Aortopexy in esophageal atresia: long-term experience of a parent support group.

Purpose: The aim of this study was to obtain the parents' view of aortopexy after esophageal atresia.

Methods: A questionnaire was completed by the parents of 24 former patients, now aged from 1 to 15 years (average, 8.9; median, 9.

Perfusion MR neuroimaging in patients undergoing balloon test occlusion of the internal carotid artery.

Background And Purpose: We sought to investigate whether the combination of conventional, diffusion-weighted, and perfusion-weighted MR imaging increases the diagnostic accuracy of balloon test occlusion of the internal carotid artery. We describe perfusion anomalies and patterns of enhancement seen in areas of altered brain perfusion during MR-monitored temporary balloon occlusion of the internal carotid artery.

Methods: Nine patients underwent balloon occlusion testing under standard angiographic conditions with continuous clinical and EEG monitoring.

NEXAFS multiple scattering calculations of KO2.

Since many years the oxidation of alkali metals has being attracted much interest due to the catalytic properties of metal promoters and the simple electronic structure of alkali atoms. The alkali-oxides phase diagram indicates that the interaction of oxygen with alkali metals can lead to the formation of different atomic O2- ions and molecular O2(-) and O(2)2- ions. Potassium superoxide has been prepared in situ and high resolution O k-edge absorption NEXAFS spectra have been measured at the VUV beam-line at ELETTRA facility.

Intraspinal epidermoid cyst: diffusion-weighted MRI.

We report a 7-year-old boy who presented with two-month history of worsening low back and right leg pain. Conventional MR images demonstrated a poorly outlined intradural mass recognized by the displacement of the conus medullaris and the nerve roots of the cauda equina at the L2-3 level. The signal intensity of the lesion was similar to CSF There was no contrast enhancement of the lesion.

The timing of the last deglaciation in North Atlantic climate records.

To determine the mechanisms governing the last deglaciation and the sequence of events that lead to deglaciation, it is important to obtain a temporal framework that applies to both continental and marine climate records. Radiocarbon dating has been widely used to derive calendar dates for marine sediments, but it rests on the assumption that the 'apparent age' of surface water (the age of surface water relative to the atmosphere) has remained constant over time. Here we present new evidence for variation in the apparent age of surface water (or reservoir age) in the North Atlantic ocean north of 40 degrees N over the past 20,000 years.

Subarachnoid hemorrhage associated with cyclosporine A neurotoxicity in a bone-marrow transplant recipient.

We report subarachnoid hemorrhage associated with cyclosporine A (CSA) neurotoxicity after bone-marrow transplantation for chronic myelogenous leukemia. CT showed occipital subarachnoid hemorrhage. MRI confirmed this, and demonstrated cortical and subcortical edema in the posterior temporal, occipital, and posterior frontal lobes bilaterally, which was typical of CSA neurotoxicity.

Experiences of a parent support group with the long-term consequences of esophageal atresia.

Purpose: The aim of this study was to study long-term effects of esophageal atresia based on data from the world's largest parent support group.

Methods: A questionnaire was completed by 128 former patients, now aged 10 to 34 years (median, 14 years), who were all members of the support group.

Results: Postoperative bougienage was performed in 70% of patients.

Brain tumor resection: intraoperative monitoring with high-field-strength MR imaging-initial results.

Purpose: To investigate the challenges and benefits of magnetic resonance (MR) imaging during brain tumor resection.

Materials And Methods: A short-bore 1.5-T MR system equipped with echo-planar-capable gradients was used in resection of brain tumors in 30 patients.

Chronic osteomyelitis in childhood: is surgery always indicated?

Background: Presently, most children with chronic osteomyelitis undergo surgery with the inherent risk of damage to their growth plate. We demonstrate a treatment regimen based on imaging procedures focussing on antibiotics in order to reduce the rate of surgical interventions.

Patients And Methods: We retrospectively evaluated all 11 patients with clinically suspected chronic osteomyelitis who were treated at our institution from 1989 to 1995.

Electron wave function at a vicinal surface: switch from terrace to step modulation.

The Cu(111) surface state has been mapped for vicinal surfaces with variable step densities by angle-resolved photoemission. Using tunable synchrotron radiation to vary the k dependence perpendicular to the surface, as well as the (k) dependence, we find a switch between two qualitatively different regimes at a miscut of 7 degrees (17 A terrace width). For larger miscut angles the step modulation of the wave function dominates, and for smaller miscut angles the terrace modulation dominates.

Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions.

Background And Purpose: Posterior reversible encephalopathy syndrome (PRES) is typically characterized by headache, altered mental functioning, seizures, and visual loss associated with imaging findings of bilateral subcortical and cortical edema with a predominantly posterior distribution. Our goal was to determine whether fluid-attenuated inversion recovery (FLAIR) imaging improves the ability to detect subtle peripheral lesions of PRES, as compared with conventional MR techniques.

