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  • 1995-1999  (177)
  • 1999  (177)
  • Life and Medical Sciences  (96)
  • Children  (81)
  • Nuclear reactions
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  • 1995-1999  (177)
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Keywords
  • 1
    Electronic Resource
    Electronic Resource
    Unilaterales laterothorakales Exanthem im Kindesalter Klinische Besonderheiten und diagnostische Kriterien bei 5 Patienten (1999)
    Springer
    Der Hautarzt 50 (1999), S. 39-41 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Kinderdermatologie ; Exanthem ; Kinder ; Key words Pediatric dermatology ; Exanthema ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Unilateral laterothoracic exanthem a (ULE) is a self-limited, probably infectious-allergic skin disease predominately affecting small children. We describe five such cases. The typical unilaterally located or at least unilaterally dominant exanthem usually starts in the axillary region and is characterized by red, partly confluent papules and fine scales. Two of the children presented with atypical manifestations of ULE. Due to its asymptomatic course, therapy is not necessary in the majority of cases.
    Notes: Zusammenfassung 5 Kinder mit der Diagnose eines unilateralen laterothorakalen Exanthems (ULE) werden vorgestellt. Beim ULE handelt es sich um eine selbstlimitierende, vermutlich infektallergische Hauterkrankung, die hauptsächlich im Kleinkindesalter auftritt. Das typischerweise streng einseitig lokalisierte, immer jedoch einseitig dominierende Exanthem geht meist von der Axillarregion aus und zeigt erythematöse, teils konfluierende Papeln. Zwei der fünf Kinder zeigten auch atypische Hautveränderungen eines ULE. Eine Behandlung ist aufgrund seines überwiegend asymptomatischen Verlaufs in der Mehrzahl der Fälle nicht notwendig.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050862
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  • 2
    Electronic Resource
    Electronic Resource
    Development of anticipatory postural adjustments in a bimanual load-lifting task in children (1999)
    Springer
    Experimental brain research 126 (1999), S. 200-204 
    Details
    ISSN: 1432-1106
    Keywords: Key words Motor development ; Anticipatory postural adjustments ; Bimanual coordination ; Children ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Anticipatory postural adjustments (APA) are needed to perform a movement without perturbing posture. We investigated the development of APA in 3- to 4-year-old children during a bimanual load-lifting task. The task required maintaining a stable elbow position despite imposed or voluntary unloading of the forearm. Although children can compensate the consequences of unloading by using APA, their performance did not reach an adults’ level. In addition, children showed high intra-individual variability in the voluntary situation, revealed by the coexistence of both adult-like and immature patterns in kinematic and electromyographic data. In conclusion, the present study reports that APA, associated with a bimanual load-lifting task, are still being set up in 3- to 4-year-old-children. The intra-individual variability should decrease with age and be associated with a progressive mastering of the timing parameters characterizing APA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002210050729
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  • 3
    Electronic Resource
    Electronic Resource
    Developmental changes in prehension during childhood (1999)
    Springer
    Experimental brain research 125 (1999), S. 239-247 
    Details
    ISSN: 1432-1106
    Keywords: Key words Precision grip ; Motor development ; Motor control ; Children ; Object manipulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Recent evidence has shown that the anticipatory control of grip and load force is not innate and develops over several years in childhood. The present study examined the development of grasping behavior by quantifying the relationship between grip force and the vertical acceleration of an object. Children and adults were requested to use a precision grip to lift an instrumented object which varied in size and weight. Grip force, grip force rate and the vertical position and acceleration profiles of the test object were measured or calculated. The results demonstrated the presence of distinct developmental milestones in the maturation of precision grip from 2 to 9 years of age. With 2-year-old children, the peak acceleration was negatively correlated (r=–0.51, n=34, P〈0.01) with peak grip force during lifting. By 3 years of age, peak acceleration and peak grip force during lifting became positively correlated (r=0.28, n=104, P〈0.01) and the correlation continued to strengthen up to 9 years of age. Variations in the temporal coupling of both peak grip force and peak acceleration also decreased with maturation. Furthermore, starting at 4-years-old, children clearly controlled the acceleration and deceleration of the object in a symmetrical pattern and used a single burst of grip force rate to grasp the object with some regularity, suggesting that the emergence of an anticipatory control strategy had already begun.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002210050679
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  • 4
    Electronic Resource
    Electronic Resource
    Bilateral optic neuritis in a child diagnosed with Gd-enhanced MR imaging using fat-suppression technique (1999)
    Springer
    European radiology 9 (1999), S. 731-733 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Optic nerves ; Neuritis ; Children ; Central nervous system ; MR imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A 4-year-old boy developed bilateral optic neuritis. Although precise neuro-ophthalmological evaluation was difficult, the diagnosis was made with gadolinium-enhanced MR imaging using fat-suppression technique in the initial stage of the disease. Enhancement and enlargement of the intraorbital and intracanalicular optic nerve were demonstrated bilaterally as well as protrusion of the optic nerve head. The disease responded dramatically to intravenous steroid therapy. The etiologies in children usually differ from those in adolescent and adult patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050744
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  • 5
    Electronic Resource
    Electronic Resource
    Pulmonary anthracosis in children (1999)
    Springer
    European radiology 9 (1999), S. 485-486 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Lung disease ; Pneumoconiosis ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report two cases of children with malignancies and subpleural nodules found on computed tomography (CT) scan. In both cases the diagnosis was anthracosis. This pathologic condition has never been reported in children. Causes of anthracosis include a smoking environment, living in urban areas and air pollution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050699
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  • 6
    Electronic Resource
    Electronic Resource
    Lethal encephalopathy complicating childhood shigellosis (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 550-552 
    Details
    ISSN: 1432-1076
    Keywords: Key wordsShigella ; Toxic encephalopathy ; Children ; Brain oedema ; Shiga toxin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 6-year-old girl is described who died following rapid neurological deterioration, ending in lethal cerebral oedema. Despite the absence of severe intestinal and metabolic derangement, Shigella was cultured from the stool. Toxic encephalopathy is responsible for death following this rare complication of childhood shigellosis in developed countries. The pathophysiology is unknown. Conclusion Lethal toxic encephalopathy can be caused by Shigella despite the absence of severe intestinal and metabolic derangement. If shigelllosis is suspected, headache may be a first significant sign for the development of toxic encephalopathy. Early recognition and rapid measures to prevent brain oedema may improve outcome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051144
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  • 7
    Electronic Resource
    Electronic Resource
    Abnormal subcortical somatosensory evoked potentials indicate high cervical myelopathy in achondroplasia (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 662-667 
    Details
    ISSN: 1432-1076
    Keywords: Key words Somatosensory evoked potentials ; Far-field potentials ; Achondroplasia ; Foramen magnum stenosis ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Children with achondroplasia may have high cervical myelopathy due to stenosis of the cranio-cervical junction resulting in neurological disability and an increased rate of sudden death. To detect myelopathy we recorded somatosensory evoked potentials (SEPs) after median nerve stimulation in 30 patients with achondroplasia aged 13 months to 18 years (mean 6 years). In addition to the conventional technique of recording the cortical N20 and the central conduction time (CCT), we employed a noncephalic reference electrode recording the subcortical waveforms N13b and P13, generated near the cranio-cervical junction. The findings were related to the clinical status and MRI results. Eighteen patients had MRI evidence of spinal cord compression with indentation or narrowing of the upper cervical cord, and 13 showed signs of myelomalacia. Seven patients had neurological abnormalities. The sensitivities of the SEPs were 0.89 for cervical cord compression, 0.92 for myelomalacia and 1.0 for the clinically symptomatic patients. There were no false-positive results. The subcortical SEPs were more sensitive than the conventional recordings. However, the conventional SEPs were highly specific in the most severely affected patients; here the specificity was 1.0 for patients with myelomalacia and 0.96 for symptomatic patients. Postoperative SEPs improved after occipital decompression in two children. Conclusion The analysis of somatosensory evoked potentials, in particular of subcortical tracings, is useful in the detection of early cervical myelopathy in children with achondroplasia. Early neurosurgical decompression may prevent irreversible damage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051172
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  • 8
    Electronic Resource
    Electronic Resource
    Hepatic steatosis: a frequent non-specific finding in HIV-infected children (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 971-974 
    Details
    ISSN: 1432-1076
    Keywords: Keywords Liver ; Steatosis ; HIV ; AIDS ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thirty HIV-infected children were cross-sectionally examined for morphologic hepatic abnormalities, using ultrasonography or histology. Abdominal ultrasonography was performed in 27 children. The liver structure was normal in four patients, one of whom had moderate symptoms of the HIV infection and three of them severe symptoms. Abnormal liver structure, compatible with hepatic steatosis, was found in 23 (85%) patients. Five of them were in an early stage of the HIV infection (category N or A), three patients were ranked in category B and 15 patients in category C. Histological examination of the liver was performed in 11 children and steatosis was documented in ten (91%). In seven (70%) of these ten children steatosis had been suspected by ultrasonography. In conclusion, steatosis is common in HIV-infected children. It is non-specific and has no impact on disease, diagnostic evaluation or management. Conclusion Ultrasonography is a sensitive, accurate, non-invasive screening tool. It is more reliable than liver function tests.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051260
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  • 9
    Electronic Resource
    Electronic Resource
    Post-trauma coagulation and fibrinolysis in children suffering from severe cerebro-cranial trauma (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S197 
    Details
    ISSN: 1432-1076
    Keywords: Key words Coagulation ; Fibrinolysis ; Head injury ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present study was designed to evaluate the post-trauma haemostatic changes in 27 children with severe cranio-cerebral trauma defined by a modified Glasgow Coma Score (GCS) 〈10. Blood samples for coagulation studies (fibrinogen, von Willebrand factor (vWf), factor VIII:C, antithrombin, protein C, plasminogen, tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI), D-dimer) were obtained within two hours of admission, 24 h later, and on days 3–5, 7–9, 21 and 35. Data of this study indicate that alterations of coagulation in paediatric patients are similar to those in adults: On hospitalisation, activated haemostasis was found with decreased fibrinogen, antithrombin and protein C along with enhanced t-PA and PAI. Twenty-four hours later, hypercoagulability with significantly increased vWF and fibrinogen started, with a peak level within the second week. Within 24 h of admission, 17 children developed disseminated intravascular coagulation (DIC) with a clear-cut decrease of antithrombin and fibrinogen together with platelet consumption and enhanced D-dimer. The outcome of children with DIC was significantly poorer than in those without DIC. Complete recovery was seen in five patients; sequelae no handicap and moderate disability were each found in six patients. Severe disability was diagnosed in two children, and fulminant DIC with lethal outcome occurred in eight patients. The GCS (P 〈 0.01) and the occurrence of DIC (P 〈 0.005) showed the strongest association with the patients' clinical outcome. Conclusion Our data underline the significance of post-trauma disturbances of the haemostatic system for the clinical course and outcome in children with severe cranio-cerebral injuries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014355
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  • 10
    Electronic Resource
    Electronic Resource
    Isolated sphenoidal sinusitis in children (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 298-301 
    Details
    ISSN: 1432-1076
    Keywords: Key words Isolated ; Sphenoid ; Sinusitis ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute isolated infectious sphenoiditis is an uncommon, potentially dangerous condition which is often misdiagnosed because of its nonspecific symptoms and paucity of clinical signs. We present eight children with isolated sphenoiditis who were managed in our medical centre during the last 2 years and review the literature. All the patients were adolescents or pre-adolescents and all experienced moderate to severe refractory oppressive headache. Four had a history of sinusitis or allergic rhinitis. None had fever or any other directing clinical sign. Diagnosis was made by cranial computer tomography. All were treated with antibiotics and recovered completely without infectious or neurological complications. Conclusion Acute isolated infectious sphenoiditis should be considered in adolescents and pre-adolescents who present with constant moderate to severe oppressive headache. Awareness of this entity will enable early diagnosis and initiation of antibiotic treatment which is essential to avoid complications and surgical intervention.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051076
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  • 11
    Electronic Resource
    Electronic Resource
    The necessity of building population specific prediction equations for clinical assessment of pulmonary function tests (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 519-522 
    Details
    ISSN: 1432-1076
    Keywords: Key words Pulmonary function test ; Adjustment ; Children ; Prediction equations ; Population specific
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fitting adequate prediction equations for pulmonary function test (PFT) parameters is crucial in the analysis of lung function tests and their interpretation. Our work aimed at studying the necessity of building population specific prediction equations, rather than using prediction equations built-in in commercial equipment. We used as an example results of studies carried out among Israeli schoolchildren. Second to sixth grade children (7–13 years old), 1064 boys and 1211 girls, were studied in Tel-Aviv. PFT (forced vital capacity, forced expiratory volume in 1st second, peak expiratory flow, forced expiratory flow in 50% volume, forced expiratory flow in 75% volume) performed by these children were adjusted for height, weight and age, for each sex separately, by a multiple regression procedure. Predicted PFT parameters of 300 boys and 301 girls aged 7–13 years, living along the southern shore of Israel, were calculated using the equations built for the same aged Tel-Aviv children as well as the prediction equations built-in in the spirometer used. The ratios between the observed PFT parameters in the southern children and their expected values, using the Israeli population specific equations, were around 1.00. Using the built-in equations resulted in ratios around 0.90. Conclusion The development of population specific prediction equations for PFT parameters is necessary. Such equations should be used both in clinical assessment to minimize misclassification (healthy/sick child) and in epidemiological studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051133
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  • 12
    Electronic Resource
    Electronic Resource
    Expression of CD69 on T-cells from HIV-1-infected children and adolescents increases with increasing viral load (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 638-644 
    Details
    ISSN: 1432-1076
    Keywords: Key words HIV-1 ; T-cells ; CD69 ; Activation ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the use of a whole-blood assay that measures spontaneous and activation-induced CD69 expression on peripheral blood T-cells in vitro for assessment of T-cell function in HIV-1-infected paediatric patients. Heparinized venous blood from 28 HIV-1 positive children and adolescents and 23 healthy controls was incubated for 4 h with or without 5 μg/ml phytohaemagglutinin (PHA). Thereafter, analysis of CD69 expression on CD4+ and CD8+ T-cells was done by flow cytometry; simultaneously we determined CD4+ T-cell counts and plasma HIV-1 viral load. Neither spontaneous nor PHA-induced CD69 expression differed significantly between HIV-1 positive patients and healthy controls. However, T-cells from HIV-1 positive patients with plasma HIV-1 viral load levels above 70 × 103 copies/ml showed a higher spontaneous CD69 expression than T-cells from patients with lower plasma viral load levels in different stages of the disease. Antiretroviral treatment in four patients reduced spontaneous CD69 expression in CD4+ T-cells and PHA-induced CD69 expression in CD4+ and CD8+ T-cells significantly after 8 weeks of therapy. Conclusion Spontaneous and activation-induced expression of the early (activation) antigen CD69 on peripheral blood T-cells does not distinguish HIV-1 positive patients from HIV-1 negative healthy controls and is not correlated with peripheral blood CD4+ T-cell counts. This test may not be a reliable marker for functional T-cell deficiency during early stages of HIV disease. Increased spontaneous as well as PHA-induced CD69 expression on T-cells from HIV-1-infected children and adolescents in vitro may rather reflect HIV-induced pre-activation of T-cells in vivo.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051167
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  • 13
    Electronic Resource
    Electronic Resource
    Clinical importance of prothrombotic risk factors in pediatric patients with malignancy – impact of central venous lines (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S147 
    Details
    ISSN: 1432-1076
    Keywords: Key words Factor V G1691A ; Prothrombin G20210A ; Lipoprotein (a) ; Central venous lines ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the role of inherited thrombophilia in the development of central venous line (CVL)-related thrombosis, the following parameters were determined in 77 pediatric-oncologic patients with CVL: activated protein C (APC)-ratio, factor V (FV) G1691A and prothrombin G20210A mutation, protein C, protein S, antithrombin, coagulation factor XII, lipoprotein (a) and homocysteine. An inherited prothrombotic risk factor was found in 17 patients (23%). Four out of 14 patients with a single defect (hyperlipoproteinemia, heterozygous FV G1691A and prothrombin G20210A mutation, protein C deficiency type I) and all three patients with combined defects (heterozygous FV G1691A mutation combined with heterozygous prothrombin G20210A variant, protein S deficiency or hyperlipoproteinemia) suffered from CVL-related thrombosis. In 11 out of 77 patients (14%) a CVL-related thrombosis was detected. In 2 children thrombosis occurred a few days after asparaginase therapy and in another three thrombosis was associated with CVL-related septicemia caused by Staphylococcus epidermidis. After removal of CVL, thrombosis was detected in 5 children, in 2 without clinical symptoms but in the presence of inherited prothrombotic risk factors. Conclusion The present study demonstrates the clinical importance of CVL in combination with inherited thrombophilia in the development of thrombosis in pediatric-oncologic patients. Before or shortly after insertion of CVL, patients should be tested for the presence of factor V G1691A mutation, prothrombin G20210A variant and increased lipoprotein (a) values.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014342
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  • 14
    Electronic Resource
    Electronic Resource
    Treatment of consumption coagulopathy with antithrombin concentrate in children with acquired antithrombin deficiency – A feasibility pilot study (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S187 
    Details
    ISSN: 1432-1076
    Keywords: Key words Antithrombin concentrate ; Children ; Septicaemia ; Acquired antithrombin deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Consumption coagulopathy is a serious problem in childhood. In addition to treatment of the underlying disease, consumption coagulopathy was previously treated with heparin. Nowadays it is treated by substitution of coagulation factors, especially antithrombin (AT) concentrate, alone or in combination with heparin. In this pilot study we administered AT concentrate (dosage 80 U/kgbw/d), without additional heparin treatment, to 29 children beyond infancy with acquired AT deficiency. Antithrombin, platelet count, fibrinogen, PT, and APTT were assayed before and during the course of AT substitution. These coagulation parameters returned to normal 48 hours after normalisation of the plasma AT level. AT levels normalised within 24 h of initial substitution in all children. Lethal outcome due to the underlying disease was observed in only two children. Conclusion Data of this pilot study suggest that, concomitantly with the treatment of the underlying disease, consumption coagulopathy in childhood can be managed successfully with early substitution of AT concentrate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014353
