bluuebunny/crossref_metadata_2025 huggingface dataset:
Prophylactic Mastectomy - Evaluation and Treatment of High Risk Patients
Authors: Remmel  , Harder
Published: January 2006

Prophylactic mastectomy is an aggressive strategy for breast cancer risk reduction. The indications and efficiency of this procedures are not yet clearly defined. Randomized, prospective studies, comparing different surgical procedures with other modalities of breast cancer risk reduction are lacking. The report evaluates the existing controversy, based on Medline search in the following sequence: risk factors, possibilities of risk reduction, effectiveness of risk reduction, technical considerations and recommendations. Patient selection is difficult and needs an interdisciplinary approach. The women have to be well informed about all treatment alternatives and various reconstructive procedures. An appropriate risk reduction strategy should be selected individually for each patient. Up to now, there exist only recommendations from different institutions but no definitive guidelines.
Treatment of Comminuted Fractures of the Proximal Ulna - A Challenge
Authors: Platz  , Payne  , Trentz
Published: January 2006

Fragestellung: Mehrfragmentäre proximale Ulnafrakturen sind schwierig zu behandelnde Verletzungen, oft kompliziert durch Mitbeteiligung des Ellbogengelenkes und kompromittierte Weichteile. Die Behandlung dieser Frakturen ist anspruchsvoll und eine Herausforderung. Wegen der Begleitverletzungen (Luxationen im humero-ulnaren Gelenk und Frakturen des Radiusköpfchens) sind die Resultate oft nur mässig. Anhand unseres Patientengutes sind wir im Sinne einer Qualitätskontrolle der Frage nachgegangen, ob die Resultate der Behandlung dieser Frakturen durch die Schwere der Fraktur bedingt sind, oder ob andere Faktoren wie beispielsweise das Ausmass des Weichteilschadens vorliegen, die den Outcome negativ beeinflussen. Methodik: Retrospektive Analyse von 18 Patienten mit mehrfragmentären proximalen Ulnafrakturen. Neben den C-Frakturen gemäss AO-Klassifikation wurden auch A1, A3, B1 bzw. B3 Frakturen mit in die Studie eingeschlossen. Klinische und radiologische Kontrollen erfolgten routinemässig 1/2-1 Jahr postoperativ bzw. je nach Knochenheilung und Arbeitsaufnahme bis 48 Monate postoperativ. Die Erfassung der Ellbogenfunktion erfolgte mit Hilfe des Morrey-Scores ein Jahr nach dem Unfall. Ergebnisse: Gemäss AO Klassifikation erlitten von den 18 Patienten je vier eine A-Fraktur bzw. eine B-Fraktur und zehn Patienten eine C-Fraktur. Bei acht von 18 Patienten lag eine offene Fraktur vor. In 10/18 der Patienten war zusätzlich das Radiusköpfchen frakturiert und in 9/18 der Fälle bestand eine Luxation im humero-ulnaren Gelenk. Die Funktion betrug bei der Ein-Jahreskontrolle durchschnittlich: Extension/Flexion 0 / 20 / 120 Grad bzw. Pronation/Supination 70 / 0 / 70 Grad. Die Bewertung nach dem Morrey-Score ergab bei zehn Patienten exzellente bis gute Resultate, mässige Resultate bei vier Patienten und bei vier Patienten musste das Resultat als schlecht bezeichnet werden. Schlussfolgerungen: Wegen Begleitverletzungen (Luxationen, Radiusköpfchenfrakturen) sind trotz korrekter Einschätzung der Schwere der Verletzung und adäquater Behandlung, die Resultate als mässig zu bezeichnen. Ziel ist eine stabile anatomische Rekonstruktion, die eine frühfunktionelle Nachbehandlung erlaubt.
Dorsal Hemi-Lithotomy Position for Femoral Fracture Nailing and the Well Leg Compartment Syndrome. Report of Two Cases, Review of the Literature
Authors: Christodoulou  , Garofalo  , Echeverri  , Pelet  , Mouhsine
Published: January 2006

