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  • 1
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Intestinale Invagination ; Hydrostatische Reposition ; Ultraschallsteuerung ; Erfolgsrate ; Key words Intestinal intussusception ; Hydrostatic reduction ; Ultrasound guidance ; Rate of success
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objective: We wanted to find out, if ultrasound guided hydrostatic reduction of intussusception, as develloped by YG Kim, and other methods of intussuseption reduction are comparable. Method: We, therefore, studied all intussusceptions, diagnosed between 1989 and 1999 at children’s hospital of the TU München and compared our results with the most important reports until 1998. Results: 9 of 158 patients with intussusception (age 2–130 months) had to be operated upon without any prior conservative trial, 10 intussusceptions dissolved spontaneously. 87,1% of 139 procedures were successful; taking into account only ileocolic intussusceptions, more than 95,1% were successful. Only a few complications were recorded. Rate of recurrence 9,5% (rate of success: 79% in recurrent intussusception), perforation 0,7%, letality 0%. These results are identical to previously published studies of ultrasound guided hydrostatic reduction. Conclusions: We recommend this procedure, because ultrasound guided hydrostatic reduction is more successful, has less risks and offers more advantages than other procedures, e.g. avoidance of x-ray exposure and recognition of impaired circulation.
    Notes: Zusammenfassung Hintergrund: Die ultraschallgesteuerte hydrostatische Reposition einer intestinalen Invagination ermöglicht im Unterschied zu anderen Therapiekonzepten eine Reposition ohne Strahlenbelastung. Gezeigt werden sollte, daß dieses Verfahren gleichwertige Erfolge bietet. Methode: Alle Invaginationen, diagnostiziert an der Kinderklinik der TU München von 1989–1999, wurden retrospektiv analysiert und durch Zusammenstellung der wichtigsten Veröffentlichungen die verschiedenen Therapiekonzepte verglichen. Ergebnisse: Von 158 Invaginationen (Alter der Patienten: 2–130 Monate) lösten sich 10 spontan, 9 mußten primär operiert werden. 87,1% aller Repositionsversuche führten zum Erfolg, bei Berücksichtigung nur der ileokolischen Invaginationen sogar 95,1%. Die Erfolgsrate betrug bei Rezidivinvaginationen 79% bei einer Häufigkeit von 9,5%. Komplikationen traten selten auf: Letalität 0%, Perforationsrate 0,7%. Diese Resultate entsprechen den Ergebnissen der ultraschallgesteuerten hydrostatischen Reposition in der Literatur. Schlußfolgerung: Die ultraschallkontrollierte hydrostatische Reposition bietet neben der höheren Erfolgsrate und der niedrigeren Rate an Komplikationen im Vergleich zu allen anderen Therapiekonzepten weitere Vorteile. Daher sollte dieses Verfahren bevorzugt werden, zumal mit der Farbdopplersonografie eine neue Möglichkeit der nichtinvasiven Durchblutungskontrolle als prognostischer Parameter besteht.
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  • 2
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Kind ; Schwimmbad ; Sprungunfall ; Unfallverhütung ; Wasserrutsche ; Key words Accident ; Child ; Prevention ; Swimming pool ; Water slide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objective: It is the aim of this study to examine causes and modes of swimming bath accidents involving children and adolescents in order to establish strategies for accident prevention. Method: In a retrospective study we identified all children ≤=16 years who were admitted at the Department of Paediatric Surgery for treatment of swimming bath injuries between January 1990 and December 1997. Charts were analyzed for gender, age and type of injury. Questionnaires were sent to the parents of these children asking for the circumstances and mode of accident and for sequels of the injury. Results: Overall 452 children were treated in the A & E department for swimming bath injuries, 199 girls (44%) and 253 boys (56%). The average age of patients was 10 years (1–16 years). In 5 children the main injury was a fracture of the skull (1.1%), a fracture of the spine/sternum in 2 (0.5%), a concussion of the brain in 44 (9.7%), a fracture of a limb in 74 (16.4%), and a tooth luxation/fracture in 5 (1.1%). Further 27.4% of children had sustained contusions, 21.7% skin wounds, 9.3% sprains and 11.7% miscellaneous injuries. Analysis of 127 questionnaires demonstrated that the majority of children were injured in water-slide accidents (18.1%), followed by children injured when jumping off the edge of the pool (14.9%), and children who fell when running on slippery ground (14.2%). Conclusion: Accurate supervision is mandatory for children using water-slides. A continuous water current at the diving-in area of water-slides could lower the rate of collision accidents. Children should be warned by pictograms, swimming instructors and parents not to jump off the edge of the swimming-pool into shallow pools or turbid water. To prevent fall accidents caused by slippery ground we recommend a no slip surface on povings and steps of ladders.