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  • 15
    Electronic Resource
    Electronic Resource
    Mild closed head injury in children compared to traumatic fractured bone; neurobehavioural sequelae in daily life 2 years after the accident (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 249-252 
    Details
    ISSN: 1432-1076
    Keywords: Key words Mild head injury ; Fractured bone ; Late sequelae ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two years after an accident resulting in either a mild head injury or a fractured bone, two groups of 22 children each, aged 4–14 years, were examined for the existence of any neurobehavioural symptoms by means of a standardized questionnaire filled out by their caretakers. Selection of the children was based on reports of the Accident and Emergency Department in 1 year. Significantly more symptoms were reported after mild head injury. The main symptoms reported were headache, dizziness, fatigue and memory problems. The total number of symptoms in the children with mild head injury exceeded four times this in the group of children with a fractured bone. Conclusion Even 2 years after a mild head injury there are still residual symptoms in daily life.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051061
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  • 16
    Electronic Resource
    Electronic Resource
    Risk factors for type I diabetes mellitus in children in Austria (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 362-366 
    Details
    ISSN: 1432-1076
    Keywords: Key words Type 1 diabetes ; Children ; Risk factors ; Case control ; Environmental
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to investigate environmental risk factors in the development of type 1 diabetes mellitus in a population-based case-control study. Parents of all patients with manifestation of type 1 diabetes between 1989 and 1994 in Vienna were asked to complete a questionnaire (n = 114). Control children (n = 495), matched for age and sex, were randomly recruited from all schools in Vienna. Fathers of diabetic children were significantly older at the time their children were born than fathers of control children (P = 0.015). Children with diabetes were more likely to be second- or third-born children (P 〈 0.05) and fewer went to kindergarten than the control group children (P = 0.007). No significant difference in duration of gestation, percentage of delivery by caesarean section, birth weight or length was found. Neonatal jaundice was more often observed in the patient group (P = 0.038). Breast feeding was reported by 82.7% of mothers of diabetic children and by 81% of mothers of control children, and the duration of breast feeding was longer in patients than in controls (n.s.). Conclusion In our study, the development of type 1 diabetes mellitus was associated with higher paternal age and neonatal jaundice. No correlation could be found with dietary intake of cow's milk products in early infancy, vaccination and other environmental factors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051092
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  • 17
    Electronic Resource
    Electronic Resource
    Gastro-intestinal bleeding caused by leiomyoma of the small intestine in a child with neurofibromatosis (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 460-462 
    Details
    ISSN: 1432-1076
    Keywords: Key words Gastro-intestinal bleeding ; Children ; Jejunal leiomyoma ; Neurofibromatosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastro-intestinal bleeding is an uncommon presentation in children with neurofibromatosis. Gastro-intestinal involvement caused by jejunal leiomyoma has only been described in adults. To the best of our knowledge, this is the first paediatric case of jejunal leiomyoma associated with neurofibromatosis. We present a 10-year-old girl with a 9-month history of anaemia and low gastro-intestinal bleeding. Abdominal sonography and small bowel series showed a submucosal mass in the proximal jejunum. On surgery, a submucosal tumour was excised and histological examination suggested a diagnosis of “smooth muscle tumour of undetermined malignant potential”. There were no recurrence of symptoms for 4 years after the operation. Conclusion Jejunal leiomyoma should be considered in a child with neurofibromatosis presenting with gastro-intestinal bleeding.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051120
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  • 18
    Electronic Resource
    Electronic Resource
    Thyroid antibodies in children of mothers with auto-immune thyroid disease (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 24-28 
    Details
    ISSN: 1432-1076
    Keywords: Key words Hashimoto thyroiditis ; Graves disease ; Children ; TSH function-blocking antibody ; Cytotoxic antibody
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a cross-sectional study, 29 children aged between 1 month and 15.3 years (average age 6.8 years) born to mothers with Graves disease or Hashimoto thyroiditis were examined clinically, biochemically, and by sonography of the thyroid gland. At the time of examination all children were clinically euthyroid. Tests of thyroid peroxidase antibody, thyroglobulin antibody, TSH receptor antibody and free thyroxine (fT4) gave normal results. In 3 children subclinical hypothyroidism with elevated TSH and normal fT4 concentrations were found; one of these children had a minor decrease of total thyroxine. Three children with otherwise normal test results had marginally elevated tri-iodothyronine concentrations. Increased antibody titres were present in 8 out of 29 children. TSH function-blocking antibodies were elevated in 8 cases. In addition, cytotoxic antibodies were found in one of the children. The distribution pattern of antibodies was different in each child and unrelated to the type of maternal thyroid disease. Conclusion Children of mothers with auto-immune thyroid disease often have thyroid antibodies without signs of thyroid disease. Whether antibody-positive children have an increased risk of developing thyroid disorders later in life must be examined in a longitudinal study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051003
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  • 19
    Electronic Resource
    Electronic Resource
    Parental attitude towards alternative medicine in the paediatric intensive care unit (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 12-17 
    Details
    ISSN: 1432-1076
    Keywords: Key words Alternative medicine ; Complementary therapies ; Critical care ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The interest in alternative medicine (AM) is growing. In the USA and Canada, studies showed that 34% of adults and 11% of children use AM. In a prospective cohort study, we investigated the interest in AM among parents of critically ill children in the paediatric Intensive Care Unit (ICU) of a university hospital. From January 1996 to April 1997, we distributed questionnaires to the parents of critically ill children. These strictly anonymous questionnaires were completed at home and returned by mail. Exclusion criteria were short (〈1 day) or repeated hospitalizations, and insufficient proficiency of the German language. The inclusion criteria were fulfilled by 591 patients; 561 received the questionnaire (95%) and 289 (52%) were returned. Of the respondents, 70% would appreciate AM as a complementary therapy on the ICU, 23% found AM equally or more important than conventional medicine whereas only 7% regarded AM as unimportant. On the ICU, 18% used AM; surprisingly 41% of them did not discuss it with physicians or nurses. An additional 21% would have liked to use AM, but did not do so. Typically, AM-users administered AM also at home to their children and themselves. Their children were however, older. Conclusions A substantial proportion of parents used measures of alternative medicine in the intensive care unit, or would have like to do so. However, few had the confidence to discuss this wish with the medical personal. This suggests that alternative medicine is of great interest, even on an intensive care unit. Nevertheless, discussion about alternative medicine seems to be taboo in doctor-patient relations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051001
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  • 20
    Electronic Resource
    Electronic Resource
    Liver transplantation in mitochondrial respiratory chain disorders (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S081 
    Details
    ISSN: 1432-1076
    Keywords: Key words Respiratory chain ; Mitochondria ; Children ; Infancy ; Liver failure ; AbbreviationsMRCD mitochondrial respiratory chain disease ; OLT orthotopic ; liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Mitochondrial respiratory chain disease may lead to neonatal or late onset liver failure, requiring liver transplantation. In rare cases, the disease is restricted to the liver and the patient is cured after surgery. More frequently, other organs are simultaneously involved and neuromuscular or other extra-hepatic symptoms may pre-exist, or appear in the post-transplant follow up. Pre-transplant evaluation should aim to rule out neurological disease, which may be difficult to differentiate from signs accompanying liver insufficiency. Cerebrospinal fluid lactic acid levels, compared to blood lactate, may be suggestive of central nervous system involvement. Of 11 cases with respiratory chain disorders who had liver transplantation in various centres, 4 are alive and well on follow up, and 6 died, three of them having developed neurological disease post orthotopic liver transplantation. All three patients with initial liver and gastro-intestinal disease died early after transplantation, indicating that these may be poor candidates for this procedure. Conclusion Liver transplantation is feasible in hepatic respiratory chain disorders, but extra-hepatic disease should be ruled out before transplantation. Extra-hepatic manifestations may, however, appear and cause patient death despite successful transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014328
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  • 21
    Electronic Resource
    Electronic Resource
    Liver transplantation in α1-antitrypsin deficiency (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S085 
    Details
    ISSN: 1432-1076
    Keywords: Key wordsα1-Antitrypsin ; Liver disease ; Liver transplantation ; Children ; AbbreviationsAATα1-antitrypsin deficiency ; OLT orthotopic liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Only a minority of infants born with α1-antitrypsin deficiency will develop serious liver disease during childhood, mostly but not always after neonatal cholestasis. Early prognosis is difficult and all children have to be followed up carefully. The liver disease progresses with varying speed and it lacks specific features. At the time of liver transplantation the young patients have no pulmonary disease induced by the deficiency and in those with renal involvement, the kidney problems can mostly be dealt with by conservative therapy. The peri- and postoperative care of the patients who undergo liver transplantation does not differ from the usual routines.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014329
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  • 22
    Electronic Resource
    Electronic Resource
    Prothrombotic risk factors in childhood stroke and venous thrombosis (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S117 
    Details
    ISSN: 1432-1076
    Keywords: Key words Stroke ; Coagulation ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Many studies have shown a high percentage of venous thromboses in children to be associated with haematological disorders. However, studies assessing the influence of haemostaseological disorders on paediatric stroke are rare. We compared 26 children with cerebral infarction (median age 2 months, range 0–16.2 years) and 17 with venous thrombosis (median age 4.5 years, range 0–17 years) with regard to prothrombotic risk factors. Prothrombotic disorders were found in 8 out of 26 patients with cerebral infarction (FV Leiden mutation: n = 4; protein C deficiency: n = 1; FV Leiden mutation + protein C deficiency: n = 2; prothrombin mutation G20210A: n = 1) and in 13 out of 17 with venous thrombosis (FV Leiden mutation n = 3; protein C deficiency n = 5; elevated HRGP + PAI: n = 1; combined deficiency of AT, protein C and plasminogen: n = 1; F XII deficiency: n = 1; lupus anticoagulans n = 1; FV Leiden + F XII deficiency + lupus anticoagulans + PAI: n = 1). Comparison of these prevalences with those of 150 healthy paediatric controls showed in children with FV Leiden mutation and/or protein C deficiency an increased risk of cerebral infarction (patients vs. controls: 26.9% vs. 6%; OR 5.77; 95%-CI 1.92–17.3; P = 0.0031) as well as of venous thrombosis (53% vs. 5.3% 19.9; 95%-CI 6–65.6; P 〈 0.0001). This result is in contrast with reports on thrombophilia in cerebral infarction in adult patients. Conclusion Our results indicate that FV Leiden mutation and protein C deficiency may contribute to the multifactorial aetiology of stroke in early childhood.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014333
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  • 23
    Electronic Resource
    Electronic Resource
    Heparin-induced thrombocytopenia in paediatric patients – a review of the literature and a new case treated with danaparoid sodium (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S130 
    Details
    ISSN: 1432-1076
    Keywords: Key words Heparin treatment ; Heparin-induced thrombocytopenia ; HIT antibodies ; Children ; Catheter patency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The immunological form of heparin-induced thrombocytopenia (HIT) is a potentially life-threatening adverse reaction of heparin medication. It is mediated by multimolecular complexes consisting of platelet factor 4 (PF4)-heparin-IgG which bind to platelets via platelet Fcγ receptors. Cross-linking of multiple Fcγ receptors results in platelet activation, platelet aggregation and enhanced thrombin generation with a increasing risk of developing new thrombosis. In children, data on HIT are sparse. This review of the literature reports on 8 children aged 3 months to 15 years and 14 newborns suffering from HIT. Additionally, we report one new case treated with danaparoid sodium. Thrombotic complications were venous (n = 12) and arterial (n = 15). The children received heparin either for a spontaneous thrombotic event, for severe cardiac diseases or to maintain patency of intravascular catheters which are used for nutrition, blood sampling, and for application of medication. After diagnosis of HIT they were further anticoagulated with aspirin, warfarin, danaparoid sodium, lepirudin or low molecular weight heparin. Conclusion Although HIT is less frequently reported in newborns and children, paediatricians should be aware of HIT in childhood as a potential complication of heparin application. The widespread practice of flushing catheters with heparin should also be debated in view of the risk of triggering the primary immune-response of HIT. In 1999, treatment options for further parenteral anticoagulation of HIT patients are danaparoid sodium (a low-molecular weight heparinoid) and lepirudin (a direct thrombin inhibitor).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014338
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  • 24
    Electronic Resource
    Electronic Resource
    Antithrombin treatment of severe hepatic veno-occlusive disease in children with cancer (1999)
    Springer
    European journal of pediatrics 158 (1999), S. S154 
    Details
    ISSN: 1432-1076
    Keywords: Key words Veno-occlusive disease ; Antithrombin ; Children ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hepatic veno-occlusive disease (VOD) is a well-known complication of chemotherapy in Wilms tumor patients, particularly young children. Although this complication resolves uneventfully in most patients, fatal cases have been reported. Severe VOD after transplantation has a high mortality rate ranging from 45% to 98%. New hemostatic therapeutic strategies have significantly improved the prognosis of VOD. Chemotherapy-related VOD in Wilms tumor usually has a good prognosis. We describe two patients with Wilms tumor and one with acute lymphoblastic leukemia, who developed severe veno-occlusive disease of the liver according to the Baltimore criteria while undergoing chemotherapy; the symptoms were hepatomegaly, ascites, hyperbilirubinemia, weight gain and, in one patient, short-term lethargy. Elevated LDH levels of 872 to 12,000 U/l were observed in our patients. All patients had thrombocytopenia between 29,000 and 40,000/μl and decreased antithrombin (AT) and protein C levels; two patients had gastrointestinal bleeding. All patients developed a coagulopathy because of severe hepatic dysfunction. Two patients received low-dose heparin at the onset of VOD. The thrombolytic therapy was rapidly changed to AT supplementation (20–80 IU/kg bw 2× per day) without heparin when thrombocytes were very low or gastrointestinal bleeding occurred. Resolution of VOD was observed in all patients receiving AT alone. The chemotherapy was discontinued in a patient with accidental actinomycin D overdosage in view of the severity of symptoms. The remaining two patients received chemotherapy according to the therapy protocol after restitution. All patients survived without sequelae with a median follow-up of 28 months (range 8–48 months). Conclusion Hepatic veno-occlusive disease is a rare but increasingly recognized complication in pediatric cancer patients receiving conventional chemotherapy. AT supplementation constitutes a good alternative treatment of severe VOD in comparison with other thrombolytic therapies, particularly in patients at high risk of bleeding.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014344
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  • 25
    Electronic Resource
    Electronic Resource
    Word-list learning in normally developing children: effects of semantic organization and retention interval (1999)
    Springer
    Italian journal of neurological sciences 20 (1999), S. 119-128 
    Details
    ISSN: 1126-5442
    Keywords: Key words Learning ; Development ; Memory ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Immediate and 15-min delayed recall of semantically related or unrelated word lists was investigated in 144 normally developing children ranging from 5 to 10 years of age. Immediate recall for the related and unrelated lists increased in a parallel fashion as a function of age. The ability to cluster semantically related items during immediate recall also improved with age. However, in no age class recall scores and clustering indexes were significantly associated. Forgetting rate passing from the last immediate to the delayed recall trial increased for the unrelated list but decreased for the related list of words as a function of age. Results of regression analyses revealed that a developmental increase in forgetting on the unrelated list was actually due to the higher number of words recalled in the last immediate trial by older children. As for the related list, instead, the larger reliance on the clustering strategy of recall by older children was responsible for the progressive reduction of forgetting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100720050019
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  • 26
    Electronic Resource
    Electronic Resource
    Chronic neuroborreliosis in infancy (1999)
    Springer
    Italian journal of neurological sciences 20 (1999), S. 303-307 
    Details
    ISSN: 1126-5442
    Keywords: Key words Lyme disease ; Chronic neuroborreliosis ; Children ; MRI ; Demyelinating disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Lyme disease is a polymorphic and multisystemic disease caused by Borrelia burgdorferi. Neurological manifestations are found in 10%–50% of cases. We present 2 cases followed for 5 and 6 years of chronic relapsing-remitting neuroborreliosis. Diagnosis of neuroborreliosis in these cases was based on serum and cerebrospinal fluid findings. We discuss clinical, neurophysiological, laboratory and instrumental aspects regarding the difficulties of reaching a correct diagnosis. Further studies, especially in the field of immunology, should help identify the mechanisms responsible for the disease becoming chronic. With this knowledge, it may be possible to design immunological therapies for relapses, and to prevent the evolution of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100720050045
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  • 27
    Electronic Resource
    Electronic Resource
    Recommendations for treatment of contralateral inguinal hernias in children (1999)
    Springer
    Hernia 3 (1999), S. 53-56 
    Details
    ISSN: 1248-9204
    Keywords: Contralateral hernia ; Children ; Incidence ; Predisposing disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It is impossible to determine whether or not a child will develop a contralateral hernia after inguinal hernia repair. There exists no risk score for the occurrence of a contralateral hernia. This well-known fact prompted us to perform the underlying study. In a retrospective trial, we reviewed the files of all children operated on for inguinal hernias in our department from January 1986 until December 1994. During this period, we performed 1721 hernia repairs on 1708 children aged 0–16 years. In 96 (5.6%) of these patients, the indication to operate was a contralateral hernia following previous unilateral repair. Comparison of the ages at the time of primary inguinal repair of those children who developed a contralateral hernia (n=96) and those who did not (n=1612) showed a significantly increased incidence of contralateral hernias if the primary operation was performed before the age of two months (p〈0.0001). Diseases predisposing to hernias were found in 38% of all children (prematurity, dystrophia, ventriculo-peritoneal shunt, ascites, asthma). The authors recommend a contralateral exploration for children under the age of two months if they have any predisposing disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01194602
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  • 28
    Electronic Resource
    Electronic Resource
    Socioeconomic risk factors in the prevalence of asthma and other atopic diseases in children 6 to 7 years old in Valencia, Spain (1999)
    Springer
    European journal of epidemiology 15 (1999), S. 35-40 
    Details
    ISSN: 1573-7284
    Keywords: Asthma ; Atopic diseases ; Children ; Epidemiology ; Socio-economic status ; Tobacco smoke