Le syndrome de loge sur positionnement prolongé en lithotomie ou en hémilithitomie, est une complication rare en chirurgie. Les dommages neurovasculaires sont souvent permanents. On reporte deux cas d'ostéosynthèse du fémur en position d'hemilithotomie, compliqués d'un syndrome de loge de la jambe controlatérale. Une revue de la littérature sur les 40 cas décrits, jusqu'à ce jour, nous démontre que cette complication est fortement liée au positionnement du patient et à la durée opératoire. Compte tenu du pronostic fonctionnel incertain, une limitation du temps de positionnement en lithotomie doit être recherchée. La surveillance postopératoire doit être rigoureuse et sans hésitation quant à une fasciotomie éventuelle sur simple examen clinique ou après la mesure de la pression dans les loges. Une technique de positionnement sur la table orthopédique est proposée.
Osseous Fragment Mimicking Pseudarthrosis in the Thumb
Authors: Kalbermatten  , von Wartburg
Published: January 2006

Als Pseudarthrose an der Hand bezeichnet man die nach 6 Monaten fehlende Konsolidierung einer Fraktur. Ursächlich für die Entwicklung einer Pseudarthrose können biologische und/oder mechanische Gründe sowie eine Infektion sein. Pseudarthrosen verlangen oft eine Resektion und nachfolgend eine stabile Osteosynthese, allenfalls eine autologe Knochentransplantation. Wir beschreiben den Fall eines jungen Patienten bei welchem aufgrund der Anamnese sowie der klinischen und radiologischen Untersuchung freie Kortikalissplitter in der Dorsalaponeurose als Pseudarthrose der Daumengrundphalanx fehlinterpretiert wurden. Wir legen Wert auf die Erkennung der Pseudarthrosen und möchten gleichzeitig auf eine mögliche überraschende Differentialdiagnose hinweisen.
Blind Loop Syndrome
Authors: Halkic  , Abdelmoumene  , Kianmanesh  , Vuilleumier
Published: January 2006

Introduction: Le syndrome de l'anse borgne désigne classiquement les complications des montages chirurgicaux en cul-de-sac de l'intestin grêle (stase entérale, prolifération microbienne, anémie mégaloblastique par malabsorption de la vitamine B12). Le but de ce travail est d'attirer l'attention sur d'autres étiologies, plus rares. Patients et méthode: Ces 20 dernières années, nous avons opéré 9 malades: 5 après anastomose latéro-latérale iléo-iléale et 4 après iléo-transversostomie termino-latérale (2) ou latéro-latérale (2). Leur résection de l'intestin grêle avait été motivée dans 8 cas par l'infarcissement d'une anse grêle sur une bride post-opératoire (appendicectomie 7 fois, opération gynécologique 1 fois) et dans 1 cas par une tumeur. Les manifestations cliniques du syndrome de l'anse borgne ont été: douleurs abdominales en crampes, vomissements, amaigrissement important, diarrhées, asthénie, anémie, altération de l'état général. Le diagnostic a été très tardif, posé en moyenne 18 ans après la résection intestinale. Résultats: Tous les patients ont été traités par antibiothérapie au long cours, résection de leur anastomose latéro-latérale ou termino-latérale et rétablissement termino-terminale de la continuité digestive. Conclusion: Une anastomose iléo-iléale ou iléo-transverse latéro- ou termino-latérale peut créer un cul-de-sac responsable d'une stase fécale avec pullulation bactérienne. Outre une antibiothérapie, le traitement doit rétablir une continuité intestinale termino-terminale.
Bilateral Popliteal Artery Entrapment Syndrome (PAES)
Authors: Candrian  , Nussbaumer  , Furrer
Published: January 2006

