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  • 25.85.Jg  (1)
  • Anorectal malformation  (1)
  • Epineural suture  (1)
  • 1
    Abstract: Following a recent classification of the VATER Association provided by the CURE-Net consortium (submitted), we investigate medical predictors of psychological stress and anxieties in this particular condition. We developed a new set of questionnaires measuring psychological adjustment and quality of life outcome in conditions associated with anorectal and/or urogenital malformation (one self- report form to be completed by patients 7-17 years of age, two parent report forms with one relating to patients with an age range of 0-6 years, resp. 7-17 years of age). The questionnaire "Malformation-related Stress and Anxieties" comprises 26 items belonging to five subscales (I. Functional and cosmetic impairment, II. Intimacy and relationship, III. Social inclusion, IV. Psychological functioning, V. Family functioning). Every item can be responded to with respect to both actual, present problems already experienced as well as to future anxieties anticipating future development and adjustment (a perspective which especially applies in younger patients). Internal consistencies of the scales are good, resp. very good (Cronbach's alpha = .85 concerning present sources of anxiety scale, resp., .94 concerning future anxieties scale). The items are supplied with a Likert-type 5-point scale. We administered the questionnaire in N = 17 children and adolescents suffering from VATER via parental (proxy) report. As most medical risk factors affected nearly the entire sample, statistical analysis excluded investigation of differential impact on psychological stress experience and anxieties in subjects exposed versus not exposed. Special attention, therefore, was paid to those medical parameters with the best statistical power to differentiate between individuals of high versus low psychological outcome. Medical predictors differentiating between individuals with high versus low adjustment comprise post-operative infections of the urinary tract (t[15] = -3.78, p = .09), wound infections (t[15] = -3.04, p 〈 .01), stoma complications (t[15] = -2.11, p = .08) (e.g., prolapsed (t[13] = -2.37, p = .05), other treatment complications (t[15] = -2.59, p 〈 .05) and presence of a megacolon (t[13] = -2.44, p = .06). From the perspective of stress psychology, the findings may indicate that particular medical characteristics of a malformation may operate via two different pathways: (a) pathway of severity of a particular medical risk factor: the presence of a megacolon, for example, may restrict quality of life and successful adjustment via multiple and long term functional impairments associated and (b) pathway of subjective predictability and controllability of treatment course. In accordance with theoretical models from stress psychology, the psychological impact of complicating factors such as wound-healing infections is not operating via severity of impairment, but via implicit messages they convey, indicating a low predictability and controllability of course of disease and treatment. As a result, they may increase intensity of worry and anxieties upon further difficulties still to come during future development. As a conclusion, psychological counseling may not only address concrete functional impairments and stressors, but also basic feelings of insecurity, controllability and self-efficacy
    Type of Publication: Journal article published
    PubMed ID: 21789667
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  • 2
    ISSN: 1435-2451
    Keywords: Nerve suture ; Late results ; Epineural suture ; Perineural suture ; Nervennaht ; Spätergebnis ; Epineurale Naht ; Perineurale Naht
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die in unserer Klinik in den Jahren 1965–1977 zunächst epineural (n = 20) und später perineural (n = 11) durchgeführten Nervennähte nach glatten Durchtrennungen des N. medianus (n = 16) und N. ulnaris (n = 15) wurden vergleichend nachuntersucht. Sowohl im Hinblick auf die Sensibilitätsrückkehr als auch auf die erreichte motorische Funktion zeigte sich kein signifikanter Unterschied zwischen den beiden Nahtttechniken. So waren brauchbare funktionelle Spätergebnisse (M3–5 nach Seddon, S2–5 nach Geldmacher) nach epineuraler Naht in 16 von 20 und nach perineuraler Naht in 8 von 11 Fällen zu erreichen. Zusätzlich durchgeführte elektrodiagnostische Verfahren konnten die Beurteilung nicht weiter differenzieren.
    Notes: Summary The report summarizes results of a comparative follow-up study in our clinic (in the years 1965–1977) of nerve sutures which were first performed epineurally (n = 20) and later perineurally (n = 11) and deals with nerve sutures after severance of the N. medianus (n = 16) and the N. ulnaris (n = 15). There was no significant difference with respect to the return of the sensitivity as well as with regard to the motoric function when comparing both suture techniques. Useful late functional results (M3–5 according to Seddon, S2–5 according to Geldmacher) were obtained after epineural suture in 16 of 20 cases and after perineural suture in 8 of 11 cases. No further differentiation was possible using electrodiagnostic methods.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1434-601X
    Keywords: 25.20.Dc ; 25.85.Jg ; 27.90.+b
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract The total photofission cross section σγ,F for235U and238U has been measured in the energy range 50≤E γ≤800 MeV at the 855 MeV Mainz Microtron MAMI using energy and time tagged photons (Glasgow Tagger) and a 4π arrangement of position sensitive fragment detectors. Besides the absolute photofission cross section σγF , which almost completely exhausts the total photon absorption cross section for these nuclei, fragment mass distributions in this energy domain were determined via time of flight techniques (TOF). The results for the total photofission cross sections σγ,F normalized to the atomic numberA for both isotopes coincide, and agree in theΔ-resonance region, within the systematic errors, with the socalled“Universal Curve” σγ,T /A of the total photon absorption cross section σγ,T . At higher energies the cross sections exhibit a smooth behaviour. In particular, it is shown for the first time that there isno resonance-like shape near the D13 resonance (at ≈710 MeV) as observed for the free proton. This complete suppression of the D13 resonance in complex nuclei is not yet understood on a microscopic level. The fragment mass distributions show a predominantly mass symmetric fission. However, contributions from mass asymmetric fission at some photon energies may give a hint of an increased mass asymmetric fission after the onset of the pion and two pion channels.
    Type of Medium: Electronic Resource
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