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A cross-sectional survey of a cohort study was carried out between June and December 1994 in Valencia, Spain (population in 1994: 764,293 inhabitants). Two hundred sixty public and private schools randomly selected from the total of schools in Valencia were invited to participate; 3948 children aged 6–7 years cooperated in our study after informed consent was obtained from parents and school director. The survey in Valencia is part of the International Study of Asthma and Allergy in Childhood (ISAAC). Prevalences for asthma, rhinitis and atopic dermatitis were determined and contrasted with socioeconomic status (SES) among children. No statistically significant associations were established between the prevalences of asthma, rhinitis and atopic dermatitis, and SES. However, atopic dermatitis was found to be common among upper class children (21.5 per 100 children). Likewise, significant associations were observed between the severity of atopy (2 or 3 atopic manifestations) and SES (p=0.000), being greater for lower strata (4.5 per 100 children); for the three SES level significant differences were established (p = 0.008) regarding passive exposure to tobacco smoke in the home.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007592121308
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  • 29
    Electronic Resource
    Electronic Resource
    Maternal knowledge and environmental factors associated with risk of diarrhea in Israeli Bedouin children (1999)
    Springer
    European journal of epidemiology 15 (1999), S. 907-912 
    Details
    ISSN: 1573-7284
    Keywords: Bedouin ; Children ; Diarrhea ; Environment ; Knowledge
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diarrhea is still a major cause of morbidity and mortality among children in developing countries. As it is due to multiple causative agents including viruses, bacteria and parasites, biological interventions are not currently available to markedly reduce incidence and severity. We examined maternal knowledge and reported behavior during diarrheal episodes, as well as environmental factors to determine their association with diarrhea. The children and mothers were from a Bedouin township in southern Israel, which has developed preventive and curative health care facilities. The Bedouin population in Israel is in transition from a nomadic to a settled life style. While almost all mothers exhibited good knowledge regarding food storage and prevention of diarrhea episodes in the children, the rate of illness in the children remained relatively high (two episodes per child year of observation). In a multivariate analysis, cessation of breastfeeding during diarrhea, child sleeping with siblings and lack knowledge about risk factors, were the major risk factors for illness with odds ratios (OR): 4.6, p = 0.02, 5.6, p = 0.03 and 1.7, p = 0.06, respectively. These data indicate that even in this population with free access to preventive medical care, greater efforts should be made to educate mothers regarding risk factor for diarrheal disease identification and the benefits of maintaining breastfeeding during diarrhea episodes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007649820423
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  • 30
    Electronic Resource
    Electronic Resource
    Inhalation burns in children (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 50-55 
    Details
    ISSN: 1437-9813
    Keywords: Key words Burns ; Inhalation injury ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Survival from serious burns in children has improved substantially in recent years. Mortality is predominantly determined by the total body surface area burned and the often unrecognised inhalation injury. A retrospective review of 4,451 consecutive children with thermal injuries over a 10-year period was undertaken to determine the incidence, clinical presentation, and pathology of inhalation injury and its contribution to morbidity and mortality. Inhalation burns were diagnosed clinically and confirmed endoscopically and post-mortem in 97 (2.2%) children; 77 sustained fire burns (mean age 4 years) and 20 hot-water burns (mean age 18 months). The Moylan classification stratified them into upper-airway burns in 59 children, major–airway burns in 29, and parenchymal burns in 44. Major-airway burns were always seen in conjunction with either upper-airway or parenchymal injury. Stridor and acute progressive respiratory distress were the two main symptoms, the onset of which was occasionally delayed for up to 72 h. Endoscopy was most helpful in confirming the diagnosis and determining airway management. Endotracheal intubation was needed in more than 50% of children, usually for less than 5 days, and was converted to tracheostomy in only 6. Persistent laryngeal and tracheal damage was identified in 4. Secondary pneumonia occurred in 41.5% of children with fire burns and 55% with hot-water burns. Extensive surface burns, parenchymal injury, and secondary pneumonia all contributed to the significant mortality. Post-mortem findings corroborated clinical and endoscopic evidence. This study suggests that inhalation burns were often not recognised, could present late, and usually had significant consequences. Early clinical diagnosis, supported by endoscopic findings and appropriate management, is essential if the high morbidity and mortality amongst these children is to be improved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050511
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  • 31
    Electronic Resource
    Electronic Resource
    Actinomycosis of the appendix in childhood (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 63-65 
    Details
    ISSN: 1437-9813
    Keywords: Key words Actinomycosis ; Antibiotic treatment ; Appendicitis ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abdominal actinomycosis (AMC) is a rare infection in children. The appendix is the most common intra-abdominal organ involved. It presents as an undifferentiated mass, forming abscesses and fistulas in the right lower quadrant. The case of a 15-year-old girl with a AMC of the appendix detected by the pathologist after routine appendectomy is discussed. Long-term antibiotic treatment and follow-up by ultrasound and laboratory controls are necessary.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050515
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  • 32
    Electronic Resource
    Electronic Resource
    A conservative treatment for ingrown toenails in children (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 121-122 
    Details
    ISSN: 1437-9813
    Keywords: Key words Ingrowing nails ; Conservative treatment ; Children ; Adolescents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Ingrowing nails are not uncommon in children, and even so receive little attention in the pediatric surgery literature. The purpose of the present study was to demonstrate our modification of the conservative treatment of ingrowing nails. Our technique of local treatment combined with patient education for better foot and toe care was successfully used and well tolerated by 19 out of 20 young patients with ingrown toenails.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050531
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  • 33
    Electronic Resource
    Electronic Resource
    Small-cell carcinoma of the ovary of the hypercalcemic type in an 8-year-old girl (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 431-434 
    Details
    ISSN: 1437-9813
    Keywords: Key words Ovarian tumor ; Children ; Hypercalcemia ; Small-Cell carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tumors of the ovary in girls represent about 80% of pediatric genital tumors; approximately 30% of these tumors are malignant. The risk of malignancy increases with decreasing age. The most frequent finding is a teratoma; other tumors are rare. Small-cell carcinoma (SCCO) of the ovary is extremely rare, occurring mostly in young women. We present an 8-year-old girl with a SCCO of the hypercalcemic type. The findings and treatment are discussed with emphasis on the poor prognosis in these patients, even in stage 1 disease. The current literature is reviewed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050625
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  • 34
    Electronic Resource
    Electronic Resource
    Hydatid cyst of the pancreas: a case report with 5 years' follow-up (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 579-581 
    Details
    ISSN: 1437-9813
    Keywords: Key words Hydatid disease ; Pancreas ; Children ; Echinococcosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Primary hydatid disease of the pancreas is rare. The authors report a 3-year-old girl who had a cystic mass in the head of the pancreas with no other viscera involved. At laparatomy the entire endocyst was totally extracted from the surrounding pancreatic parenchyma. The postoperative course was uneventful. She is currently disease-free with a follow-up of 5 years. Only four other pediatric cases have been reported in the English literature.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050677
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  • 35
    Electronic Resource
    Electronic Resource
    Graded compression ultrasonography in the assessment of the “tough decision” acute abdomen in childhood (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 32-35 
    Details
    ISSN: 1437-9813
    Keywords: Key words Appendicitis ; Ultrasonography ; Children ; Graded compression ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The diagnosis of acute appendicitis in childhood is frequently difficult. In some situations the need to operate is clear, but in others the decisions may be much “tougher” because the clinical findings are equivocal. This is a retrospective study of a consecutive series of 253 children presenting with “acute abdominal pain? appendicitis” who had graded compression ultrasonography (GCUS) because the clinical scenario did not warrant immediate laparotomy. This represents 30% of all cases seen in the study period. The aim of the study was to examine the role of GCUS and a clinical scoring system (the Alvarado score) in patients in whom the diagnosis is uncertain.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050506
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  • 36
    Electronic Resource
    Electronic Resource
    Acute scrotal pain in children: results of 543 surgical explorations (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 353-357 
    Details
    ISSN: 1437-9813
    Keywords: Key words Testis torsion ; Scrotum ; Appendage ; Cremasteric reflex ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 543 boys suffering from acute scrotal pain underwent emergency surgery between 1986 and 1996. Of these, 91 had a testicular torsion (TT) (16.8%) and 250 had an appendage torsion (AT) (46%). The cause varied with patient age, with most TTs in newborns and boys of 15 years and most ATs in 10–11-year-olds; 21.5% were operated upon within 6 h of the onset of pain and 69.2% within 24 h. Most stayed in hospital for less than 24 h. Pre-surgical examination identified no criterion for excluding TT. We therefore believe that all children complaining of acute scrotal pain should undergo surgery. As release of an inflamed AT reduces pain, three-fourths of the children benefited directly from surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050598
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  • 37
    Electronic Resource
    Electronic Resource
    A method to overcome the inability to draw blood from central venous lines in children (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 525-526 
    Details
    ISSN: 1437-9813
    Keywords: Key words Central venous catheters ; Children ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The insertion of central venous catheters has become an established practice in the management of children with different types of malignancies for the administration of chemotherapeutic agents, antibiotics, blood and blood products, as well as drawing blood for various investigations. A commonly encountered problem is that despite the catheter being patent it may be impossible to draw blood from it. We believe this is related to the cut of the catheter tip. To overcome this problem, a technique for cutting the tip of the catheter is described.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050659
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  • 38
    Electronic Resource
    Electronic Resource
    Chemotherapy for intracranial ependymomas (1999)
    Springer
    Child's nervous system 15 (1999), S. 563-570 
    Details
    ISSN: 1433-0350
    Keywords: Key words Ependymoma ; Children ; Chemotherapy ; Phase II
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Chemotherapy has been used extensively in the management of children with intracranial ependymoma. In this review, we discuss the results of phase II studies and clinical trials conducted in newly diagnosed and recurrent ependymomas. There is little evidence that chemotherapy is effective in this tumour. The response rate to single agents is 11%, with less than 5% complete responses, cisplatin being the most active agent in phase II studies. Combinations may be more effective, although the response rate with high-dose regimens is disappointing. Early results of protocols conducted in infants and young children do not suggest that chemotherapy is beneficial. A more rigorous assessment of chemotherapy is required in order to define its role in patients with intracranial ependymomas. Indeed, it is difficult to justify the use of chemotherapy outside such studies. More large studies, perhaps intergroup, limited to children with ependymomas would be of particular value.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050544
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  • 39
    Electronic Resource
    Electronic Resource
    Vincristine pharmacokinetics after repetitive dosing in children (1999)
    Springer
    Cancer chemotherapy and pharmacology 44 (1999), S. 203-209 
    Details
    ISSN: 1432-0843
    Keywords: Key words Vincristine ; Pharmacokinetics ; Repetitive dosing ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: We studied vincristine disposition after 169 weekly i.v. bolus injections in 32 children with acute lymphoblastic leukemia, non-Hodgkin lymphoma, or Wilms' tumor. The aim of the study was to determine intrapatient and interpatient variability in vincristine disposition and demographic, clinical, and biochemical characteristics influencing this variability. Methods: Vincristine plasma concentrations were measured by a high-performance liquid chromatography assay with electrochemical detection. A limited sampling strategy was used based on a bayesian parameter estimation algorithm that is part of the ADAPT II software package. A two-compartment, first-order model was fitted to the data, and pharmacokinetic parameters were calculated from the model using the ADAPT II software. For statistical analysis, analysis of variance (ANOVA), t test, simple and multiple regression analysis, and non-parametric or robust equivalents were used. Results: Results showed a large intrapatient and interpatient variability in distribution half-life, elimination half-life, total body clearance, apparent volume of distribution at steady state, and area under the concentration–time curve. Intrapatient variability was significantly smaller than interpatient variability for all these parameters except distribution half-life. The diagnosis or treatment protocol turned out to be the most predictive characteristic; leukemia and non-Hodgkin lymphoma patients had a significantly higher total body clearance than Wilms' tumor patients. Conclusions: We conclude that both intrapatient and interpatient variability in vincristine pharmacokinetics is large in pediatric cancer patients and that variability, although significantly influenced by diagnosis, largely remains unpredictable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002800050968
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  • 40
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    Natural Haemophilus influenzae type b capsular polysaccharide antibodies in 412 infants and children from West Africa (Burkina-Faso) and France: A cross-sectional serosurvey (1999)
    Springer
    European journal of epidemiology 15 (1999), S. 577-582 
    Details
    ISSN: 1573-7284
    Keywords: Children ; ELISA ; Haemophilus influenzae type b ; Infants ; Natural immunity ; Vaccination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Prior to possible introduction of large-scale vaccination programmes, an estimation and comparison of naturally acquired immunity against Haemophilus influenzae type b (Hib) was carried out in two populations of age-stratified infants and children (from birth to 14 years old) in Burkina-Faso (West Africa) (n = 206) and France (n = 206). Hib capsular polysaccharide antibodies were detected by an ELISA method. The difference in the percentages of minimum protective levels for the two populations were not significant (0.15 μg/ml) for newborns (0–1 month) but became significant as early as 2 to 3 months of age (p 〈 0.01) when lower levels were found among infants from Burkina-Faso. Subsequently, the percentages in both countries remained low until 11 months of age and showed no significant differences. For children between 12 and 35 months, the results ≥ 0.15 μg/ml were significantly higher in France (p ≤ 0.05). From 36 months, the percentage of minimum seropositivity increased in Burkina-Faso, so that the difference was no longer significant. In each country, the percentage of children with the minimum protective level varied significantly (p les; 0.05) according to age (0–47 months). None of the children from Burkina-Faso or France had antibody levels 〉 1.0 μg/ml before one year of age. Thereafter, only 9.51% of French children in the 12- to 17-month age stratum and 19.2% over 4 years of age had antibody levels 〉 1.0 μg/ml. There were no non-detectable results for children over 4 years of age, and the means for natural detectable Hib CP antibodies were 〉 0.15 μg/ml for both populations. Hib invasive infections depend on climate, socioeconomic status and ethnic and genetic factors. In Burkina-Faso, the large number of infants and children under 4 years of age susceptible to Hib infections suggests that large scale vaccination programmes are needed soon after birth. However, it would first be necessary to evaluate such factors as the frequency of Hib diseases in this population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007668003578
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  • 41
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    Electronic Resource
    National Surveillance System and Hib meningitis incidence in Italy (1999)
    Springer
    European journal of epidemiology 15 (1999), S. 685-687 
    Details
    ISSN: 1573-7284
    Keywords: Children ; Epidemiology ; Hib meningitis ; Italy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 1994, the Italian Ministry of Health implemented a National Surveillance System to obtain data on the incidence of bacterial meningitis and its causative agents, including Haemophilus influenzae type b (Hib). As a consequence, case reporting of Hib meningitis is increasing year by year; in 1996, there were 126 notifications, of which 73% were in children under 2 years of age. Although underreporting still exists, parallel prospective or retrospective epidemiological surveys conducted in some Italian Regions allowed for partial correction of the incidence of Hib meningitis (up to 18.5/100,000 population in 1994).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007670904487
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  • 42
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    Electronic Resource
    Designing handheld technologies for kids (1999)
    Springer
    Personal and ubiquitous computing 3 (1999), S. 81-89 
    Details
    ISSN: 1617-4917
    Keywords: Child-centred participatory design ; Children ; Collaboration ; Education ; Handheld computing ; Learning environments
    Source: Springer Online Journal Archives 1860-2000
    Topics: Electrical Engineering, Measurement and Control Technology
    Notes: Abstract Computers are becoming an important tool in learning environments; however, children's access to computer technology is often limited. Computers are commonly placed at the back of the classroom or in a separate computer room. At home, if computers are available, they are often found in a home-office or another communal area. In both cases, the physical location of the computers is separate from many places where children's activities and learning occur. Flexible access to technology will provide tools to help children construct knowledge throughout their daily activities. The growth of handheld computers provides the potential to integrate computer technology into the many facers of children's lives. This paper investigates issues surrounding the design of handheld computers for children's use in learning environments. It focuses on child-centred design, engaging children as active participants in the design of handheld technologies. Two central issues are addressed: mobility and sharability.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01305323
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  • 43
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    Electronic Resource
    It's fun to do things together: Two cases of explorative user studies (1999)
    Springer
    Personal and ubiquitous computing 3 (1999), S. 137-140 
    Details
    ISSN: 1617-4917
    Keywords: Children ; Product concept design ; Social aspects of fun ; User study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Electrical Engineering, Measurement and Control Technology
    Notes: Abstract This paper describes two explorative user studies conducted in a research project called Maypole. The purpose of the first user study was to understand how children thought communication with personal technologies could be fun. The second study focused on what children thought was fun in taking and editing digital images. In both studies, children aged 7–12 were given existing personal technologies to use in their own environment for one week. After that, a focus group was held with the children in order to discuss what they thought was fun in using the technologies. The results of the two user studies illustrate how fun in using personal technologies could relate to a user's social behaviour, and not only to human-computer interaction. Therefore, designers are encouraged to explore further the social aspects of fun in their creations. Moreover, the two studies illustrate some methodological problems in studying a user's experience of fun, which refer to a need for more public research on methods.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01305339
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  • 44
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    Electronic Resource
