[Three-dimensional visualization for preoperative planning and evaluation in head and neck surgery]. / Dreidimensionale Bildprozessierung in der HNO-Onkologie zur präoperativen Planung und Evaluierung.

There are a lot of diagnostic possibilities for the preoperative planning in head and neck surgery. So far, no study was performed to evaluate if there is an advantage of three-dimensional visualization compared to conventional computed tomography yet. Additionally, there are no specifications for such a visualization prior surgery in head and neck surgery. This work describes different possibilities for segmentation and three-dimensional visualization for preoperative planning in head and neck surgery and tumor volumetry compared to conventional computed tomography. We describe new techniques and specifications for three-dimensional visualization.

[Three-dimensional visualization of CT of the neck for surgical planning]. / Dreidimensionale Darstellung von CT-Datensätzen des Halses für die chirurgische Planung: Eine Machbarkeitsstudie.

BACKGROUND: Surgical planning in ENT profits from computer assisted preoperative visualization and planning. The informative capability is to be improved by three-dimensional illustrating of the preoperative available data. The possibility of a 3-D-visualization of lymph nodes stands in the center of the interest. METHODS: 16 CT data sets with a tumor-classification of T1N1 or higher were included. Altogether 720 pseudo-3-D-illustrations were provided with an average of 9.3 objects. Current algorithms were used for the segmentation and visualization and the results were divided in three classes. RESULTS: The average time requirement for visualization and segmenting amounted to 122 minutes, the minimum value is at 61 minutes per data set. Automatic segmenting succeeded only with structures with clear grey tone differences to the environment. In all other cases an additional manual interaction had to take place. CONCLUSIONS: 3-D-Visualising of CT of the neck represents a new quality in preoperative planning. A clear trend at increasing detail loyalty and information efficiency showed up in the groups of B and C. It is possible to make from these pictures a quantitative statement on surgery relevant infiltration. Likewise conceivable are the postoperative quality control or planning and process control of a postoperative radio-chemotherapy. The automatic algorithms can be estimated as reliable. Application is still far from a clinically efficient use. With the rising efficiency of the computing systems, the improved software and the imaging systems the problems mentioned are, however, solvable.

[The importance of cultural coding in nursing practice, nursing research and nursing science--components of a critical concept of culture]. / Zur Bedeutung kultureller Codierungen in Pflegepraxis, Pflegeforschung und Pflegewissenschaft--Bausteine eines kritischen Kulturkonzeptes.

Based on the question, on which conditions the understanding of the strange is possible at all, this article points out--illustrated by research material on nursing practice, nursing education and nursing science--collective interpretative patterns that are based on binary codings like "nature-culture", "body-mind", "female-male", "strange-familiar", foreign-native", "you-we", "sick-healthy", "black people-white people", etc. These patterns and the value judgements expressed by them are social constructions within specific in certain historical and cultural contexts. Yet people neither experience collective interpretative patterns nor recognize them as such, but deal with them as if they were natural facts. This (unrecognised) process of naturalization of social-cultural phenomena provokes contradictions and conflicts in all fields of practical life--in nursing practice and nursing education too, which will be shown by examples. To describe and analyse these complex circumstances, an approach to a critical concept of culture is developed in this article. The approach includes social-cultural events, processes and structures as well as their implicated symbolization. However, this heuristic construct itself must not be naturalized and "essentialized".