclear explosions2"4 indicate that the depth of the core-mantle boundary is ...
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  • 6
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature Publishing Group
    Nature 210 (1966), S. 619-620 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Fig. 1. Residuals for North American stations Fig. 2. The variation in azimuthal dependence from station to station precludes any possibility that the effect is due to errors in location of epicentres. See, for example, the marked contrast in the azimuthal effects at ISA and LCNM, even though the ...
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1573-7640
    Keywords: Distributed system ; logic programming ; backtracking ; communication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science
    Notes: Abstract Simulation models involve the concepts oftime andspace. In designing a distribution simulation programming system, introducing a temporal construct results in a specification language for describing a changing world, introducing a spatial construct makes it possible to coordinate multiple, simultaneous, nondeterministic activities. In this paper, we present a new distributed logic programming model and discuss its implementation. A distributed program is represented by avirtual space—a set of process which are logical representations of system objects, and is evaluated with respect tovirtual time—a temporal coordinate which is used to measure computational progress and specify synchronization. The major focus of the implemention is the ability to accomplish global backtracking. The proposed implementation collects global knowledge through interprocess communication, controls global backtracking distributedly according tovirtual time anddependency relations, and capture heuristics in that earlier synchronizations may make subsequent synchronizations more likely to succeed. As compared with other distributed logic programming systems, our system provides a simpler syntax, well-defined semantics, and an efficient implementation.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Constraints 2 (1997), S. 131-162 
    ISSN: 1572-9354
    Keywords: contructive negation ; logic programming ; interval arithmetic ; constraint logic programming
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science
    Notes: Abstract A system which extracts a dataflow graph from sets of arithmetic constraints is described. This information is used to simplify constraints and to extract positive information from negations of constraints. The context for this work is a Prolog implementation where intervals are used to represent the underlying arithmetic variables. The system uses simple information about the existence of solutions of primitive constraints to derive the dataflow graph. This makes the system easily extensible to new primitives and domains. A practical implementation over both real and integer arithmetic is described and an extended example of its application given.
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