    Low back pain in a population of school children (1999)
    Springer
    European spine journal 8 (1999), S. 439-443 
    Details
    ISSN: 1432-0932
    Keywords: Key words Low back pain ; Children ; Clinical examination ; Questionnaire ; Prevalence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A study was undertaken to analyse the prevalence of low back pain (LBP) and confounding factors in primary school children in the city of Antwerp. A total of 392 children aged 9 were included in the study. All children completed a validated three-page questionnaire and they all underwent a specific lumbar spine oriented medical examination during their annual routine medical school control. This examination was performed by the city school doctors. The questionnaire was composed of easy “yes/no” questions and visual analogue scales. Statistical analysis was performed using Student’s t-test and chi-squared test at the significance level P 〈 0.05. The prevalence of LBP was high. No gender difference was found. A total of 142 children (36%) reported having suffered at least one episode of LBP in their lives. Of these, 33 (23%) had sought medical help for LBP from a doctor or physiotherapist. Sixty-four percent of children reporting LBP said that at least one of their parents suffered from or complained of LBP. This was significantly higher than for the children who did not report having suffered LBP. The way in which the school satchel was carried (in the hand, on the back) had no bearing on the incidence of LBP. There was significantly more LBP in children who reported playing video games for more than 2 h per day, but this was not so for television watchers. The visual analogue scales concerning general well-being were all very significantly correlated with self-reported LBP, with children who reported LBP being more tired, less happy, and worse sleepers. Of the 19 clinical parameters taken down during the medical examination, only one was significantly more prevalent in the group of children reporting LBP: pain on palpation at the insertion site on the iliac crest of the ilio-lumbar ligament. From this study we can establish that there are few clinical signs that can help to single out school children with LBP.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005860050202
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  • 45
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    Electronic Resource
    Changes in brain water diffusion during childhood (1999)
    Springer
    Neuroradiology 41 (1999), S. 929-934 
    Details
    ISSN: 1432-1920
    Keywords: Key words Magnetic resonance imaging ; diffusion weighted ; Myelination ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the changes in brain water diffusion in childhood as seen on diffusion-weighted MRI in 30 children from 1 day of life to 17 years to provide a data base and to investigate the correlation of diffusion changes with known patterns of white matter maturation. The apparent diffusion coefficient (ADC) and apparent anisotropy (AA) were calculated in numerous regions of the brain to include major white matter tracts and gray matter. ADC and AA values were directly related to the structural maturity and compactness of the white matter tracts and changed with aging in a way that predated early myelination markers such as signal change on T1- or T2-weighted images. Diffusion of water is sensitive to structural changes in the brain such as white matter maturation and may be useful in investigating white matter disorders.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050869
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  • 46
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    Electronic Resource
    MRI of primary meningeal tumours in children (1999)
    Springer
    Neuroradiology 41 (1999), S. 512-516 
    Details
    ISSN: 1432-1920
    Keywords: Key words Meninges ; Tumours ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Childhood meningeal tumours are uncommon and mostly meningiomas. We reviewed the histological and radiological findings in meningeal tumours in six children aged 12 years or less (four benign meningiomas, one malignant meningioma and one haemangiopericytoma). Compared to the adult counterpart, childhood meningiomas showed atypical features: cysts, haemorrhage, aggressiveness and unusual location. MRI features varied according to the site of the tumour, histology, haemorrhage, and presence of intra- or peritumoral cysts. Diagnosis of the extra-axial tumour was relatively easy in two patients with meningiomas, one malignant meningioma and one haemangiopericytoma. MRI findings strongly suggested an intra-axial tumour in two patients with benign meningiomas, because of severe adjacent edema. Awareness of the variable findings of childhood meningiomas and similar tumours may help in differentiation from brain tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050794
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  • 47
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    Electronic Resource
    Die Chirurgie der erworbenen laryngotrachealen Stenosen im Kindesalter. Erfahrungen und Ergebnisse von 1988–1998 Teil II: Die cricotracheale Resektion (1999)
    Springer
    HNO 47 (1999), S. 611-622 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Laryngotracheale Stenose ; Cricotracheale Resektion ; Kinder ; Tracheotomie ; Key words Laryngotracheal stenosis ; Cricotracheal resection ; Tracheostomy ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Approximately 90% of infants and children with severe acquired laryngotracheal stenoses are tracheotomy dependent and therefore impaired in their physical and speech developments. In addition, tracheotomized infants can be endangered by the cannula due to the possible crusting of secretions or its dislocation. Thus, early repair of a stenosis is mandatory. Within the last 10 years, we successfully operated on 18 children with severe laryngotracheal stenoses. Ten children were treated with a modified Cotton technique. This paper reports our results of cricotracheal resection performed in 8 children since 1994 (age distribution: 7 months through age 15 years). Four children had Cotton grade II stenoses, three had grade III stenoses and one grade IV stenoses. In 3 patients a tracheotomy had been performed at another institution. Since their tracheostomas were too far caudal, they could not be included in the primary resection. All 8 children have been successfully decannulated. Five children without tracheotomies could be extubated uneventfully on the 5th postoperative day. All three primarily tracheotomized children needed further endotracheal stenting with T-tubes because of stomal and suprastomal collapse. Two of these latter children additionally required a tracheoplasty with rib cartilage grafts in order to stabilize the suprastomal trachea prior to decannulation. No patient experienced injuries to the recurrent laryngeal nerves or insufficiencies of the anastomosis. All children’s voices were not impaired. This is the third report in literature of cricotracheal resections in infants and children, indicating that this effective, one-stage procedure is superior to laryngotracheal reconstruction with rib cartilage.
    Notes: Zusammenfassung Kinder mit schweren, erworbenen subglottischen laryngotrachealen Stenosen sind zu 90% tracheotomiert und daher in ihrer körperlichen und sprachlichen Entwicklung beeinträchtigt. Zusätzlich sind mit einer Trachealkanüle versorgte Kinder, insbesondere Kleinkinder, gefährdet, so daß die chirurgische Beseitigung der Stenose dringend geboten ist. Wir haben innerhalb der vergangenen 10 Jahre 18 Kinder mit einer schweren subglottischen laryngotrachealen Stenose operiert; 10 Kinder, über die kürzlich berichtet wurde, konnten mit der modifizierten Cotton-Technik erfolgreich dekanüliert werden. Über 8 Kinder (Alter 7 Monate bis 15 Jahre, 4mal Stenose II. Grades, 3mal Stenose III. Grades, einmal Stenose IV. Grades), die wir mit cricotrachealer Resektion (CTR) und thyrotrachealer Anastomose operierten, wird in der vorliegenden Arbeit berichtet. 3 Kinder waren anderenorts bereits tracheotomiert. Da die Stomata zu weit kaudal lagen, konnten sie nicht in die Resektion einbezogen werden. Alle 8 Kinder konnten inzwischen dekanüliert werden und sind beschwerdefrei: Die 5 nicht tracheotomierten Kinder konnten problemlos am 5. postoperativen Tag extubiert werden. Die zuvor tracheotomierten Kinder konnten erst nach endotrachealer Schienung (2mal nach zusätzlicher Trachealplastik mit Rippenknorpel bei suprastomaler Tracheomalazie) dekanüliert werden. Bei keinem der Kinder trat eine Recurrensparese auf. Die Stimme bei allen Kindern ist unbeeinträchtigt. Die CTR, über die bei kindlichen laryngotrachealen Stenosen mit dieser Arbeit in der Literatur zum 3. Mal berichtet wird, ist eine sehr effektive, einzeitige, komplikationsarme Operationsmethode, deren Resultate für Atmung und Stimme günstiger sind, als mit der Erweiterungsplastik nach Cotton.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050434
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  • 48
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    Electronic Resource
    Blood salvage in craniosynostosis surgery (1999)
    Springer
    Child's nervous system 15 (1999), S. 695-710 
    Details
    ISSN: 1433-0350
    Keywords: Key words Craniosynostosis ; Blood salvage ; Blood conservation ; Allogeneic blood transfusion ; Children ; History
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In the history of surgery, every single step forward in the development of complex surgical techniques has been sustained by the acquisition of more reliable and effective methods for controlling hemostasis. For many years, in fact, uncontrolled hemorrhages, together with infections, represented the most deadly hazard of surgical procedures. In the last century, technical advances in surgical hardware and homologous blood transfusions have been utilized to counteract operative and postoperative anemia and hypovolemia. At the end of this millennium, however, new revelations about the infective and noninfective risks of allogeneic blood transfusions have led to a new acceleration in patients’ and physicians’ demands for autologous transfusions and more efficient blood conservation techniques. Specific surgical protocols, based on the preoperative administration of r-HuEPO, preoperative autologous blood donation, acute preoperative normovolemic hemodilution and intraoperative blood salvage techniques, have been designed by pediatric neurosurgeons to minimize the exposure of patients affected by craniosynostoses to allogeneic blood and blood components even when the surgical procedure is to be realized at an early age. In spite of the evolution expected in this area in the immediate future, the implementation of these blood concentration methodologies may prove to be highly effective only when associated with a concerned attitude of the surgeon toward blood-sparing intraoperative strategies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050459
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  • 49
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    Electronic Resource
    Ethical issues in managed and rationed care for children with severe neurological disabilities: a questionnaire survey (1999)
    Springer
    Child's nervous system 15 (1999), S. 342-346 
    Details
    ISSN: 1433-0350
    Keywords: Key words Severe neurological disabilities ; Managed and rationed care ; Children ; Questionnaire survey ; Pediatric neurosurgeons
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The attitudes of pediatric neurosurgeons to managed and rationed care for children with severe neurological disabilities were surveyed as reflected in responses from International Society for Pediatric Neurosurgery (ISPN) members to a questionnaire. Of 399 ISPN members, 156 (39.1%) responded to the questionnaire. There were 15 questions, which were designed to explore what care is medically indicated, whether all medically indicated care should always be provided, and how this care should be managed or rationed. Most respondents agreed that these patients should receive the same level of medical care as a normally developing child. However, respondents felt that cardiopulmonary resuscitation (CPR) is not indicated if a child is not retrievable. Most respondents also felt that provision of care should be influenced by cost. The responses to the questions from ISPN members were compared with those from Child Neurology Society (CNS) members.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050408
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  • 50
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    Electronic Resource
    „No-puncture-Laparoskopie“ während der Hernienversorgung im Kindesalter – sinnvolle Ergänzung eines bewährten Therapiekonzepts (1999)
    Springer
    Der Chirurg 70 (1999), S. 290-293 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Hernia repair ; Children ; Laparoscopy ; Patient selection. ; Schlüsselwörter: Kinderchirurgie ; Leistenhernie ; intraoperative Laparoskopie ; Diagnostik ; Patientenselektion.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Aus epidemiologischen Untersuchungen ist bekannt, daß bei ca. 50 % der Kinder mit einseitiger Leistenhernie auf der Gegenseite ebenfalls ein offener Processus vaginalis vorliegt. 10–25 % dieser Kinder entwickeln in der Folge eine kontralaterale Hernie. Seit 1996 wird in unserer Klinik bei Säuglingen und Kindern mit klinisch unilateraler Leistenhernie mittels intraoperativer Laparoskopie durch den eröffneten Bruchsack der kontralaterale innere Leistenring inspiziert. Vorgehen: Bisher wurden 112 Kinder untersucht (Alter: 6 Monate bis 7 Jahre; 78 Jungen, 34 Mädchen). Nach Freipräparation des Bruchsacks wurde dieser eröffnet und ein 5,5-mm-Trokar durch den inneren Leistenring eingebracht. Nach Anlage des Pneumoperitoneums erfolgte mit einer 5-mm-(30 °)-Optik zunächst die orientierende Laparoskopie, anschließend mit der 70 °-Optik die Inspektion des kontralateralen inneren Leistenrings. Ergaben sich Hinweise für einen breit offenen Processus vaginalis (Typ III nach Chin), wurde in gleicher Narkose diese Seite ebenfalls offen chirurgisch exploriert. Ergebnisse: Laparoskopisch fand sich bei 19 Patienten (17 %) ein nach oben genannten Kriterien pathologischer Befund (6 Mädchen, 13 Jungen). Diese wurden auf der Gegenseite operiert und die laparoskopische Diagnose in allen Fällen bestätigt. Verfahrensbedingte Komplikationen traten nicht auf. Die Eingriffe erfolgten im Rahmen der Eintageschirurgie. Die Operationsdauer erhöhte sich durch die intraoperative Laparoskopie um im Median 6 min (3–11 min). Deutlich häufiger fanden sich pathologische Befunde bei Patienten unter 2 Jahren (14 von 19 Patienten). Schlußfolgerungen: Das beschriebene Verfahren erlaubt ohne nennenswerten zusätzlichen Zeitbedarf, Patienten zu selektionieren, die von einer einzeitigen offenen Exploration der gegenseitigen Leistenregion profitieren. Somit können Zweitoperationen mit erneuter Narkose und Hospitalisierung vermieden werden. Zusätzlich erlaubt die intraoperative Laparoskopie die allgemeine Beurteilung der Abdominalorgane sowie Klärung spezieller Fragen wie, z. B. die Vitalität reponierter Darmschlingen.
    Notes: Summary. Background: Approximately 50 % of children with a clinical unilateral inguinal hernia display a patent processus vaginalis on the contralateral side; half of these children subsequently develop an inguinal hernia.The management of this problem is still controversial. The purpose of this study was to evaluate the usefulness of intraoperative laparoscopy in a no-puncture technique through the opened hernia sack. Method: In 112 children (age 6 months to 7 years ) with clinical unilateral hernia laparoscopy (5 mm laparoscope, 30 ° and 70 °). In cases of a wide-open contralateral internal inguinal ring (type III) open surgical exploration was performed. Results: Nineteen patients (17 %) fulfilled the laparoscopic criteria of a type III ring; the diagnose was confirmed during open contralateral exploration. Fourteen of these patients were younger than two years. The median time for laparoscopy was 6 min (3–11 min). No complications associated with the laparoscopy were observed. Conclusions: Intraoperative laparoscopy during unilateral hernia repair allows the identification of patients who profit from bilateral open surgery during the same operation with little additional operating time and so far with no resulting complications. Application of this method may avoid a second hospitalization and operation, as well as an unnecessary routine bilateral open exploration. As an additional source of information through excellent visualization of the abdominal cavity, this method proved helpful to examine incarcerated bowel after repositioning.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050645
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  • 51
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    Electronic Resource
    Cerebrospinal fluid shunt infection in children: efficiency of management protocol, rate of persistent shunt colonization, and significance of `off-antibiotics' trial (1999)
    Springer
    Child's nervous system 15 (1999), S. 38-43 
    Details
    ISSN: 1433-0350
    Keywords: Key words Cerebrospinal fluid shunt ; Infection ; Colonization ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the efficiency of our management protocol, 33 pediatric cases of bacteria-infected cerebrospinal fluid shunt were reviewed. The causative organism was staphylococcus in 23 patients. In 23 patients, shunt infection was managed according to the protocol. The complexity of the shunt system did not prolong hospitalization. Unchanged but externalized tubings showed persistent colonization despite adequate antibiotics in 10 of 21 patients. Staphylococcal infection was oxacillin-resistant in 7 of 19. The efficiency of an `off-antibiotics' trial was minimal. Further modification of the protocol is expected to enhance efficiency of the management.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050324
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  • 52
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    Electronic Resource
    Surgery or conservative treatment in children with traumatic intracerebral haematoma (1999)
    Springer
    Child's nervous system 15 (1999), S. 267-269 
    Details
    ISSN: 1433-0350
    Keywords: Key words Head injury ; Children ; Traumatic intracerebral haematoma ; Coma scale
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In contrast to the case of extracerebral haematomas, the criteria for operative treatment of traumatic intracerebral haematoma (TIH) are not clear. The purpose of this study was to find factors that would be helpful in reaching a decision for surgical or conservative treatment of TIH. We performed a retrospective analysis of 31 consecutive cases of TIH treated in our department. The following factors were estimated: age, mechanism of injury, initial GCS or CCS score, neurological deficits, coexistence of arterial hypotension and respiratory disturbances, and localisation and size of the haematoma. The outcome was evaluated according to a modified GOS. Treatment was surgical for 20 patients and conservative for 11. Patients with GCS or CCS scores of 3–8 were treated surgically significantly more often than those with higher scores. The other factors did not correlate with type of treatment. It seems, then, that the clinical status of the patient, especially the level of consciousness according to the GCS or CCS score, is the most important predictor of the need for surgery in children with TIH.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050389
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  • 53
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    Electronic Resource
    Clinical pattern of newly-diagnosed seizures in Saudi Arabia: a prospective study of 263 children (1999)
    Springer
    Child's nervous system 15 (1999), S. 468-471 
    Details
    ISSN: 1433-0350
    Keywords: Key words Seizures ; Epilepsy ; Children ; EEG ; Computed tomography (CT) ; Saudi Arabia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The clinical patterns, including history, examination, and electroencephalographic (EEG) and computed tomography (CT) findings were examined prospectively in 263 children (153 boys, 110 girls) with newly diagnosed recurrent seizures. The overall mean age was 4.2 years, with a range of 0.05–13 years. The age of onset was within the first year of life in 128 (48.7%) of the patients. Hypoxic-ischemic encephalopathy (14.8%), febrile seizures (9.1%) and developmental delay (4.6%) were the predominant signs in this age group. Consanguinity of the parents was present in 29.7% cases. The main EEG abnormalities were epileptiform activity, which was generalized in 133 (50.6%) and focal in 80 (30.4%). Other abnormalities included slow wave activity in 41 (15.6%) and hypsarrhythmia in 3 (1.1%). The main seizure types were generalized in 60.4% and partial in 32.7%. The types of epileptic syndromes included localization-related (28.1%), generalized (23.2%), undetermined (37.4%) and (special) syndromes 11.4%. The cranial CT findings were normal in 60.5%, and the predominant abnormality was cerebral atrophy in 25.3%. The pattern of seizure types and the peak presentation in early childhood are comparable to those in western reports.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050441
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  • 54
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    Electronic Resource
    Nachbarschaft von Tic und Zwang (1999)
    Springer
    Der Nervenarzt 70 (1999), S. 1-10 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Tic-Störung ; Zwangsstörung ; Kinder ; Jugendliche ; Neurobiologie ; Psycho- pharmakologie ; Verhaltenstherapie ; Key words Tic-disorder ; Obsessive-compulsive disorder ; Children ; Adolescents ; Neurobiology ; Psychopharmacology ; Behavior therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In children and adolescents motor/vocal tics and obsessive-compulsive behavior are known to be closely related. Thereby, a continuum of symptoms ranging from single tics to a mixed picture of tics/rituals/obsessive-compulsive traits to clinically relevant obsessions and compulsions could be described. As neurobiological substrates dysfunctions in corresponding cortico-striato-thalamo-cortical circuits (sensorimotor circuit in tic symptomatology, orbitofrontal circuit in obsessive-compulsive behavior) were postulated. For both disturbances behavioral therapy can be used to improve control mechanisms to counterregulate tics and obsessive-compulsive behavior, respectively, and psychopharmacological agents can be administerd to compensate dysbalances in neurotransmitter systems. In case of a mixed symptomatologic picture it is necessary to include interventions for both pols of the symptom-continuum in the therapeutic programme to achieve extensive improvement as a basis for a further positive development of the patient.