Methods: Sixteen patients with clinical and imaging findings consistent with PRES were studied.

Use of an artificial neural network (ANN) for classifying nursing care needed, using incomplete input data.

Background: In German nursing insurance, the act of classifying the client into four categories of disability is based on legally defined distinct criteria. When classifying deceased persons it is often impossible to collect all the required information.

Primary Objective: We aimed to determine the ability of an artificial neural network (ANN) to calculate the category of disability, to investigate the response of the ANN to input items of different nature, quantity and data quality, and to estimate the minimum number of training data required.

[Improving communication between ambulatory and inpatient care. A pilot project].

Medical care of our population has made dramatic progress during recent decades. However, problems arose from an increasing specialization and subspecialization on the one hand and from the complexity of care structures on the other hand. In light of scarce financial resources and of increasing demands regarding quality by both recipients and payers of medical care the analysis of diagnostic and treatment processes gained considerable attention.

Cystic hygroma of the skull base.

Cystic hygroma is a benign developmental tumor formed by lymph vessels that occurs in 1 of 12000 individuals and presents most frequently in the head and neck. It is often difficult to manage because the tumor frequently envelopes nearby vital structures. Lesions that extend significantly above the hyoid are especially difficult to excise because of the complexity of achieving a complete excision.

Homonucleotide expansion and contraction mutations of PAX2 and inclusion of Chiari 1 malformation as part of renal-coloboma syndrome.

Renal-Coloboma syndrome, an autosomal dominant disorder characterized by colobomatous eye defects, vesicoureteral reflux, and abnormal kidneys, results from mutations in PAX2. The purpose of this study was to identify mutations in PAX2 and understand the associated patient phenotypes. We report a severely affected girl and a mildly affected mother and daughter, all of whom have PAX2 homoguanine tract (7 G) missense mutations.

[Modular nursing system in pediatric ambulatory care according to nursing insurance legislation XI].

Unlabelled: In the compulsory nursing insurance according to German legislation, the assessed degree of disablement in children is dependent on their daily quantitative need for nursing care with respect to 19 distinctive items belonging to the four sectors "personal hygiene", "mobility", "nutrition", and "household duties", that exceeds normal age-dependent requirements. In ambulatory nursing, exactly that care is given to the clients.

Objective: Are there typical combinations of items scoring positively, delivering the basis for a simplified billing schedule?

Design And Methods: 4500 records from the expert assessment of children < 18 years underwent a hierarchical cluster analysis (SPSS, Ward's method).

Accidental iatrogenic intoxications by cytotoxic drugs: error analysis and practical preventive strategies.

Objectives: Drug errors are quite common. Many of them become harmful only if they remain undetected, ultimately resulting in injury to the patient. Errors with cytotoxic drugs are especially dangerous because of the highly toxic potential of the drugs involved.

[Is there equality of nursing care insurance coverage for ambulatory and non-ambulatory clients according to German law?].

Unlabelled: In nursing insurance according to German legislation, the act of classifying the client into degrees of severity of disablement (0 = none, 1 to 3 = considerable, severe, most severe disablement) by expert assessment is based on legally defined distinct criteria (need for help items). Over and above these criteria, information with regard to the activities of daily life (ADL) is also documented routinely.

Purpose: Is there a fundamental difference between patients suitable for ambulatory or non-ambulatory nursing care, or are their positive pattern scores for needing help fundamentally different?

Methods: Based on 7,000 electronic records of the assessments for ambulatory, and another 7,000 records for non-ambulatory nursing care, we fed artificial neural networks with all, or subsets, of the available items.

[Management of dementia patients and their relatives: report from the routine practice of a family physician].

In the care of patients with dementia the family physician takes the role of a supportive coordinator. His main partner is the caring significant other. The family physician has to adapt the results of 'evidence based medicine' to the situation of the patient and transform it into 'individually balanced medicine'.

[Tina, a model for a supra-regional expert assessment information system].

A problem common to most medical assessment centres is how to avoid redoing work already done in a similar case? Or, more precisely, how to get knowledge about that similar case? The problem is aggravated by the companies' decentralization and the vast amount of yearly assessments. We present a model of an information system based on a public wide-area network which nevertheless complies with German law in respect of handling personal data. The system neither compiles a full-text data base, nor does it allow access to original documents.

Predicting length-of-stay in preterm neonates.

Unlabelled: In neonatology, the early prediction of length-of-stay (LOS) may help in decision making. We retrospectively studied the accuracy of two LOS prediction models, namely a multiple linear regression model (MR) and an artificial neural network (ANN). Preterm neonates (n = 2144) were randomly assigned to a training-and-test (75%), or validation patient set (25%).

High-field strength interventional magnetic resonance imaging for pediatric neurosurgery.

Background: Interventional magnetic resonance (MR) imaging allows neurosurgeons to interactively perform surgery using MR guidance. High-field (1.5-Tesla) strength imaging provides exceptional visualization of intracranial and spinal pathology.