Gerichtliche Geburtshilfe

International Journal of Legal Medicine -     

Leichenerscheinungen

Ohne Zusammenfassung     

Ungleichseitiger Übergangswirbel,jahrelang als Wirbelbruch (Unfallfolge) mißdeutet

Ohne Zusammenfassung     

Noma: the Sokoto approach

On October 1996 a Dutch-German medical team spent three weeks in Sokoto, Nigeria to initiate a surgical aid program for the treatment of noma. For logistic reasons a semiquantitative classification system for noma was devised, describing the extent of tissue loss of anatomical units such as the nose, the outer cheek and the inner lining of the cheek, the upper lip and lower lip, and the degree of trismus (NOITULP). This system proved useful in planning the operations of the 23 noma patients treated during this period and may be helpful for future evaluation of postoperative results and the development of standardized treatment. For patients with severe trismus an intubation strategy was developed. If two attempts at blind intubation had failed, the policy was: quick cutting of the scar tissue supposedly causing the trismus and intubation (QCI). If this approach failed a Seldinger minitracheostomy was performed. In eight patients with severe (T3, T4) trismus this procedure was performed. In three patients a minitracheostoma was necessary. The operative procedures consisted of a large variety of local flaps. Forehead flaps and cervical rotation flaps were used most frequently. In four patients wound healing was complicated necessitating additional surgical treatment. Received: 9 June 1997 / Accepted: 19 January 1998     

Activation of Genes for Superoxide Dismutase,Interleukin-1ß, Tumor Necrosis Factor-a,and Intercellular Adhesion Molecule-1 during Healing of Ischemia-Reperfusion-Induced Gastric Injury

The diagnostic sensitivity and specificity of IgA endomysium antibodies (EmA) and IgA gliadin antibodies (AGA) for coeliac disease (CD) were studied in Swedish children. Indirect immunofluorescence was used for demonstration of EmA and the diffusion-in-gel enzyme-linked immunosorbent assay method for AGA. Serum samples were collected and analysed from 77 consecutive children undergoing small-intestinal biopsy on recognized clinical indications. The diagnostic sensitivity for CD was 98.1% for EmA and 86.5% for AGA. The specificity of the two tests was 92.7% for EmA and 92.7% for AGA in paediatric patients. In addition, 115 sera from control children showed 2.6% positive for EmA and (1.9% positive for AGA.     

Erwärmung der Atemluft in der Nase

BACKGROUND AND OBJECTIVE: The purpose of this study was to determine whether the temperature at the end of inspiration is the same as the temperature a few seconds after breathing stops at the end of inspiration to study if the nasal mucosa are capable of providing heat during a cessation of breathing. PATIENTS/METHODS: Fifteen healthy volunteers were included in the study.The temperature at the end of inspiration was compared to the temperature obtained 5 s after cessation of breathing at the end of inspiration and at the end of expiration. Intranasal temperature measurements were taken at three locations in the nose with a miniaturized thermocouple. RESULTS: The temperature increased during cessation of breathing at all locations.The highest temperature differences between the end of inspiration and 5 s later (breathing at rest) could be observed at the nasal valve area.The lowest temperature difference was found in the nasopharynx. At the end of expiration,the temperature decreased only slightly from the nasopharynx to the nasal valve area. CONCLUSIONS: The anterior part of the nose in particular is capable of heating the inspired air.This is also important for humidification. Heating of inspired air requires special anatomical conditions of the anterior nasal segment.     

Unusual birth injury of the scrotum

Birth injury of scrotum in newborns is extremely rare. In one case testis and spermatic cord were replaced immediately and the wound closed. After 16 months the postoperative result was without pathological findings.     

Effects of treatment in mother-child rehabilitation centres

Effects of Treatment in Mother-Child Rehabilitation Centres. The study aims at an external evaluation of mother-child rehabilitation centres in Germany. The centres taking part in the project will get detailed information about their present state of quality in the dimensions of structure, process and outcome as well as patient satisfaction and job satisfaction of the employees. This article focuses on quality of outcome. Two main questions are addressed: How do women treated in mother-child rehabilitation centres assess their health problems at admission, and what are the effects after three weeks of inpatient treatment? The results show that in comparison with a German norm population, 55 % to 75 % of the women in the present study reported intense distress in all dimensions of health (somatic, functional and psychosocial). The analysis of effects after treatment confirms a distinct improvement of health status reported by patients as well as by doctors and therapists. Data of a follow-up after 6 months will show whether these positive effects can be maintained.