Das arterielle popliteale Entrapmentsyndrom (PAES) ist eine seltene Ursache einer Claudicatio intermittens, sollte jedoch gerade bei jüngeren Patienten mit arteriellen Durchblutungsstörungen immer in die Differentialdiagnose miteinbezogen werden. Die Aetiologie liegt zum grössten Teil in einer Störung der embryonalen Entwicklung, je nach zugrunde liegender Anatomie werden dabei vier Typen des Entrapments unterschieden. Der natürliche Krankheitsverlauf ist gekennzeichnet durch fortschreitende Gefässwandläsionen infolge des repetitiven arteriellen Traumas. Anhand einer Kasuistik einer 37-jährigen Patientin mit einem beidseitigen, jedoch nur einseitig symptomatischen PAES sowie einer Literaturübersicht wird auf die Klinik, Diagnostik sowie die gängigen Therapieempfehlungen eingegangen. Insbesondere wird das Vorgehen bezüglich der asymptomatischen Gegenseite diskutiert.
Krukenberg's Tumor, Three Years after a Colic Carcinoma
Authors: Praz  , Nordback  , Billing  , Merlini
Published: January 2006

We report a case of left ovarian Krukenberg's tumor in a 65 year-old patient, three years after resection of a colonic carcinoma (pT3, G2, pN1, Stage 3, Dukes C). The case is briefly discussed with reference to the literature. Krukenberg's tumor usually occurs in younger patients, with a peak frequency before 40 years. Both ovaries are involved in 90% of cases. Pathogenetically the ovarian involvement arises either from hematogenous, lymphatic spreading or from contiguous extension from the primary colonic tumor. There may be some anatomic predispositions such as utero-ovarian vessel anastomosis in the ligamentum latum or by peritoneal adhesions.
Laparoscopic Cholecystectomy
Authors: Vogelbach  , Bogdan  , Rosenthal  , Pfefferkorn  , Triponez
Published: January 2006

Fragestellung: Die dieser Untersuchung zugrunde liegende Frage war, ob das angewandte Ausbildungskonzept geeignet war, um am Beispiel der Einführung der laparoskopischen Cholezystektomie eine neue Operationsmethode in einer universitären Ausbildungsklinik mit einer grossen Anzahl Chirurgen zu etablieren. Patienten und Methodik: Seit Einführung der ersten laparoskopischen Cholezystektomie wurden alle Cholezystektomien während zwei Jahren (Mai 1990 bis Mai 1992) prospektiv erfasst. Ein Ausbildungskonzept wurde gewählt, bei dem jeweils ein Operateur durch einen Tutor geschult wurde und so 15 konsekutive Eingriffe durchführte, um dann die Technik einem weiteren auszubildenden Chirurgen zu instruieren. Resultate: In zwei Jahren wurden 355 Patienten cholezystektomiert. 60% der Operationen wurden laparoskopisch durchgeführt oder begonnen. 40% der Operationen wurden offen durchgeführt. In den ersten zwei Jahren konnten 13 Operateure (durchschnittlich 16 Operationen / Operateur , range 1 - 60) in die neue Technik eingeführt werden. Es traten keine schweren Komplikationen, insbesondere keine Gallenwegsverletzungen in dieser Einführungsphase auf. Diskussion: In der Literatur wird dieses Vorgehen bei der Einführungsphase seit 1992 wiederholt vorgestellt, diskutiert und empfohlen. Zwischenzeitlich gibt es Richtlinien von Fachgesellschaften und nationalen Institutionen, welche die Ausbildung zur Ausführung neuer chirurgischer Techniken reglementieren. In den letzten Jahren verlagern sich die ersten Ausbildungsschritte in Richtung Trainingskurse an skill-stations und virtual reality Trainer. Schlussfolgerung: Das beschriebene Ausbildungskonzept bewährte sich in der Einführungsphase der laparoskopischen Cholezystektomie zu Beginn der 90er-Jahre.
Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?
Authors: Perruchoud  , Vuilleumier  , Givel
Published: January 2006