    Notes: Zusammenfassung Motorische/vokale Tics und zwanghafte Verhaltensweisen kommen bei Kindern und Jugendlichen häufig gemeinsam vor; dabei kann ein Symptomkontinuum von solitär auftretenden Tics über ein Mischbild von Tics und Ritualen/zwanghaften Gedanken und/oder Handlungen bis hin zu eindeutigen Zwangsphänomenen beschrieben werden. Neurobiologisch können diesem Symptomkontinuum unterschiedlich ausgebreitete Dysfunktionen entsprechender kortiko-striato-pallido-thalamo-kortikaler Regulationssysteme zugrunde liegen. Therapeutisch lassen sich bei beiden Verhaltensauffälligkeiten mittels verhaltenstherapeutischer Techniken Steuerungs- und Kontrollmöglichkeiten zur Gegenregulation der Auffälligkeiten verbessern sowie durch Einsatz von Psychopharmaka Dysbalancen von Neurotransmittersystemen ausgleichen. Bei einem Mischbild von Tics und Zwängen sind therapeutische Interventionen für beide Zielbereiche erforderlich. Nur so können umfassende Verbesserungen erreicht und günstige Entwicklungsbedingungen für die betroffenen Kinder und Jugendlichen eröffnet werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050394
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    Dokumentation der Auswirkungen von Kinderknallpistolen (1999)
    Springer
    HNO 47 (1999), S. 535-540 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Hörschäden ; Knalltrauma ; Kinder ; Tinnitus ; Erweiterte Hochtonaudiometrie ; Key words Hearing loss ; Acoustic trauma ; Children ; Tinnitus ; High-frequency audiometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The study presents an analysis of 20 cases of acute acoustic trauma caused by toy pistols. The problem generally involves boys within the age range from 6 to 11 years. Half of the incidents involved attacks with toy pistols used as weapons. Auditory damage appeared in two types, each of which had a notch in the audiogram at the frequency range between 10 and 14 kHz. In children, a shot close to one ear can damage both ears. Great differences in the severity of tinnitus were apparent. The most severe cases of tinnitus were observed in the children with no or minor premanent auditory damage. Children experiencing long periods of uninterrupted tinnitus suffer significantly. This is not only detrimental to family-life but also to the performance of the children at school. The total expenses of treatment for these 20 cases were estimated to be approximately 80,000 DM (40.000 Euro).
    Notes: Zusammenfassung Im Rahmen einer Studie wurden 20 Fälle von Knalltraumata durch Kinderpistolen erfaßt und ausgewertet. Die Problematik betrifft fast nur männliche Personen und schwerpunktmäßig den Altersbereich von 6–11 Jahren. Die Hälfte der Vorfälle waren Angriffe, bei denen die Kinderpistole als Waffe eingesetzt wurde, 2 Typen von Hörschäden sind festzustellen, die jedoch beide durch eine Senke im Bereich von 10–14 kHz charakterisiert sind. Bei Kindern kann der Schuß in eines der Ohren auch das andere Ohr schädigen. Sehr große Unterschiede bestehen im Auftreten von Tinnitus. Die Fälle mit starkem Tinnitus haben keine oder nur geringe bleibende Hörschäden. Die von Knalltraumata betroffenen Kinder leiden oft sehr stark unter langanhaltendem Tinnitus. Dabei wird nicht nur das Leben der Familien beeinträchtigt, sondern auch die schulischen Leistungen der Kinder leiden teilweise sehr stark darunter. Für die Therapie dieser 20 Fälle entstanden Gesamtkosten von ca. 80.000,- DM
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050420
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    Electronic Resource
    Körperliche Beschwerden bei Kindern in Deutschland und in den Niederlanden (1999)
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 122-127 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Körperliche Beschwerden ; CBCL/4 ; 18 ; Kultur-vergleichend ; Kinder ; Jugendliche ; Key words Somatic complaints ; CBCL/4 ; 18 ; Cross-cultural ; Children ; Adolescents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Question: What is the frequency of parent-reported somatic complaints of children in Germany and the Netherlands dependent on their age, sex and the education of their parents. Methods: 4876 CBCL (Child Behaviour Checklist) of children aged 4 through 17 years from the general population were analysed. Results: Dutch children were scored higher by their parents than German children. Moreover somatic complaints increased with age and girls were scored higher. The frequencies of somatic complaints varied from 2% for ’problems with eyes’ to 15% for ’headaches’. The presence of one somatic complaint increased the likelihood of concomitant somatic complaints. Conclusion: Somatic complaints of children without any known cause are often seen. Some symptoms are often reported together. More, especially causal studies on the somatic symptoms of children are recommended.
    Notes: Zusammenfassung Fragestellung: Wie verhält sich die Häufigkeit körperlicher Beschwerden bei Kindern in Deutschland und den Niederlanden nach Laieneinschätzung, gibt es Unterschiede abhängig vom Alter und Geschlecht der Kinder und des Ausbildungsniveaus der Eltern? Methode: 2757 deutsche und 2119 niederländische CBCL (child behavior checklist) über Kinder und Jugendliche im Alter zwischen 4 und 17 Jahren aus repräsentativen Studien wurden mit Hilfe von Varianzanalysen ausgewertet. Ergebnisse: Niederländische Eltern beschrieben mehr körperliche Beschwerden als deutsche. Die Ausprägung auf der Symptomskala stieg mit zunehmendem Alter und zeigte höhere Werte für Mädchen. Die Häufigkeit der Beschwerden variiert von 2% für „Augenbeschwerden” bis zu 15% für „Kopfschmerzen”. Bei Anwesenheit eines körperlichen Symptoms stieg die Frequenz zusätzlicher Beschwerden. Schlußfolgerung: Körperliche Beschwerden bei Kindern treten häufig ohne bekannte Ursache auf, bestimmte Beschwerden werden häufig gleichzeitig beschrieben, wobei die Koinzidenz nicht umkehrbar ist. Weitere, besonders ursächliche Studien auf dem Gebiet der körperlichen Beschwerden bei Kindern sind auch hinsichtlich steigender Kosten im Gesundheitswesen empfehlenswert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050409
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    Asthma bronchiale bei türkischen und deutschen Schulkindern Häufigkeit, Schweregrad und Behandlung (1999)
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 328-332 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Asthma bronchiale ; Schulkinder ; Türkische Kinder ; Key words Asthma ; Children ; Turkish children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objectives: In Germany 4.2% (in Munich 8.6%) of all children under 15 years of age are of Turkish origin, representing the largest ethnic minority in this age group. However, very little is known about the prevalence, severity and management of asthma and other atopic diseases in Turkish children living in Germany. Methods: In a cross-sectional survery the prevalence, severity and treatment of asthma and other atopic diseases was assessed in 7,445 schoolchildren aged 9 to 11 years, living in Munich, southern Germany. Questionnaires were distributed to the parents for self-completion and children underwent skin-prick tests and cold-air hyperventilation challenge. Results: Of those returning the questionnaires (n = 6490/87%), 5,030 (77.5%) were of German and 451 (7%) of Turkish origin. Turkish children showed a significantly lower prevalence of asthma (5.3% versus 9.4%, P 〈 0.05) than their German peers. Furthermore, Turkish children with asthma were less frequently free of symptoms (10.5% versus 34.6%, P 〈 0.05), reported more severe symptoms (41.2% versus 10.9%, P 〈 0.05) and more hospital admissions (55.6% versus 21.6%, P 〈 0.05) due to asthma than German children. Conclusions: The results of this study indicate that despite the lower prevalence of asthma and allergy in the Turkish population living in Germany, asthma is a major health problem for Turkish children. Furthermore, these findings suggest inadequate management of asthma in Turkish children.
    Notes: Zusammenfassung Fragestellung: Türkische Kinder stellen in der Bundesrepublik Deutschland mit 4,2% und in München mit 8,6% den größten Anteil nicht-deutscher Kinder in der Altersgruppe bis 15 Jahren. Wenig ist jedoch bisher über Häufigkeit, Symptome und Behandlung von Asthma bronchiale und anderer atopischer Erkrankungen der türkischen Minderheit in Deutschland bekannt. Methodik: In einer Querschnittstudie wurde bei 7445 Schulkindern im Alter von 9 bis 11 Jahren im Großraum München die Häufigkeit, der Schweregrad und die Behandlung des Asthma bronchiale und anderer atopischer Erkrankungen untersucht. Fragebögen wurden von den Eltern ausgefüllt, Lungenfunktionsuntersuchungen und Hautpricktests wurden bei den Kindern durchgeführt. Ergebnisse: Von denen, die die zugeschickten Fragebögen ausfüllten (n = 6490/87%), waren 5030 (77,5%) deutscher und 451 (7%) türkischer Nationalität. Die türkischen Kinder zeigten eine niedrigere Prävalenz von Asthma bronchiale (5,3% versus 9,4%, p 〈 0,05) und Neurodermitis (1,6% versus 12,9%, p 〈 0,001) im Vergleich zu den deutschen Kindern. Signifikante Unterschiede bestanden zwischen türkischen und deutschen Kindern in Art der Symptome und der Krankheitswahrnehmung. Türkische Kinder mit Asthma bronchiale waren seltener beschwerdefrei (10,5% versus 34,6%, p 〈 0,05) berichteten von schwereren Symptomen (41,2% versus 10,9%, p 〈 0,05) und von einer größeren Anzahl von Krankenhausaufenthalten (55,6% versus 21,6%, p 〈 0,05) aufgrund von Asthma bronchiale. Schlußfolgerung: Die Ergebnisse der Studie legen den Schluß nahe, daß Asthma bronchiale trotz der niedrigeren Prävalenz in der türkischen Bevölkerungsgruppe ein erhebliches Gesundheitsproblem bei türkischen Schulkindern darstellt. Die höhere Anzahl von Fehltagen in der Schule und die deutlich höhere Anzahl von Klinikaufenthalten aufgrund von Asthma bronchiale sprechen für eine mangelhafte präventive Behandlung dieser Erkrankung bei türkischen Kindern.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050430
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    Naturlatexallergie-Screening bei Kindern mit neurogener Blasenentleerungsstörung (1999)
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 351-355 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Latexallergie ; Neuogene Blasenentleerungsstörung ; Kinder ; Key words Latex allergy ; Neurogenic bladder dysfunction ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objectives: The risk to suffer from natural latex allergy is increased in children with congenital neurogenic bladder dysfunction. We, therefore, evaluated whether or not a serologic screening for detection of sensitization to latex is reasonable in these children. Patients and Methods: 40 children aged from 6 months to 17 years were examined by specific questionnaire-based patient histories, and by determination of total serum immunoglobuline E (total IgE) and natural latex-specific serum immunoglobulin E (latex-IgE) by solid-phase immunoassays. Results: 5 children had a history of allergic reaction to rubber containing materials. In 10 children, latex-IgE was elevated 〉 0.35 kU/l, 6 out of these 10 children without a history of allergic reactions to rubber containing materials. There was a positive correlation of elevated latex-IgE values and the number of former surgical procedures (p 〈 0.006), while no correlation was found between elevated latex-IgE values and clean intermittent catheterization (p = 0.408). Conclusion: Compared to questionnaire-based patient histories, serologic screening examination including determination of latex-IgE values may better identify children at risk to suffer from sensitization to natural latex.
    Notes: Zusammenfassung Fragestellung: Naturlatexallergien kommen bei Kindern mit angeborener neurogener Blasenentleerungsstörung gehäuft vor. Es wurde deshalb untersucht, ob bei dieser Patientengruppe ein serologisches Screening zur Erfassung einer Sensibilisierung gegenüber Naturlatex sinnvoll ist. Patienten und Methode: Untersucht wurden 40 Kinder im Alter von 6 Monaten bis 17 Jahren. Die Untersuchung umfaßte eine gezielte Anamneseerhebung durch Fragebogen sowie die Bestimmung des Gesamtimmunglobulin E (Gesamt-IgE) und des naturlatexspezifischen Immunglobulin E (Latex-IgE) im Serum durch Festphasenimmunoassays. Ergebnisse: 5 Kinder hatten anamnestisch Zeichen einer allergischen Reaktion nach Gummikontakt. 10 Kinder wiesen im Serum erhöhte Werte des Latex-IgE auf, wobei 6 dieser Kinder bisher noch keine Zeichen einer Latexallergie hatten. Pathologische Werte für das Latex-IgE korrelierten statistisch signifikant mit der Anzahl operativer Eingriffe (p 〈 0,0006), nicht aber mit einem durchgeführten sauber intermittierenden Einmalkatheterismus (p = 0,408). Schlußfolgerung: Im Vergleich zur alleinigen fragebogengestützen Anamneseerhebung können durch ein serologisches Screening mit Bestimmung des Latex-IgE mehr Kinder entdeckt werden, die durch eine Sensibilisierung gegenüber Naturlatex gefährdet sind.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050434
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    Electronic Resource
    Treatment of cholesteatoma in children (1999)
    Springer
    European archives of oto-rhino-laryngology and head & neck 256 (1999), S. S8 
    Details
    ISSN: 1434-4726
    Keywords: Key words Cholesteatoma ; Children ; Tympanoplasty
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied retrospectively 28 cases of cholesteatoma in children whose ages were 3 to 13 years old. All had undergone surgery between 1989 and 1995. The intact canal wall technique was the predominant method used in the initial operation, with long term goals of an anatomically normal and infection-free ear. Cholesteatoma was found postoperatively in 15 cases and was considered to be residual in 6 cases and recurrent in 9. The residual cholesteatoma was relatively uncommon and usually removable in an exploratory second operation. Our findings showed that the intact canal wall technique was the best initial operation if two-stage surgery was planned. Avoidance of a retraction pocket, which tends to progress to a recurrent cholesteatoma, is important to successful treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014160
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  • 60
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    Electronic Resource
    Complications in pediatric cochlear implant surgery (1999)
    Springer
    European archives of oto-rhino-laryngology and head & neck 256 (1999), S. 128-132 
    Details
    ISSN: 1434-4726
    Keywords: Key words Cochlear implant ; Management of ; complications ; Children ; Postoperative care ; Infection ; Device failure ; Reimplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a retrospective analysis we evaluated the intra- and postoperative complications in children who underwent cochlear implantation between 1984 and 1993 at the Medizinische Hochschule Hannover. The data and records of 366 children were collected and analyzed. Relevant parameters were major complications such as significant infection, intraoperative bleeding, facial nerve injury, implant loss and device failure, as well as lesser complications, including delayed wound healing, chronic pain and vertigo. Late complications such as cholesteatoma or electrode dislocations were also registered. Cases of acute otitis media were managed with conservative treatment. Data presented indicate that cochlear implant surgery in children is a reliable and safe procedure with a low percentage of severe complications. Problems related to ear surgery can occur and should be manageable with standard procedures. Careful operative techniques and sufficient personal experience can help avoid severe postoperative problems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004050050124
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    Vergiftungs- und Todesfälle durch Substitutionsmittel im Umfeld von substituierten Drogenabhängigen (1999)
    Springer
    Rechtsmedizin 9 (1999), S. 90-93 
    Details
    ISSN: 1434-5196
    Keywords: Key words Methadone ; Dihydrocodeine ; Substitution ; Poisoning ; Children ; Schlüsselwörter Methadon ; Dihydrocodein ; Substitution ; Intoxikationen ; Kinder
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Description / Table of Contents: Zusammenfassung Es wird über 3 überlebte und 4 tödlich verlaufene akzidentelle Intoxikationen, sechs mit Methadon, eine mit Dihydrocodein, berichtet. Die Intoxikationen betrafen nicht die Substituierten selbst, sondern deren Familienangehörige, Bekannte oder Mit-Patienten. In allen Fällen wurden die Substitutionsmittel weitgehend ungesichert und teilweise vermutlich auch unbeschriftet stehengelassen. Den Substituierten selbst war dabei die Gefahr, die von ihrem Substitutionsmittel ausging, offenbar nicht ausreichend bewußt. Diese Fälle zeigen deutlich, daß qualitätssichernde Maßnahmen bei der immer großzügigeren Substitutionspraxis, insbesondere in Hinblick auf „take-home“-Dosen, notwendig sind.
