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  • 1
    Electronic Resource
    Electronic Resource
    Kongenitale zystadenomatoide Malformation (CCAM) beider Lungen Verlängertes Überleben nach Pneumonektomie und Implantation eines Platzhalters (1998)
    Springer
    Monatsschrift Kinderheilkunde 146 (1998), S. 129-132 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Ballonplatzhalter ; CCAM ; Pneumonektomie ; Pneumothorax ; Key words Balloon prothesis ; CCAM ; Pneumonectomy ; Pneumothorax
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The rarely occurring bilateral CCAM has a poor prognosis. Case Report: At birth boy E. presented with respiratory distress. His bilateral severe CCAM was misdiagnosed until the typical bullous x-ray pattern developed within the first few days of life. His condition deteriorated despite conservative treatment. Facing respiratory and cardiac decompensation he underwent unilateral pneumonectomy. The diagnosis was histologically confirmed. A refillable balloon was implanted to prevent mediastinal shifting. Boy E. stabilized gradually and came off both CPAP and supplementary oxygen. At age 1 y, during a course of severe pneumonia he died of sudden cardiac arrest. Discussion: According to the literature, bilateral severe CCAM unequivocally leads to death within days or weeks. In contrast, our patient improved gradually after surgery. But, CCAM bears an increased risk of cardial decompensation in infancy which surgery can reduce but not eliminate. For the time being, in cases of severe bilateral CCAM there is no effective treatment modality other than surgery.
    Notes: Zusammenfassung Folgen der seltenen beidseitigen pulmonalen CCAM sind hochgradige Ateminsuffizienz und rechtskardiale Belastung mit Dekompensation typischerweise innerhalb weniger Lebenstage. Fallbericht: Unser Patient fiel als Neugeborenes durch respiratorische Insuffizienz auf. Eine beidseitige CCAM wurde initial als Atemnotsyndrom verkannt. Auch nach zügiger Diagnosestellung drohte unter konservativer Therapie die respiratorische und kardiale Dekompensation, weshalb wir uns zur einseitigen Pneumonektomie mit Einlage eines Ballonplatzhalters entschlossen. Die Histologie bestätigte unsere radiologische Diagnose. Im weiteren Verlauf zeigte sich zunächst eine Stabilisierung; der Patient war zeitweilig ohne Atemhilfe oder supplementären Sauerstoff. Mit 1 Jahr kam es zum Sekundenherztod im Rahmen einer schweren Pneumonie. Entgegen der kurzfristig infausten Literaturprognose berichten wir von einem zunächst guten Behandlungserfolg. Diskussion: In Analogie zur bronchopulmunalen Dysplasie ist ein bis zum 3. Lebensjahr wesentlich erhöhtes Risiko der kardialen Dekompensation anzunehmen. Die Operation kann dieses Risiko nur mindern, nicht ausschließen. In Anbetracht des – wenngleich temporären – Operationserfolgs halten wir therapeutischen Nihilismus bei beidseitiger CCAM für unangebracht.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050258
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  • 2
    Electronic Resource
    Electronic Resource
    Predicting length-of-stay in preterm neonates (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 59-62 
    Details
    ISSN: 1432-1076
    Keywords: Key words Artificial neural network ; Neural networks computer ; Length-of-stay ; Preterm neonate ; Prediction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract 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%). A total of 40 first-day-of-life items (input data) and the date of discharge (output data) were routinely available. Training-and-test set data were used to identify input items with impact on LOS (input variables) using MR analysis to establish a MR prediction model and to train and test an ANN on those selected variables. Fed with validation set data, predicted LOS obtained from MR and ANN was compared individually with actual LOS. Predicted and actual LOS were highly correlated (for MR, r = 0.85 to 0.90; for ANN, r = 0.87 to 0.92). Conclusion Even first-day-of-life data may contain substantial information with which to predict individual length-of-stay.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051010
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The “Pre-Molten Globule,” a New Intermediate in Protein Folding (1997)
    Springer
    The protein journal 16 (1997), S. 433-439 
    Details
    ISSN: 1573-4943
    Keywords: Pre-Molten globule ; folding intermediate ; NMR, proton exchange ; circular dichroism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract In vitro folding studies of several proteins revealed the formation, within 2–4 msec, of transient intermediates with a large far-UV ellipticity but no amide proton protection. To solve the contradiction between the secondary structure contents estimated by these two methods, we characterized the isolated C-terminal fragment F2 of the tryptophan synthase β2 subunit. In β2, F2 forms its tertiary interactions with the F1 N-terminal region. Hence, in the absence of F1, isolated F2 should remain at an early folding stage with no long-range interactions. We shall show that isolated F2 folds into, and remains in, a “state” called the pre-molten globule, that indeed corresponds to a 2- to 4-msec intermediate. This condensed, but not compact, “state” corresponds to an array of conformations in rapid equilibrium comprising native as well as nonnative secondary structures. It fits the “new view” on the folding process.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026397008011
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    Paper (German National Licenses)
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