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.
Minor Traumatic Brain Injury: Risk factors
Authors: Baumgartner  , Baier  , Schmitz  , Farthmann
Published: January 2006

Ziel: Identifizierung von Risikofaktoren für eine intrakranielle Blutung bei leichtem Schädelhirntrauma (SHT), die eine Überwachung auf der Intensivstation erforderlich machen. Methode: Anhand von Krankenakten wurden retrospektiv 464 Patienten ausgewertet, die mit der initialen Diagnose "leichtes SHT" in unserer Klinik von Januar 1996 bis Dezember 1997 behandelt wurden. Klinische und diagnostische Befunde, die auf eine erhöhte Blutungswahrscheinlichkeit hindeuten, wurden eruiert. Resultate: 67.5% der Patienten waren männlich, das Durchschnittsalter lag bei 36.1 Jahren. Häufigste Unfallursache waren Stürze (27.4%) und Fahrrad-/Mopedunfälle (24.8%). 30.4% der Patienten waren alkoholisiert. 17.2% der Fälle waren bei Aufnahme bewusstseinsgestört und 12.5% zeigten neurologische Auffälligkeiten. Bei zehn Patienten wurde eine intrakranielle Blutung nachgewiesen, die während der Primärdiagnostik entdeckt wurden. Diskussion/Schlussfolgerungen: Ein erhöhtes Risiko für eine intrakranielle Blutung haben Patienten folgender Gruppen: Alter > 60 und < 16 Jahre, Stürze als Unfallursache, Tachykardie, GCS < 15, Bewusstseinstrübung, neurologische Ausfälle, Schädelfrakturen und Koagulationsstörungen. Alkoholisierte Patienten sind klinisch schwer zu beurteilen und deshalb als Risikogruppe zu betrachten. Patienten mit Risikofaktoren sollten auf einer Intensivstation überwacht werden. Patienten ohne Risikofaktoren können auf einer Normalstation überwacht bzw. nach erneuter Untersuchung nach wenigen Stunden entlassen werden.
Open or Closed Pinning for Distal Humerus Fractures in Children?
Authors: de Buys Roessingh  , Reinberg
Published: January 2006

Introduction: In children, the choice between percutaneous pinning (PP) and open pinning fixation (OPF) for the surgical treatment of fractures of the distal humerus remains controversial, especially the PP method for internal humeral condylar (IHC) fractures. Patients and methods: Eighty fractures of the distal humerus in children were treated surgically in our hospital over a ten year period. 47% (n = 38) were supracondylar (SC), 20% (n = 16) comminuted (COM), 18% (n = 14) internal humeral condylar (IHC), and 15% (n = 12) lateral humeral condylar (LHC). We used PP, OPF and three times osteosynthesis with screws. Results: In comparison to OPF, PP reduced the length of hospitalization in SC fractures (2.8 versus 6.1 days) and IHC fractures (2.4 versus five days). It reduced the risk of extension deficiency (11.1% versus 15%) and of cubitus valgus (0% versus 20%) in SC fractures, and of cubitus varus in IHC fractures (0% versus 11.1%). However it induced a higher rate of cubitus valgus (11.1% versus 20%) in IHC fractures, one persistent neurological motor deficiency (radial nerve) and four cases of transitional neurological involvement (ulnar nerve). Conclusions: PP is a good surgical method for SC and for also for IHC fractures, if performed by experienced surgeons so as to avoid neurological damage.
Carcinoma of the Esophagastric Junction: Operative Strategies
Authors: Siegel  , Wagner  , Seiler
Published: January 2006