    Notes: Zusammenfassung Fragestellung: Welche Ursachen und Unfallmechanismen führen zum Auftritt von Schwimmbadverletzungen im Kindes- und Jugendalter, und lassen sich Unfallpräventionsstrategien ableiten? Methode: In einer retrospektiven Studie wurden alle Kinder im Alter bis zu 16 Jahren erfaßt, die zwischen Januar 1990 und Dezember 1997 an der Universitätsklinik für Kinderchirurgie Graz wegen einer Schwimmbadverletzung behandelt wurden. Analysiert wurden das Alter zum Unfallzeitpunkt und die Art der Verletzungen. An die Familien dieser Kinder wurden Fragebögen mit Fragen zu Unfallort, -zeit, -hergang und -folgen versandt. Ergebnisse: 452 Kinder wurden in die Studie einbezogen, 199 Mädchen (44%) und 253 Knaben (56%). Das mittlere Alter der Kinder lag bei 10 Jahren (1–16 Jahre). 5 Kinder (1,1%) hatten Schädelfrakturen, 2 Kinder Wirbel- bzw. Sternumfrakturen (0,5%), 44 Gehirnerschütterungen (9,7%), 74 Extremitätenfrakturen (16,4%), 5 Zahnluxationen bzw. -frakturen (1,1%) und 5 Rißquetschwunden im Genitalbereich (1,1%) erlitten, während die übrigen Kinder v.a. Kontusionen (27,4%), Hautwunden (21,7%), Distorsionen (9,3%) und sonstige Verletzungen (11,7%) davontrugen. Die Analyse der 127 auswertbaren Fragebögen ergab, daß sich die Unfälle v.a. bei Wasserrutschenbenutzung (18,1%), (Kopf-)Sprüngen vom Beckenrand (14,9%) oder beim Laufen in der Schwimmbeckenumgebung (14,2%) ereignet hatten. 6 Kinder (4,7%) leiden an Spätfolgen des Unfalls [rezidivierende Kopfschmerzen (2), Gesichtsnarben (2), Verlust eines Zahns (1), knöcherne Schiefnase (1)] Schlußfolgerung: Zur Reduktion der häufigen Wasserrutschenunfälle sind eine ständige Aufsicht und die Einhaltung der gültigen Sicherheitsnormen unabdingbar. Unterwasserstömungen im Eintauchbereich am Wasserrutschenende können die Kollisionsgefahr reduzieren. Warnpiktogramme, Wassertiefenangaben und vermehrte Aufklärung im Schwimmunterricht könnten mithelfen, (Kopf-)Sprünge vom Beckenrand des Nichtschwimmerbereichs oder in seichte Badeseen zu verhindern. Griffigere Bodenbeläge und Auftrittsflächen sowie abgerundete Kanten in der Umgebung des Schwimmbeckens würden das Risiko des Ausrutschens senken.
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  • 3
    ISSN: 1434-4475
    Keywords: Keywords. Ruthenium(II) complexes; ( ; )-diop; Optically active co-ligands; Diastereomers;Stereoselectivity.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Description / Table of Contents: Zusammenfassung.  Die Synthese von neuen Ruthenium(II)-Komplexen, die zwei verschiedene chirale Liganden enthalten, wird beschrieben. Diese Liganden sind zum einen (−)-diop und zum anderen optisch aktive Imine, die aus der Kondensation von (S)-1-Phenylethylamin mit 2-Pyrrolaldehyd oder 2-Salicyladehyd stammen. Die Synthese beinhaltet die Darstellung der Vorstufen, die aus 1,5-Cyclooctadien (cod) und den entsprechenden Iminliganden bestehen. Obwohl für die oktaedrischen (−)-diop-Imin-Ruthenium(II)-Komplexe sechs Diastereomere möglich sind, wird in einer hoch stereoselektiven Reaktion jeweils nur ein Diastereomer gebildet.
    Notes: Summary.  The synthesis of novel ruthenium(II) complexes containing two different chiral ligands is described. These ligands are on the one-hand (−)-diop and on the other hand optically active imines derived from the condensation of (S)-1-phenylethylamine with 2-pyrrolealdehyde or 2-salicylaldehyde. The synthesis includes the preparation of the precursors containing 1,5-cyclooctadiene (cod) and the corresponding imine ligands. Although for the octahedral (−)-diop-imine-ruthenium(II) complexes six diastereomers are possible, in highly stereoselective reactions only one diastereomer is formed.
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  • 4
    Electronic Resource
    Electronic Resource
    [s.l.] : Macmillan Magazines Ltd.
    Nature 399 (1999), S. 84-84 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Nature 397, 350–355 (1999) The cover image on this issue should have been orientated as shown here ... to conform with the location of the notochord as described in the cover ...
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  • 5
    Electronic Resource
    Electronic Resource
    [s.l.] : Macmillan Magazines Ltd.