    Notes: Abstract A total of seven cases of accidental ingestion of methadone or dihydrocodeine by four children and three adults are reported of which four were fatal. In each case, someone in the environment was taking methadone or dihydrocodeine as a substitute drug for heroin addiction who obviously did not realize the dangers of methadone for non-addicts. Possible preventive measures are the usage of child-proof containers with adequate labels for take-home medications. Furthermore substituted addicts have to be thoroughly indoctrinated concerning the toxicity and hazards of methadone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001940050087
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  • 62
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    Childhood cancer and residential radon exposure – results of a population-based case-control study in Lower Saxony (Germany) (1999)
    Springer
    Radiation and environmental biophysics 38 (1999), S. 211-215 
    Details
    ISSN: 1432-2099
    Keywords: Key words Case-control study ; Children ; CNS tumour ; Environmental exposure ; Indoor radon ; Leukaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Physics
    Notes: Abstract  A population-based case-control study on risk factors for childhood malignancies was used to investigate a previously reported association between elevated indoor radon concentrations and childhood cancer, with special regard to leukaemia. The patients were all children suffering from leukaemia and common solid tumours (nephroblastoma, neuroblastoma, rhabdomyosarcoma, central nervous system (CNS) tumours) diagnosed between July 1988 and June 1993 in Lower Saxony (Germany) and aged less than 15 years. Two population-based control groups were matched by age and gender to the leukaemia patients. Long-term (1 year) radon measurements were performed in those homes where the children had been living for at least 1 year, with particular attention being paid to those rooms where they had stayed most of the time. Due to the sequential study design, radon measurements in these rooms could only be done for 36% (82 leukaemias, 82 solid tumours and 209 controls) of the 1038 families initially contacted. Overall mean indoor radon concentrations (27 Bq m–3) were low compared with the measured levels in other studies. Using a prespecified cutpoint of 70 Bq m–3, no association with indoor radon concentrations was seen for the leukaemias (odds ratio (OR): 1.30; 95% confidence interval (95% CI): 0.32–5.33); however, the risk estimates were elevated for the solid tumours (OR: 2.61; 95% CI: 0.96–7.13), mainly based on 6 CNS tumours. We did not find any evidence for an association between indoor radon and childhood leukaemia, which is in line with a recently published American case-control study. There is little support for an association with CNS tumours in the literature.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004110050158
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    Fremdkörperaspiration (1999)
    Springer
    Der Radiologe 39 (1999), S. 467-471 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Fremdkörper ; Aspiration ; Diagnostik ; Kinder ; Atemwege ; Key words Foreign body ; Aspiration ; Diagnostic imaging ; Children ; Respiratory tract
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Aspiration of foreign bodies is a common cause of respiratory distress in children between the age of 6 months and 3 years. The diagnosis of radiopaque foreign bodies is easy when the whole respiratory tract is depicted. Nonopaque foreign bodies need a more differentiated diagnostic approach. The first step should be plain films in inspiration and expiration. The performance of additional chest radiographs, fluoroscopy and if need be CT or nuclear scans depends on the result of the plain films. The chest radiograph may reveal a variety of findings, the commonest of which is unilateral air trapping. Rarely, atelectasis, recurrent pneumonia at the same localisation and inspiratory obstruction are found. Combinations of the above-mentioned findings are possible. Moreover, the absence of positive radiological findings does not exclude the diagnosis of foreign body aspiration.
    Notes: Zusammenfassung Die Fremdkörperaspiration stellt eine häufige Ursache für Atemnot und respiratorische Insuffizienz bei Säuglingen und Kleinkindern zwischen 6 Monaten und 3 Jahren dar. Röntgendichte Fremdkörper bereiten bei Abbildung des gesamten Respirationstraktes keine diagnostischen Schwierigkeiten. Nicht röntgendichte Fremdkörper erfordern ein differenzierteres Vorgehen, wobei der erste radiologische Schritt in einer konventionellen Thoraxaufnahme in In- und Exspiration bestehen sollte. Zusätzliche Aufnahmen, Durchleuchtungsuntersuchung und gegebenenfalls die Durchführung einer computertomographischen oder szintigraphischen Untersuchung hängen vom Ergebnis der Thoraxaufnahme ab. Häufigstes radiologisches Erscheinungsbild ist die einseitige exspiratorische Ventilstenose mit Überblähung des betroffenen Lungenabschnittes. Seltener finden sich Atelektasen, rezidivierende Pneumonien an identischer Lokalisation und inspiratorische Ventilstenosen. Kombinationsbilder sind möglich, selbst ein unauffälliges Untersuchungsergebnis kann eine Aspiration nicht ausschließen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050536
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    Electronic Resource
    Fremdkörperingestion (1999)
    Springer
    Der Radiologe 39 (1999), S. 472-477 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Fremdkörper ; Ingestion ; Kinder ; Diagnostik ; Key words Foreign body ; Ingestion ; Children ; Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Foreign body ingestion is not infrequent in infants and children. The diagnosis of radiopaque foreign body ingestion does not pose a major problem. It is crucial to take an X-ray from the pharynx to the level of the pylorus. If a foreign body that might get stuck at the ileocoecal valve is ingested, it is necessary to perform a radiograph of the whole abdomen. Foreign bodies that do not pass the cardia must be extracted endoscopically. In the case of foreign bodies with a smooth contour that have passed the pylorus, parents are advised to check the child’s stool or collect it and bring it for X-raying. If after a week there is no definite evidence that the foreign body has been excreted a follow-up radiograph is carried out. If the foreign body is still in the stomach or duodenum, endoscopy is necessary. The detection of nonopaque foreign bodies can be facilitated by giving oral contrast medium, making the depiction of the foreign body as a filling defect possible. As a complication, perforation can occur, the diagnosis of which may entail the use of sonography, conventional radiography and, to a lesser extent, CT.
    Notes: Zusammenfassung Fremdkörperingestion ist im späten Säuglings- und frühen Kleinkindalter kein seltenes Ereignis. Die Diagnose röntgendichter Fremdkörper bereitet keine Schwierigkeiten. Hierbei ist jedoch zu beachten, daß die Region vom Pharynx bis zum Pylorus abgebildet sein sollte. Wurden Fremdkörper verschluckt, bei denen die Gefahr der Einklemmung in der Bauhin’schen Klappe besteht, sollte das komplette Abdomen bis zum Anus dargestellt werden. Fremdkörper, welche die Kardia nicht passieren, müssen endoskopisch extrahiert werden. Haben glatt begrenzte Fremdkörper den Pylorus passiert, werden die Eltern aufgefordert, den Stuhl zu untersuchen oder zu sammeln und ihn zur röntgenologischen Untersuchung mitzubringen. Sollte der Fremdkörper innerhalb einer Woche nicht auffindbar sein, wird eine Kontrolluntersuchung durchgeführt. Ist der Fremdkörper dann noch im Magen oder im Duodenum, sollte er ebenfalls extrahiert werden. Der Nachweis nicht röntgendichter Fremdkörper kann mittels Gabe von positivem Kontrastmittel als Aussparungsfigur gelingen. Als Komplikation kann eine Perforation auftreten. Hierbei dienen Sonographie, konventionelles Röntgen und gegebenenfalls CT zur Diagnosefindung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050537
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    Polyclonal hypergammaglobulinemia at the onset of acute myeloid leukemia in children (1999)
    Springer
    Annals of hematology 78 (1999), S. 445-448 
    Details
    ISSN: 1432-0584
    Keywords: Key words Hypergammaglobulinemia ; Polyclonal ; Acute myeloid leukemia ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Polyclonal hypergammaglobulinemia (PHG) associated with hematological malignancies is a rare occurrence. We reviewed our series of 47 children with AML in order to define the prevalence of PHG and its prognostic value in achieving complete remission (CR) after induction treatment. Patients were stratified by immunoglobulin levels into two groups: with PHG and without PHG. CR reached after induction chemotherapy was considered a positive response. Conditional exact tests were used for the statistical analysis; conditional maximum likelihood estimates of the odds ratio (OR) were obtained. Significance levels (p) were determined from two-tailed tests. Twenty-two of 38 (57.9%) evaluable children showed PHG. Children with PHG and AML were more likely to be in CR after first induction treatment (OR=6.25, p=0.021), independent of sex, age at diagnosis, white blood cell count, percentage of blasts in the bone marrow, FAB phenotype, and treatment protocol. Infections seemed to positively influence early treatment response (p=0.038). PHG and infections were not statistically associated (p=0.16). PHG may result from the uncontrolled stimulation of B lymphocytes by cytokines. Infections or transfusions may act as triggers for the immune system, leading to the antileukemic effect seen in patients with AML and PHG going into spontaneous remission. It could be that this activation caused the larger number of CRs observed in our series. Clarification of why PHG exerts a positive influence on children with AML could help us to understand the ways by which the organism is able to control a malignant disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050596
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  • 66
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    Serum levels of thrombopoietin, IL-11, and IL-6 in pediatric thrombocytopenias (1999)
    Springer
    Annals of hematology 78 (1999), S. 401-407 
    Details
    ISSN: 1432-0584
    Keywords: Key words Thrombopoietin ; Interleukin-11 ; Interleukin-6 ; Thrombocytopenia ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We measured serum levels of thrombopoietin (TPO), interleukin (IL)-11, and IL-6 in 90 different samples from 67 pediatric patients with thrombocytopenia (TP). The cytokine levels were determined by enzyme-linked immunosorbent assays (ELISA), and the biological activity of TPO was measured using a cell line transfected with human c-mpl. In patients with impaired megakaryocytopoiesis, as found in diseases such as aplastic anemia, amegakaryocytic TP, or TP with absent radii, we found TPO levels which were highly elevated compared with normal values (mean=261 AU/ml, n=52, vs. 22 AU/ml in healthy controls). In contrast, patients suffering from idiopathic thrombocytopenic purpura (mean=16 AU/ml, n=31) or platelet function defects (mean=23 AU/ml, n=7) demonstrated normal TPO levels. The biological activity tested in the bioassay correlated well with the ELISA data. However, sera of some patients with amegakaryocytic TP demonstrated a remarkably higher biological activity of TPO than expected from the ELISA data. Within the different groups there was no correlation between platelet counts and TPO levels. Only 27% of all samples had elevated levels of IL-11 (mean=450 pg/ml, n=20). Elevated IL-6 serum levels were detected in only 13% of all samples analyzed (mean=42 pg/ml, n=12). We conclude that megakaryocytopoiesis is regulated mainly by TPO, that it is dependent on the platelet and the megakaryocytic mass, and that IL-11 plays an additional role in supporting the platelet production. IL-6 does not appear to be up-regulated in children with thrombocytopenia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050538
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  • 67
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    Electronic Resource
    Fractures of the patella in children (1999)
    Springer
    Knee surgery, sports traumatology, arthroscopy 7 (1999), S. 243-245 
    Details
    ISSN: 1433-7347
    Keywords: Key words Patella ; Fracture ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Fractures of the patella are relatively rare injuries for children. Fourteen patients with patellar fractures were reviewed. There were 12 boys and two girls with the age ranging between 9 and 15 years and an average of 11.4 years. Sleeve fractures were the most common type of patellar fractures observed (eight cases), followed by transverse fractures (four cases) and comminuted fractures (two cases). All the fractures were treated with open reduction and followed up for 2 to 20 years. Overall results were good in 13 patients, and flexion limitation of the knee was seen in one. Fractures of the patella in children are characterised by sleeve fractures. The prognosis of the patients treated with open reduction is generally good.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001670050156
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  • 68
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    Electronic Resource
    Treatment with implantable defibrillators in childhood (1999)
    Springer
    Herzschrittmachertherapie & Elektrophysiologie 10 (1999), S. 248-251 
    Details
    ISSN: 1435-1544
    Keywords: Key words Implantable cardioverter defibrillator ; Sudden cardiac death ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Implantable cardioverter defibrillators (ICDs) are the treatment of choice in adults with symptomatic ventricular tachycardia or aborted sudden cardiac death. Treatment with implantable defibrillators is also possible in children, although experience in this patient group is scanty. A review of the literature on the subject of defibrillator therapy in combination with epicardial electrodes is provided. Endocardial electrodes, which have now become the gold standard in adult treatment, have only rarely been used in children. However, our own experience shows that endocardial electrodes can be implanted in most children, which generally obviates the need for thoracotomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003990050072
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  • 69
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    Electronic Resource
    The effect of user charges and socio-demographic environment on paediatric trauma hospitalisation in Helsinki in 1989–1994 (1999)
    Springer
    European journal of epidemiology 15 (1999), S. 133-139 
    Details
    ISSN: 1573-7284
    Keywords: Children ; Emergency room charge ; Hospitalisation ; Injuries ; Socio-economic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although many studies have shown an association between socio- economic environment and childhood injury mortality rates, little research has focused on the association between injuries which require hospitalisation and the child's socio-economic environment. All municipal emergency care was free of charge before the beginning of 1991, from then on a moderate patient charge was introduced by the City of Helsinki. An earlier report from a completely different social environment suggest that even a moderate user charge might create systematic discrimination against indigent families. We studied the childhood injury hospitalisation rates during 1989–1994 in Helsinki and analysed the association between rates of hospitalisation and local socio-economic and demographic factors. We also examined the effect of introduction of emergency room user charges on the rate of hospitalisation. Data from 1607 injuries from Helsinki City Hospital and 769 injuries from Helsinki University Central Hospital from years 1989 through 1994 were used. Annual rates of child hospitalisation were calculated at city level. Local socio-economic and demographic variables were derived from the Helsinki Bureau of Statistics. The possible association between the explanatory variables and hospitalisation rates at Helsinki City Hospital was calculated using annual data from the 33 health districts in Helsinki. The overall rate of hospitalisation for injuries declined but not statistically significantly. No association between socio-economic and demographic variables and hospitalisation rates was found. The moderate user charge had no effect on hospitalisation rates, proving that, in this setting, the demand for care was rather inelastic in paediatric injuries severe enough to require hospitalisation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007595925452
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  • 70
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    Electronic Resource
    Clinical and epidemiological aspects of respiratory syncytial virus lower respiratory tract infections (1999)
    Springer
    European journal of epidemiology 15 (1999), S. 359-363 
    Details
    ISSN: 1573-7284
    Keywords: Children ; Clinical characteristics ; Lower respiratory tract infections ; Nosocomial infections ; Respiratory syncytial virus ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper has analyzed respiratory syncytial virus lower respiratory tract infections in 201 hospitalized children. In children with wheezing, erythrocyte sedimentation rate (ESR) was significantly higher in those with pneumonia than with syndroma pertussis, while the white blood cell (WBC) count was significantly lower in patients with bronchitis than in those with bronchiolitis and syndroma pertussis. Bronchodilatators were applied in 75.6% and corticosteroids in 20% of patients. Ten patients were ventilated. Fatal disease outcome was observed in one infant. Twelve consecutive-year study of respiratory syncytial virus (RSV) infections showed that 27.3% of these diseases were bronchiolitis and pneumonia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007503302742
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  • 71
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    Electronic Resource
    Blood lead levels in children: Epidemiology vs. simulations (1999)
    Springer
    European journal of epidemiology 15 (1999), S. 485-491 
    Details
    ISSN: 1573-7284
    Keywords: Blood lead levels ; Children ; Modeling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The key problem in environmental health is to identify the potential health hazards at the lowest possible cost based upon available environmental data. Biokinetic models such as IEUBK Lead 0.99d are very promising in this respect. We attempted a comparison between epidemiological data and predictions of the model. As input, we used the existing exposure data for the Katowice Voivodship (administrative district, Poland). Epidemiological analysis was based on the results of the screening programme ‘Prevention of the Environmental Lead Intoxication in Children Living in Katowice Voivodship’. The simulations consisted of predicted distributions of blood lead levels in children. They have been compared with observed distributions. Sensitivity analysis of simulations with respect to lead concentration in air, soil, water and diet has also been performed. The agreement between predicted and observed mean blood lead levels was quite good (relative difference of about 40%) as for the coarse exposure assessment employed. At the level of risk (fraction of population having blood lead levels exceeding 10 μg/dl) the difference is much higher (about a factor of 2). In order to explain this discrepancy we checked the goodness of fit for the log-normal distribution function (usually taken as a template distribution for lead in the population) in the right tail of the distribution. We noticed a systematic effect depleting the right tail of the actual distribution as compared with the log-normal one. Therefore one can expect that using (as a template) another skewed distribution better fitted in the right tail would improve the accuracy of risk assessment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007570026641
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  • 72
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    Sociodemographic Correlates of Visual Acuity Impairment in Hispanic Children and Adolescents (1999)
    Springer
    Journal of immigrant health 1 (1999), S. 223-228 
    Details
    ISSN: 1573-3629
    Keywords: Children ; visual acuity ; sociodemographic factors ; Hispanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sociodemographic correlates of visual impairment were examined in 6- to 19-year-old Hispanic children and adolescents using data from the Hispanic Health and Nutrition Examination Survey. Mexican American and Puerto Rican children whose parents had 0 to 6 years of education were more likely to remain visually impaired even when tested with their glasses or contact lenses, if any (i.e., with usual correction) than children whose parents reported 12 to 17 years of education. Mexican Americans residing below versus at or above the poverty line were more likely to remain visually impaired even with the usual correction. Mexican Americans enrolled in the Medicaid program or who were without health insurance were more likely to remain visually impaired than Mexican Americans with private health insurance. When tested without glasses or contact lenses, Cuban Americans and Mexican Americans born outside of the mainland United States had lower rates of visual impairment compared to those born in the United States; however, children in this latter group were more likely to remain visually impaired with usual correction than U.S.-born Mexican Americans. These findings suggest that Hispanic children from economically disadvantaged households and those born outside the United States may not be receiving optimal eye care that could improve visual function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1021868002511