Die Inzidenz des oesophagogastralen Übergangskarzinoms nimmt gerade bei jungen weissen Männern zu (+35% in 30 Jahren). Gründe hierfür sind neben der ursächlichen Gastro-oesophagealen-Reflux-Krankheit (GERD) bisher noch nicht eindeutig bekannt. Wichtig für die Therapie ist eine korrekte Klassifizierung in die drei Subtypen: ein distales oesophageales, ein Cardia- und ein subcardiales Karzinom (Typ I, II und III). Als wichtigster Risikofaktor für die Entstehung eines Typ-I-Karzinoms gilt die "Barrett-Metaplasie" aufgrund einer langjährigen Refluxkrankheit. Bei Typ-II- und Typ-III-Karzinomen scheinen Adipositas und hoher Fettkonsum als Risikofaktoren in Betracht zu kommen. Die Beteiligung von Helicobacter pylori ist zum jetzigen Zeitpunkt noch unklar. Das präoperative Staging ist schwierig und das Tumorstadium oft (schon bei der High-grade-Dysplasie) wesentlich unterschätzt. Die Therapie dieser Karzinome besteht in der chirurgischen Resektion, wobei für Typ-I-Karzinome eine transhiatale (selten transthorakale) Oesophagektomie einschliesslich Lymphadenektomie und proximaler Magenresektion erfolgt. Typ-II- und Typ-III-Karzinome werden wie ein Magen-Karzinom mit einer totalen Gastrektomie inkl. Lymphadenektomie und distaler Oesophagusresektion versorgt. Prognostisch ungünstig sind fortgeschrittenen Tumorstadien sowie das Vorhandensein von Lymphknotenmetastasen. Ist eine R0-Resektion inkl. ausgedehnter Lymphadenektomie möglich, verbessert diese die Prognose des Patienten deutlich. Der Nutzen einer (neo-)adjuvanten Radio-Chemotherapie ist bisher noch nicht klar belegt, aussagekräftige Studien fehlen noch. Sind Fernmetastasen vorhanden, so ist eine Radio-Chemotherapie im Rahmen einer palliativen Therapie, kombiniert mit palliativen gastroenterologischen Massnahmen (Stent, PEG etc.), die Therapie der Wahl.
A Ten Year Experience of Surgical Reanimation in a University Center
Authors: Schreyer  , Engeler  , Leyvraz
Published: January 2006

Les auteurs ont évalué dix ans de prise en charge, en réanimation chirurgicale du CHUV, des patients polyblessés. Chez le polyblessé, la coagulopathie irréversible, cause première de décès découle de l'effet conjoint de l'acidose, de l'hypothermie et des troubles de la crase, éléments constitutifs de la "triade fatale du traumatisé". Les auteurs on recherché un critère simple d'identification du patient à risque de décéder de coagulopathie irréversible (CI). Chaque valeur de pH, TP, PTT, compte thrombocytaire (Th) et de besoins transfusionnels (CE) ont été systématiquement recherchées à chaque moment clé de la prise en charge. Ces valeurs ont été considérées comme devenant valeur critique (VC) selon des critères reconnus (30). L'apparition de ces VC dans ce collectif de patients répartis en 3 groupes: survivants; décédés; décédés de coagulopathie irréversible, a permis d'établir que l'apparition d'une troisième VC peut devenir un critère d'identification du polyblessé à risque de décéder. Chez les patients instables une chirurgie de type "Damage control" peut être recommandée. Cette notion de troisième VC devient une des bases de la décision multidisciplinaire d'adoption d'une chirurgie du type DCS. Les auteurs inscrivent cette nouvelle notion dans un algorithme décisionnel qui rend interdépendants la salle de déchocage, le bloc opératoire et les soins intensifs. L'état biologique du patient, évalué par la recherche protocolée des VC, devient un élément décisionnel majeur dans la circulation du patient au sein de ces structures.
Two Siblings with Total Colonic Aganglionosis Extended to the Ileum
Authors: Aslan  , Caglar  , Karagüzel  , Melikoglu
Published: January 2006