    Nature 397 (1999), S. 350-355 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Growth cones at the tips of extending neurites migrate through complex environments in the developing nervous system and guide axons to appropriate target regions using local cues,. The intracellular calcium concentration ([Ca2+]i) of growth cones correlates with ...
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 30 (1999), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Evaluation of an innovative curriculum: nursing education in the next century The present research focused on an interim evaluation of a new nursing curriculum made by first- and second-year undergraduates. Study 1 examined the assessments made by 90 students of the new, actual programme of their studies, as well as an ideal one, on 21 bipolar criteria reflecting the developing changes in health care practices and higher educational processes in western society. The results of study 1 indicated that students perceived the actual programme as compatible with health care changes, but lacking in terms of the learning process. Study 2 investigated the same assessments among 105 registered nurses who evaluated the traditional nursing programme under which they were trained as well as an ideal one. The results of study 2 showed that registered nurses perceived past curricula as lower than the ideal on both health care and process of learning. The results of this interim evaluation imply that the new nursing curriculum follows health care trends, but a shift in the educational process is required.
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In 1989 the two German countries, FRG and GDR, were reunited after 50 years of political separation. During this time, these countries underwent independent, and in parts quite different, developments. While the reunification has had less effect on the overall situation in the Western part of the country, the Eastern part has experienced considerable changes, including the health service. In the field of pacing and ICD therapy, this study finds that 8 years after the reunification, the German federal states of both parts of the country have converged in the field of pacing and ICD therapy.
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  • 8
    ISSN: 1432-2072
    Keywords: Key words MDE ; Ecstasy ; Methamphetamine ; Psilocybin ; Entactogens ; Psychopathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to contribute to the characterization of the entactogen (ecstasy) substance group. The psychopathological, neuroendocrine and autonomic effects of common recreational doses of the entactogen 3,4-methylenedioxyethylamphetamine (MDE), the hallucinogen psilocybin, the stimulant d-methamphetamine and placebo were investigated in a double-blind study with healthy volunteers (n = 32). Psychological effects of the drugs were assessed by means of standardized rating scales, self assessment inventories and free descriptions. The most characteristic effects of MDE were pleasant emotional experiences of relaxation, peacefulness, content and closeness to others. However, significant stimulant and hallucinogen-like effects were also present, although the latter were weaker than the effects of psilocybin. MDE elicited the strongest endocrine and autonomic effects among the three drugs, including robust rises of serum cortisol and prolactin, elevations of blood pressure and heart rate, and a moderate, but significant rise of body temperature. The apparent contrast between psychological and autonomic effects (subjective relaxation versus physical activation) was a unique feature of the MDE state. Our findings are in line with both users’ reports and results from previous experimental studies, and support the view that entactogens constitute a distinct psychoactive substance class taking an intermediate position between hallucinogens and stimulants.
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  • 9
    ISSN: 1573-4838
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract Large bone defects caused by severe trauma, infection or tumor resection are still a major challenge for orthopaedic surgery. The key concept for successful bone regeneration consists of combining the osteoinductive effect of osteogenic cells with a suitable carrier structure to promote osteoblastic differentiation and optimal matrix production. Therefore, periosteal cells cultured in polyglycolic-polylactid acid (PGLA) fleeces were investigated for their osteogenic differentiation and used to repair critical size bone defects in a rabbit model. Periosteal cells were isolated from New Zealand White rabbits and expanded in vitro. Osteogenic differentiation was investigated by analysis of alkaline phosphatase and osteocalcin production in vitro depending on culture conditions and passage number. Cells were seeded into PGLA fleeces. After further cultivation, tissue constructs were examined histologically and by immunohistochemistry for cell distribution and osteogenic differentiation. These constructs of defined size were used to repair critical size calvarial defects (group I) in rabbits compared to a defect repair with polymers only (group II) or to untreated defects (group III). Bone healing was evaluated after 4 weeks by radiodensitometry and a special histological scoring system. For early evaluation, radiodensitometry was not sensitive enough to detect differences in calcification. However, on histologic examination the group with cell/fleece constructs revealed intense formation of uncalcified bone. The mean defect closure of the experimental group I was 65%, compared to control groups II and III with 31% and 22%, respectively. The established methods of 3-D-cell culture and ex-vivo transplant assessment proved to be a valuable tool for quality assurance. The results demonstrate that the combination of periosteal cells and polymer fleeces is a tissue engineering approach, which may have clinical applications in various fields of reconstructive surgery.
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  • 10
    ISSN: 1573-3599
    Keywords: albinism ; systems ; family therapy ; genetic counseling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract A systems approach to family therapy assumes that a person and his/her problems do not operate in a social vacuum but instead are imbedded in a social context. This context includes fairly small social systems such as a nuclear family and larger social systems such as school systems and cultural beliefs. A case of a girl with albinism born to a couple from India will be used to discuss how a systems approach might be useful in a genetic counseling setting.
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