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  • 73
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    Electronic Resource
    Bullies, Victims and Bystanders: A Method of In-School Intervention and Possible Parental Contributions (1999)
    Springer
    Child psychiatry & human development 30 (1999), S. 29-37 
    Details
    ISSN: 1573-3327
    Keywords: In-School Intervention ; Suspensions ; Reading ; Consistency ; Parents ; Schools ; Children ; Bullies ; Victims ; Anti-social Behavior
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study developed a method of in-school intervention that dramatically reduced the suspension rate and violence in elementary schools. It suggests that children who were not read to by their parents often become bullies and/or victims of bullies. Other parental practices, including inconsistent discipline in the home, also may be contributing factors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1022619025074
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  • 74
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    Electronic Resource
    The Rituals, Fears and Phobias of Young Children: Insights from Development, Psychopathology and Neurobiology (1999)
    Springer
    Child psychiatry & human development 29 (1999), S. 261-276 
    Details
    ISSN: 1573-3327
    Keywords: Children ; Obsessive-Compulsive ; Rituals ; Fear
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study examined the relationship between ritualistic, compulsive-like behaviors and normative fears and phobias in 61 children ranging from 1 to 7 years of age. Parents reported on their children's ritualistic habits, and perfectionistic behaviors that reflect what we have previously called “compulsive-like” behaviors. Parents also reported on their children's fears and phobias. Results indicated that various aspects of children's ritualistic and compulsive-like behaviors are correlated with children's fears and phobias. Developmental differences existed such that younger children's (〈 4 years) repetitive, compulsive-like behaviors were related to “prepotent” fears such as stranger and separation anxieties, whereas the compulsive-like behaviors of older children (〉 4 years) were correlated with more specific, “contextual” fears such as fears of contamination, death, and fears often associated with concerns of the inner city such as burglars, assault, etc. These findings are discussed in terms of the phenomenologic and possible neurobiological continuities between normative and pathologic rituals, fears and phobias.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1021392931450
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  • 75
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    Training of medical staff positively influences postoperative pain management at home in children (1999)
    Springer
    Pharmacy world & science 21 (1999), S. 168-172 
    Details
    ISSN: 1573-739X
    Keywords: Adenoidectomy ; Children ; Day‐case surgery ; Home care ; Pain medication ; Postoperative pain ; Tonsillectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract The aim of this study was to describe how parents manage their child's postoperative pain at home following day‐case surgery. The incidence of pain, different analgesics used and problems related to administering medications were the main interests of the study. A postal questionnaire was sent to the parents of 275 children who were under 8 years of age and had undergone an ear, nose and throat (ENT) day‐case operation. The questionnaire was sent to the parents a week after discharge from hospital. Altogether, the parents of 227 children answered the questionnaire (response rate 83%). The study was divided into two phases (preintervention and postintervention), and incorporated a training program for doctors and nurses between these two phases. The training program aimed to improve the treatment practices of postoperative pain in children. Seventy‐eight per cent of the children in the preintervention study and 75% in the postintervention study experienced at least mild pain after discharge. The training program for doctors and nurses affected the home treatment practices of postoperative pain. The proportion of parents treating their children increased from 68% to 80% after the training program (p=0.028). Many parents faced problems while treating their children; for example, 19% (n=30) of the children refused to take their medicine, and suppositories were regarded to be an especially unpleasant dosage form. However, no serious adverse effects were reported. We conclude that due to the pain experienced at home by the great majority of children following day‐case ENT operations, parents need information on how to manage their child's pain. A training program for doctors and nurses can improve the treatment of children's pain even at home. Since some children dislike suppositories, it would be worth considering the use of small tablets or mixtures instead.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008793223756
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  • 76
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    Electronic Resource
    Co-activation of vastus lateralis and biceps femoris muscles in pubertal children and adults (1999)
    Springer
    European journal of applied physiology 79 (1999), S. 504-511 
    Details
    ISSN: 1439-6327
    Keywords: Key words Co-activation ; Children ; Knee ; Electromyography ; Isokinetic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Determining the mechanisms of co-activation around the knee joint with respect to age and sex is important in terms of our greater understanding of strength development. The purpose of this study was to examine the effects of age, sex and muscle action on moment of force and electromyographic (EMG) activity of the agonist and antagonist muscle groups during isokinetic eccentric and concentric knee extension and flexion. The study comprised nine pubertal boys [mean age 12.6 (SD 0.5) years], nine girls [12.7 (SD 0.5) years] nine adult men [23.1 (SD 2.1) years] and nine adult women [23.7 (SD 3.1) years] who performed maximal isometric eccentric and concentric efforts of knee extensors and flexors on a dynamometer at 30° · s−1. The moment of force and surface EMG activity of vastus lateralis and biceps femoris muscles were recorded. The moment of force:agonist averaged EMG (aEMG) ratios were calculated. The antagonist aEMG values were expressed as a percentage of the aEMG activity of the same muscle, at the same angle, angular velocity and muscle action when the muscle was acting as agonist. Three-way analysis of variance (ANOVA) designs indicated no significant effects of age or sex on moment:aEMG ratios. Eccentric ratios were significantly higher than the corresponding concentric ones (P 〈 0.05). The results also indicated no significant effect of age and sex on the aEMG of the vastus lateralis and biceps femoris muscles when acting as antagonists. The antagonist aEMG was significantly greater during concentric agonist efforts compared with the corresponding eccentric ones (P 〈 0.05). These findings would suggest that the moment exerted per unit of agonist EMG and the antagonist activity are similar in children compared with adults and are not sex dependent. Future comparisons between eccentric and concentric moments of force and agonist ENG should take into consideration the antagonist effects, irrespective of age or sex.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004210050545
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  • 77
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    Electronic Resource
    Breath-to-breath “noise” in the ventilatory and gas exchange responses of children to exercise (1999)
    Springer
    European journal of applied physiology 80 (1999), S. 118-124 
    Details
    ISSN: 1439-6327
    Keywords: Key words Exercise ; Children ; Ventilation ; Gas exchange
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purposes of this investigation were to quantify the noise component of child breath-by-breath data, investigate the major determinants of the breath-to-breath noise, and to characterise the noise statistically. Twenty-four healthy children (12 males and 12 females) of mean (SD) age 13.1 (0.3) years completed 25 min of steady-state cycle ergometry at an exercise intensity of 50 W. Ventilatory and gas exchange variables were computed breath-by-breath. The mean (SD) oxygen consumption (V˙O2) ranged from 0.72 (0.16) to 0.92 (0.26) l · min−1; mean (SD) carbon dioxide production (V˙CO2) ranged from 0.67 (0.20) l · min−1 to 0.85 (0.16) l · min−1; and mean (SD) minute ventilation ranged from 17.81 (3.54) l · min−1 to 24.97 (5.63) l · min−1. The majority of the breath-to-breath noise distributions differed significantly from Gaussian distributions with equivalent mean and SD parameters. The values of the normalised autocorrelation functions indicated a negligible breath-to-breath correlation. Tidal volume accounted for the majority of the V˙O2 (43%) and V˙CO2 (49%) variance. The breath-to-breath noise can be explained in terms of variations in the breathing pattern, although the large noise magnitude, together with the relatively small attainable response amplitudes in children reduces the certainty with which ventilatory and gas exchange kinetics can be measured.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004210050567
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  • 78
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    Electronic Resource
    Biokinetics and radiation doses for carbon-14 urea in adults and children undergoing the Helicobacter pylori breath test (1999)
    Springer
    European journal of nuclear medicine 26 (1999), S. 573-580 
    Details
    ISSN: 1619-7089
    Keywords: Key words:Helicobacter pylori ; Carbon-14 urea breath test ; Biokinetics ; Dosimetry ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The long-term biokinetics and dosimetry of carbon-14 were studied in nine adults and eight children undergoing carbon-14 urea breath test for Helicobacter pylori (HP) infection. The elimination of 14C via exhaled air and urine was measured with the liquid scintillation counting technique and with accelerator mass spectrometry. After the subjects had been given 110 kBq 14C-urea (children: 55 kBq) orally, samples of exhaled air were taken up to 180 days after administration and samples of urine were collected up to 40 days. Sixteen of the subjects were found to be HP-negative. In these subjects a total of 91.1%±3.9% (mean of adults and children ± standard error of the mean) of the administered 14C activity was recovered. The majority of the administered activity, 88.3%±6.2% in adults and 87.7%±5.0% in children, was excreted via the urine within 72 h after administration. A smaller fraction was exhaled. In adults 4.6%±0.6% of the activity was exhaled within 20 days and in children 2.6%±0.3%. Uncertainties in the biokinetic results are mainly due to assumptions concerning endogenous CO2 production and urinary excretion rate and are estimated to be less than 30%. The absorbed dose to various organs and the effective dose were calculated using the ICRP model for urea and CO2. The urinary bladder received the highest absorbed dose: in adults, 0.15±0.01 mGy/MBq and in children of various ages (7–14 years), 0.14–0.36 mGy/MBq. The findings indicate that an investigation with 14C-urea gives an effective dose to adults of 2.1±0.1 µSv (for 110 kBq) and to children of 0.9–2.5 µSv (for 55 kBq). From a radiation protection point of view, there is thus no reason for restrictions on even repeated screening investigations with 14C-urea in whole families, including children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002590050424
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  • 79
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    Electronic Resource
    Effect of Ascaris infection on the nutritional status and I.Q. of children (1999)
    Springer
    International journal of anthropology 14 (1999), S. 55-59 
    Details
    ISSN: 1824-3096
    Keywords: Ascaris ; Nutrition ; I.Q. ; Children ; Egypt
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract It was estimated that about 1.3 billion persons all over the world were infected with Ascaris Lumbricoides (A.L.), Especially children in tropical and subtropical countries. AIM To investigate the effects of A.L. infection on the nutritional status and the intellectual level in a sample of Egyptian primary school children from rural Giza province. SUBJECTS AND METHODS A sample of 637 children (329 boys and 308 girls) aged 6–12 years, have been subjected to some anthropometric measurements including body weight, body height, arm circumference, head circumference and triceps skinfold thickness. In addition, the I.Q. was determined using “Draw-a-man” test. Blood hemoglobin concentration was also determined using a spectrophotometric method. All the children were then subjected to stools and urine examinations, and peri-anal swab. Only 242 children were included for further study, of whom 45 boys and 38 girls were found infected with A.L. solely, and 81 boys and 78 girls of about the same age free of parasitic infections were taken as control. RESULTS Children infected with A.L. has significantly lower body weight, height, and arm circumference but insignificantly lower skinfold thickness and head circumference as comparedto the control group. Infected children had significantly lower hemoglobin concentration and I.Q. than the controls. CONCLUSIONS Selected anthropometric measurements, biochemical and intellectual tests from a useful complementary battery for reliable and informative investigation of the effects of parasitic infection on child nutrition and health. A.L. was found to have a significant effect on the physical and intellectual status of the rural Egyptian children of age 6–12 years.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02447627
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  • 80
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    Ultrastructural features of the myocardium of children with dilated cardiomyopathy (1999)
    Springer
    Heart and vessels 14 (1999), S. 52-56 
    Details
    ISSN: 1615-2573
    Keywords: Endomyocardial biopsy ; Dilated cardiomyopathy ; Children ; Ultrastructure ; Basal lamina layering of capillary
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We analyzed the electron-microscopic features of endomyocardial biopsy from pediatric patients with dilated cardiomyopathy (DCM). The specimens examined were taken from the right ventricle of ten patients aged from 2 to 15 years (mean 9.7 years). Biopsy specimens from eight patients with congenital heart disease (tetralogy of Fallot), aged from 3 to 12 (mean 7.3 years), and ten adult patients with DCM, aged from 32 to 60 (mean 45 years), were also examined. Patients considered to have endocardial fibroelastosis, arrhythmogenic right ventricular cardiomyopathy, specific cardiomyopathy, or coronary heart disease were excluded from this study. Specimens from pediatric patients with DCM showed various degrees of ultrastructural abnormalities of myocytes, including myofibrillar fragmentation, mitochondrial abnormalities, and intracellular edema. The ultrastructurally determined contractility failure index based on the severity of myocardial degeneration at the electronmicroscopic level was 4.9 ± 1.1. This value was significantly higher than that in patients with tetralogy of Fallot (0.9 ± 0.6,P 〈 0.001) but was not significantly different from that in adult patients with DCM (6.1 ± 2.6). The index of pediatric patients with DCM who died within 3 years was high (6.0 ± 0.8). Basal lamina layering of a capillary (BLL) in the myocardium was revealed in 1 of the 10 (10%) pediatric patients with DCM and in 6 of the 10 (60%) adult patients with DCM (P 〈 0.05). No BLL was noted in the patients with tetralogy of Fallot. These findings may be related to the pathogenesis of DCM in children and adults.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02481742
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  • 81
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    Die behandlung von unterarmfrakturen bei kindern (1999)
    Springer
    European journal of trauma 25 (1999), S. 254-266 
    Details
    ISSN: 1615-3146
    Keywords: Unterarmfraktur ; Kind ; Konservative/operative Therapie ; Forearm fractures ; Children ; Conservative/operative treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Forearm fractures rank among the most frequent injuries of children and adolescents. At our department, during a 5-year's period a total of 783 forearm fractures have been treated. The patient's age ranged between 1 and 17 years, with an average of 10.2 years. The vast majority were isolated forearm lesions without concomitant injuries, and the gender ratio of males to females was nearly 3 : 2. With 58.1% the left extremity was involved more frequently than the right one (40.4%), in 12 children (1.5%) fractures of both forearms were diagnosed simultaneously. Predominantly isolated radius fractures (59.1%) were seen, followed by complete forearm fractures (36.7%). Greenstick fractures occurred as frequent as 38.2%. With 78.7% the distal forearm was the most common location, followed by the middle and proximal shaft with 14.3% and 7.0%, respectively. Treatment was predominantly non-operative, only in 2.6% open reduction internal fixation (ORIF) became necessary. Therefore, majority treatment was outpatient and complications occurred very rarely. The data presented confirm the outstanding spontaneous correction capacity of the distal forearm in children in contrast to fractures located more proximally. Therefore, patients suffering from shaft fractures of the middle third have been invited to follow-up examinations revealing 44.4% excellent and good results, respectively. Fair and unsatisfying results have been found in 5.6% each. It could be demonstrated, that residual angulations of the middle third often overtax the organism's spontaneous correction capacity, at least as far as children aged 10 years and older are concerned. Therefore, in middle shaft forearm fractures in children generally should be reduced anatomically. If anatomical reposition and redression cannot be achieved conservatively, operative stabilization is indicated. We consider closed reduction and elastic stable intramedullary nailing (ESIN) the treatment of choice. In cases of higher degree open fractures or nerve lesions, revision with open reduction internal fixation (ORIF) using plates or external fixation are recommended, respectively.
    Notes: Zusammenfassung Unterarmfrakturen gehören zu den häufigsten Verletzungen im Kindes- and Jugendalter. In einem Zeitraum von fünf Jahren wurden insgesamt 783 Kinder and Jugendliche im Alter von einem bis zu 17 Jahren mit Unterarmfrakturen behandelt. Der Altersdurchschnitt lag bei 10,2 Jahren. Es handelte sich vorwiegend um isolierte Verletzungen, and das Verhältnis von Jungen zu Mädchen lag bei 3 : 2. Der linke Arm war mit 58,1% häufiger betroffen als der rechte (40,4%), zwölf Kinder (1,5%) hatten doppelseitige Frakturen. Zum größten Ted (59,1%) handelte es sich um isolierte Radiusfrakturen, gefolgt von den kompletten Unterarmfrakturen (36,7%). In 38,2% der Fälle lagen Grünholzfrakturen vor. Die Frakturen des distalen Schaftdrittels wurden mit 78,7% am haufigsten gesehen, gefolgt von Brüchen des mittleren (14,3%) and proximalen (7,0%) Drittels. Die Therapie erfolgte vorwiegend konservativ, die osteosynthetische Versorgung wurde nur in 2,6% der Fälle erforderlich. Somit konnte die Behandlung meist ambulant erfolgen, and Komplikationen waren außerordentlich selten. Das gute Spontankorrekturpotential kindlicher Unterarmfrakturen des distalen Drittels gegenüber weiter proximal gelegenen Frakturen bestätigte sich in der vorliegenden Untersuchung. Daher wurden die Patienten mit Frakturen des mittleren Drittels — soweit erreichbar - embestellt and eingehend nachuntersucht. Hierbei fanden sich in jeweils 44,4% der Fälle sehr gute and gute funktionelle Ergebnisse. Befriedigende and schlechte Behandlungsresultate wiesen je 5,6% der Patienten auf. Es zeigte sich, daß belassene Achsfehlstellungen im mittleren Drittel vor allem nach Erreichen des zehnten Lebensjahres die spontane Korrekturfähigkeit im Rahmen des weiteren Wachstums häufig überfordern and mit einem Ausgleich der Fehlstellung daher nicht regelhaft gerechnet werden darf. Daher sollten Unterarmfrakturen des mittleren Schaftdrittels bei Kindern anatomiegerecht reponiert werden. Gelingen Reposition oder Retention auf konservativem Wege nicht, ist die Indikation zur osteosynthetischen Versorgung gegeben. Hier empfiehlt sich, außer bei höhergradig offenen Frakturen oder Nervenschäden, als Therapie der ersten Wahl die geschlossene Reposition in Narkose mit elastisch-stabiler Markraumschienung (ESM). Dieses Osteosyntheseverfahren birgt gleichzeitig die Vorteile des kleineren operativen Traumas mit Verkürzung von Ruhigstellung (Gipsbehandlung) and Krankenhausaufenthalt. Schlüsselwörter: Unterarmfraktur - Kind - Konservative/operative Therapie
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    Der weite Weg der europäischen Waldbäume (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 12-17 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Die heutigen Wälder, die man in Europa vorfindet, waren nicht immer dort. VOr 22000 Jahren - im Hochglazial - gab es nur im Mittelmeergebiet die klimatischen Voraussetzungen für das Wachstum von Bäumen. Allerdings waren dies meist keine dichten Wälder, sondern Steppen mit einzelnen Baumgruppen. Das bedeutet jedoch, daß die heute in Europa wachasenden Bäume während der letzten 12000 Jahre - also seit dem Ende der letzten Eiszeit - nach Mittel- und Nordeuropa eingewandert sein müssen. Am Beispiel der Waldbäume Eiche (Quercus), Hainbuche (Carpinus), Fichtet (Picea) und Tanne (Abies) soll diese Einwanderung aufgezeigt werden.
