During the last decade screening has improved prostate cancer detection. The main reason for this development is a better understanding of the margins of prostate-specific antigen (PSA) serum levels and the classification of PSA subtypes. In contrast, the introduction of transrectal ultrasound has not led to a measurable change in the prostate cancer detection rate. Our aim was to develop a novel ultrasound system for the acquisition of elastographic images of the prostate and evaluate the system regarding its clinical applicability. We used a technically modified conventional ultrasound system and analyzed the high-frequency ultrasonic data with a computer program. The first patient-based results suggest that elastography allows an accurate measurement of tumor size and localization in contrast to conventional transrectal ultrasound. Elastography visualizes different tissue elasticities to distinguish benign and cancerous tissue. Thus, we were able to even correctly classify prostate cancer lesions which are iso- or hyperechoic in B-mode sonography.
One of the weak points of augmentation or replacement of cruciate ligaments by synthetic material is the fixation of these artificial ligaments to the bone. The present investigation examines the mechanical properties of a newly developed anchoring technique (ligament fixation device = LFD) in regard to linear and maximum load, stiffness, creep, and long-term durability compared to single staples, double staples in belt buckle technique, and passing the ligament through an additional bone tunnel. The tests are carried out on cadaver knees and plastic bones under standardized conditions with the same artificial ligament in all experiments (Trevira hochfest). The LFD shows a linear load of 1866 N in cadaver knees and 1874 N in plastic bones. The stiffness is 68.3 N/mm respectively 51.9 N/mm, the elongation at 500 N load 12.7 mm respectively 10.9 mm. In the hysteresis tests with submaximum loads the ligament/LFD-unit lasts 8515 cycles in the plastic bone and 4431 cycles in the cadaver knee. These results are significantly superior to all other fixation techniques concerning linear load, stiffness and long-term durability. They permit aggressive functional treatment and immediate postoperative weight bearing of the operated knee.
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