    Additional Material: 8 Ill.
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    Et in scientia ego! Von ästhetischen Momenten und Poetischen Potentialen der WissenschaftHans-Günter Gassen zum 60. Geburtstag (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 6-11 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Irgendwie wird niemand mehr richtig glücklich mit der Wissenschaft, so erfolgreich sie auch ist und so sehr unsere alltäglichen Verrichtungen von ihren Ergebnissen und Lieferungen auch abhängen. Das Verständnis der öffentlichen Beobachter nimmt trotz aller Bemühungen nicht zu, sondern ab, und die professionellen Betreiber sehen sich unentwegt nach ihrer Verantwortung gefragt und in ethische Debatten verstrickt. Die ursprüngliche Idee, daß Wissenschaft nur gut sein kann, hat massiv an Überzseugungskraft verloren, und dieser Verlust tritt deshalb besonders deutlich hervor, weil man spürt, wie die alte Basis der Rationalität brüchig geworden ist, ohne einen neuen Grund zu erkennen, auf den man in Zukunft bauen kann. Dabei übersehen wir ein Fundament, auf dem Menschen immer schon gestanden haben und zu dem sie also auch zu jeder Zeit wieder zurückkommen können.
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    Aus der Redaktion (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 55-55 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
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    URL: http://dx.doi.org/10.1002/biuz.960290109
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    Blaue Liste Institute (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 56-57 
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    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Additional Material: 2 Ill.
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    Wissenschaft (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 60-60 
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    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/biuz.960290113
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    Masthead (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999) 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/biuz.960290201
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  • 88
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    Gelatinöses Zooplankton - materialsparende Leichtbauweise im Ozean (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 90-97 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Die fossile Überlieferung aus den letzten präkambrischen Jahrmillionen deutet darauf hin, daß gelatinös organisierte Formenj, also quallenähnlich gebaute Organismen, die das marine Pelagial (den freien Wasserkörper des Meeres) besiedelten ‘3’. Was sie dort vorfanden war jedoch wenig labensfreundlich. Zwar wimmelte das Meer von bakterien und Protozoen, aber im wesentlichen waren die riesigen Wasserräume leer und unbesiedelt. Crustaceen und andere Organisationsformen waren - wenn die Befunde stimmen - noch in der Entwicklungsphase beziehungsweise noch nicht zu der pelagischen Lebensweise übergegangen. Wie überlebten die quallenförmigen Organismen in dieser Umwelt, und warum leben sie noch heute in allen Bereichen des Meeres, von der Flach- bis in die Tiefsee, von den Polen bis zu den Tropen? Der pelagische Lebensraum beinhaltet Tausende von Arten, die viel “höher” organisierten Gruppen angehören, die schneller und kräftiger sind. Wieso wurden die gelatinösen Plankter nicht in irgendeine skurrile Nische gedrängt oder über die Konkurrenz völlig ausgeschaltet? Mögliche Antworten auf diese Fragen finden wir in der Gegenwart.
    Additional Material: 9 Ill.
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    URL: http://dx.doi.org/10.1002/biuz.960290205
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    Rätsel (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 117-117 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Additional Material: 2 Ill.
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  • 90
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    Kontrazeption beim Mann (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 110-116 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Als Fertilitätsrate bezeichnet man die Zahl der Geburten pro Frau in ihrer Lebensspanne. Wenn Zu- Oder Abwanderung in einer Population gering sind, läßt eine Fertilitätsrate von 2,0 eine konstante Bevölkerungszahl erwarten. Bei der Entwicklung der Erdbevölkerung beobachtet man in den industrialisierten Ländern derzeit keinen Anstieg. Die Fertilitätsrate liegt in den USA bei 2,1 und in Europa durchschnittlich bei 1,4. Mit 1,2 und 1,15 haben Italien und Spanien dabei die weltweit niedrigsten Fertilitätsraten. Somit ist örtlich sogar ein Bevölkerungsrücksgang zu erwarten. Auch in ostasiatischen Ländern wie China und Korea hat sich der Bevölkerungszuwachs verlangsamt. In Südasien und in afrikanischen Ländern wie China und Korea hat sich der Bevölkerungszuwachs verlangsamt. In Südlich der Sahara finden wir jedoch nach wie vor relativ hohe Gebeurtenraten. Im westafrikanischen Nigeria liegt die Fertilitätsrate bei 6,3. Für Indien und Pakistan werden Werte von 3,5 und 5,6 angegeben. Es gibt also noch viele Regionen mit einer hohen Fertilitätsrate. Manche Wissenschaftler gehen sogar davon aus, daß sich die Zahl entsprechender Staaten eher noch erhöhen wird ‘7’. Deshalb weichen auch die Schätzungen voneinander ab, bei welcher Bevölkerungszahl Wachstumsstillstand eintreten wird. Viele Demographen gehen davon aus, daß sich die Erdbevölkerung bis zum Jahr 2050 bei 10 Milliarden stabilisieren wird ‘9’. Andere schätzen, daß danach ein weiterer Ansteig auf etwa 12 Milliarden menschen zu erwarten ist ‘7’. Der Rückgang der Geburtenzahlen in den industrialisierten Ländern wurde mit kontrazeptiven Maßnahmen erzielt, die uns schon lange zur Verfügung stehen und die gut eingeführt sind. Auf den ersten Blick Sch eint es somit aus bevölkerungspolitischer Sicht auf dem Gebiet der Kontrazeption keinen zwingenden Bedarf für Neuentwicklungen zu geben. Dennoch sind Forschungsaktivitäten im Gang, die auf eine pharmakologische Kontrazeption beim Mann gerichtet sind. Im vorliegenden Artikel werden neben den traditionellen Möglichkeiten, die dem Mann zur Kontrazeption offenstehen, der wissenschaftliche Hintergrund und der Entwicklungsstand einer “Pille für den Mann” vorgestellt.
    Additional Material: 5 Ill.
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    URL: http://dx.doi.org/10.1002/biuz.960290207
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    Chemie (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. X 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/biuz.960290215
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  • 92
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    Anwendung der „Grünen Gentechnik“ ohne ökologische Risiken? (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 151-157 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Generell ist der Markt für gentechnisch veränderte Pflanzen und daraus hergestellte Produkte in den letzten Jahren gewachsen. In Deutschland zeigen sich indessen eher verhaltene Auswirkungen dieser Entwicklung ‘3’. Die wirtschaftliche Entfaltung der Gentechnik und Biotechnologie ist in Deutschland noch gering. Als ein Maß für den Entwicklungsstand der Gentechnik in der Pflanzenzüchtung ‘2’ und damit unter anderem auch deren Auswirkung auf die Futter- und Lebensmittelproduktion kann die Anzahl von Freisetzungsvorhaben mit gentechnisch veränderten Organismen (GVO) gelten. Von den rund 1300 Freisetzungsvorhaben im Bereich der EU entfallen 90 auf Deutschland. Im Vergleich zu den anderen EU-Mitgliedsstaaten rangiert Deutschland damit auf dem siebenten Platz.
    Additional Material: 4 Ill.
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    URL: http://dx.doi.org/10.1002/biuz.960290305
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    Rätsel (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 188-188 
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    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
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    URL: http://dx.doi.org/10.1002/biuz.960290310
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  • 94
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    Landwirtschaftlicher Pflanzenbau und biologische Vielfalt (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 177-183 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Vielfalt in allen Erscheinungsformen kennzeichnet schon die unbelebte und in noch stärkerem Maße die belebte Natur. Dagegen drängt die Nutzung von Naturkräften durch den Menschen, insbesondere in ihren weiter entwickelten und technisierten Formen stets auf Vereinfachung. So werden landwirtschaftliche Kulturpflanzen bei ein- bis mehrjähriger Nutzung im Regelfall in Reinkultur angebaut, ganz im Gegensatz zur standorttypischen Artenvielfalt eines natürlichen Pflanzenbestandes. Lediglich die verbliebene Unkrautflora erinnert dann and die ursprüngliche Artenvielfalt einer Pflanzengesellschaft. Es kommt hinzu, daß sich landwirtschaftlicher Pflanzenbau auf nur wenige anbauwürdige Kulturpflanzenarten konzentriert. Weltweit nimmt das Ackerland etwa 10 % der Landoberfläche der Erde ein, die mit nur etwa 30 Kulturpflanzenarten von überregionaler Bedeutung bestellt werden. Allein 37,4% davon sind dem Anbau von nur dreif für die Ernährung der Menschheit besonders bedeutsamen Arten (Weizen, Resi und Mais) gewidmet. In Deutschland werden gegenwärtig sogar 33% der Landoberfläche als Ackerland genutzt. Von den insgesamt etwa 14 bei uns häufiger anzutreffenden Kulturpflanzenarten besetzen die drei dominierenden Arten (Winterweizen, Mais und Wintergerste) dabei 48% der Anbaufläche. Landwirtschaftlicher Pflanzenbau wird also generell artenarm betrieben.Die zweite Ebene bilogischer Vielfalt im landwirtschaftlichen Pflanzenbau stützt sich auf die mehr oder weniger regelmäßige Folge verschiedener in Reinkultur angebauter Kulturpflanzenarten. Bozogen auf die Gesamtfläche eines Betriebes order die Feldflur einer Gemeinde ergibt sich dann noch immer ein abwechslungsreiches Gesamtbild verschiedener Aussaat-, Blühund Erntezeiten. Für artenreiche Fruchtfolgen lassen sich darüber hinaus viele, für die Bodenbewirtschaftung vorteilhafte Argumente anführen. Die hohe Schlagkraft der vollmechanisierten Betriebe und die beliebige Verfügbarkeit von Dünge- und Pflanzenschutzmitteln in Verbindung mit artunterschiedlichen Ertrags- und Preisrelationen haben jedoch auf intensive bewirtschafteten Betrieben in günstigen Lagen zu einer oft drastischen Reduktion der Pflanzenproduktion (auf den Anbau von nur noch drei, manchmal sogar nur zwei Arten) geführt, von denen der jeweils höchste Beitrag zur Deckung der Betriebskosten erwartet werden kann.Inzwischen hat sich jedoch die Erkenntnis durchgesetzt, daß die Aufrechterhaltung “biologischer Diversität” ein wesentliches Element zur Sicherung der “Nachhaltigkeit” der landwirtschaftlichen Pflanzenproduktion darstellt. Dies hat in der Konferenz von Rio (1992) im Rahmen der Agenda 21 zum Abschluß einer “Konvention über Biologische Vielfatl” geführt, der auch die Bundesrepublik Deutschland beigetreten ist.Mit dem Begriff biologische Vielfalt werden in dieser Konvention nicht nur Naturschutzverpflichtungen zur Sicherung des Erhalts bedrohter Tier- und Pflanzenarten übernommen, sondern es geht zu einem wesentlichen Teil auch um die 3. Ebene der biologischen Vielfalt in Form der genetischen Vielfalt innerhalb der für die Welternährung grundlegend bedeutsamen Kulturpflanzenarten. In diesem Zusammenhang soll hier gefragt werden, ob mit der Einführung transgener Nutzpflanzen neben ihrem wirtschaftlichem Nutzen auch Risiken für die biologische Vielfatl verbuden sind.
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  • 95
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    Masthead (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999) 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/biuz.960290401
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  • 96
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    Jagd- und Paralysierungsstrategien solitärer Wespen (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 223-237 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Zu den faszinierendsten “Waffen” im Tierreich gehören die Gifte. Auch viele Insekten setzen Gifte ein, zum Beispiel als Wehrgifte, wie sie von den staatenbildenden sozialen Hymenopteren, den Bienen, Hornissen und Faltenwespen bekannt sind. Die Wirkung dieser Gifte ist aufgrund ihrer medizinischen Bedeutung bereits intensiv untersucht. Über die Art und Weise der Giftinjektion sowie die Wirkungsweise der Gifte solitär lebender Wespenarten, etwa von Weg- und Grabwespen, ist vergleichs weise wenig bekannt. Eine Besonderheit der solitären Wespenarten ist, daß ausschließlich ihre Weibchen Insekten oder Spinnen jagen, um ihre künftige Brut zu versorgen. Spezielle jagdstrategien verringern dabei die Gefahr, daß potentielle Beutetiere die jagenden Wespenweibchen früch zeitig entdecken. Ist ein Beutetier optisch und/oder chemisch identifiziert. wird es je nach Wespenart durch einen oder mehrere Stiche paralysiert (gelähmt). Anfängliches Abwehrverhalten, selbst größerer Beutetiere, wird auf diese Weise unterbunden, und die Opfer können an einen sicheren Ort, ein Nest oder eine umfangreiche Nestanlage mit günstigem Mikroklima, gebracht werden, wo anschließend ein Ei abgelegt wird. Die sich auf ihrem Wirt entwickelnde Larve ist so vor dem Zugriff durch Feinde geschützt.Die an der Beute als Folge eines Stiches zu beobachtenden Giftwirkungen reichen von der vollständigen Paralyse, also dem totalen, in einigen Fällen auch irreversiblen Verlust der Fähigkeit, such zu bewegen, über vielfähigkeit, sich zu bewegen, über vielfältige, durch sas Gift bewirkte auffällige Verhaltensänderungen. Im Hinblick auf das Nervensystem lassen sich peri pher und zentral wirkende Gifte unter sscheiden, wobei der Wirkort durch das Stechverhalten der Wespe vorgegeben sein kann.
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    Blaue Liste Institute (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 256-256 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: No Asbstract.
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    URL: http://dx.doi.org/10.1002/biuz.960290411
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    Für Ihre Dokumentation von Nr. 4/99 Biologie in unserer Zeit (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 260-260 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/biuz.960290414
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  • 99
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    Verschwendung oder Sparsamkeit? - Über den Umgang der Blütenpflanzen mit ihrem Pollen (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 268-277 
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    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Additional Material: 18 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/biuz.960290503
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    Induzierbare VerteidigungsmechanismenHerrn Prof. Dr. Klaus Heckmann zum 65. Geburtstag gewidmet. (1999)
    Weinheim : Wiley-Blackwell
    Biologie in unserer Zeit 29 (1999), S. 292-300 
    Details
    ISSN: 0045-205X
    Keywords: Life and Medical Sciences
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology
    Notes: Zu en vielen Schutz- und Verteidigungsstrategien, die von den Organismen entwickelt wurden, um dem Gefressenwerden zu entgehen, Zählen ein sperrigerwerden der Individuen, die Bildung von Panzern, Stacheln und Dornen, das Produzieren und Speichern von schwerverdaulichen Stoffen und Giften, aber auch die Entwicklung eines komplexen verhaltensrepertoires zur Vermeidung von Freßfeinden ‘8’. Bis zur dieses Jahrhunders glaubte man, daß die der Verteidigung dienenden Maßnahmen dauerhaft seien, also im Laufe der Evolution entstanden sind und im Verlauf ddes Lebens eines Individuums zu einem bestimmten Zeitpunkt zur Ausprägung, gelangen, unabhängig von der gerad herrschenden Bedrohung. Heute wissen wir, daß neben einer solchen kionstitutiven Verteidigung in vielen Organismengruppen auch induzierbare Verteidigungsmechanismen existieren, welche nur dann wirksam werden wenn Freßfeinde im Biotop in größerer Dchte auftreten und somit eine ernstzunehmende Bedrohung darstellen. Das Spektrum induzierbarer Feindabwehrmechanismen ist der Palette der kionstitutiven Abwehrmaßnahmen dabei durchaus sehr ähnlich. Der entscheidende Unterschied ist jedoch der, daß der bedrohte Organismus erst auf ein bestimmtes Signal hin von seinem genetisch festgelegten Schutzmechanismus Gebrauch macht. Dadurch werden die Kostenfür die Feindabwehr minimiert. Neben physikalischen Signalen (wie Licht und Temperatur), welche dem Organismus indirekt Auskunft über den Grad einer aktuellen Bedrohung geben können, spielen von den Freßfeinden abgegebene chemische Signale (Kairomone) eine entscheidende Rollen als Auslöser der induzierbaren Verteidigungsmechanismen. An der Aufklärung der chemischen Natur der Kariomione wird zur Zeit intenxiv gearbeitet.
    Additional Material: 8 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/biuz.960290506
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