Total colonic aganglionosis (TCA) extended to the ileum is seen quite rare among infants with Hirschsprung's disease. Type and timing of definitive surgery in these patients are controversial. This report was presented to discuss the management of two siblings with TCA. Case 1: A two-day-old girl was operated for partial intestinal obstruction. During laparotomy, serial frozen biopsies proved TCA extended to the terminal ileum and a loop ileostomy was performed. At five months of age, a modified Duhamel-Martin procedure without protective ileostomy was performed. An endo-GIA stapler was transanally used for colo-ileal anastomosis. She is doing well for the last five years. Case 2: A one-day-old boy admitted to the hospital with similar findings to his sister. Frozen biopsies during first laparotomy proved that majority of ileum and entire colon was aganglionic and a proximal ileostomy was performed. At 10 months of age, he underwent a similar Duhamel-Martin operation. He is in a good condition for the last four years. Conclusion: In infants, our modification on Duhamel-Martin procedure, which is based on the use of an endo-GIA stapler transanally for colo-ileal anastomosis without protective ileostomy, may be utilized as an alternative method in the definitive treatment of patients with TCA.
Dual Transplant of Marginal Kidneys
Authors: Matter  , Venetz  , Aubert  , Gachet  , Burnier  , Barbey
Published: January 2006

Introduction: Double transplantation is one possible answer to the shortage of donor organs. While each donor kidney would be unsuitable when considered as a single allograft, use of both kidneys should provide sufficient nephron mass for effective glomerular filtration. Case report: This is the first Swiss report of a dual adult transplant of marginal kidneys in a 46-year-old man, who was transplanted for the fourth time. Follow-up at 6 months is excellent without acute rejection. Conclusion: Recent analysis of dual marginal versus single ideal transplant outcomes, found a comparable 1-yr graft survival in both of the procedures. Long term results are still lacking and guidelines to decide between single, double or no transplantation are emerging.
Islet of Langerhans Transplantation for the Treatment of Type 1 Diabetes
Authors: Bucher  , Mathe  , Bosco  , Andres  , Bühler  , Morel  , Berney
Published: January 2006

Islet of Langerhans transplantation is gaining recognition as a therapy for type 1 diabetes. The procedure involves enzymatic digestion of the pancreatic tissue, purification of the islets from the exocrine tissue, infusion of the islets into the portal vein and implantation in the liver. Until 1999, an overall rate of insulin independence of 14% at one year was reported in the International Islet Transplant Registry. The results of the "Edmonton protocol" since 2000 were a breakthrough in the field, with reports of 80% insulin independence at 1-year after solitary islet transplantation in non uremic patients with brittle type 1 diabetes. A rapamycin-based, steroid-free, islet-sparing immunosuppressive regimen was designed and the problem of the insufficient islet mass was tackled by sequential infusions of islets isolated from at least two pancreata. The University of Geneva has been involved in clinical islet transplantation since 1992, and has performed 51 allogeneic and 17 autologous. Twenty-one patients have been transplanted in Geneva since 2002. They were five solitary islet transplants, 14 islet after kidney transplants and two simultaneous islet-kidney (SIK) recipients. Insulin independence was achieved in 67%.
Costs of Multiple Trauma Patients Treatment During the Acute Phase
Authors: Ganzoni  , Zellweger  , Trentz
Published: January 2006

Alljährlich steigende Kosten im schweizerischen Gesundheitswesen geben immer wieder Anlass zu Diskussionen. Klarheit und Fakten über die differenzierten Behandlungskosten liegen keine vor. Ziel dieser Arbeit ist es, die Akuttherapiekosten von Polytraumatisierten am Universitätsspital Zürich zu untersuchen. Basierend auf den Schlussabrechnungen von gemäss Spitalleistungskatalog (SLK) abgerechneten Patientinnen und Patienten untersuchten wir in 16 Fällen mit einem mittleren Injury Severity Score (ISS) von 33.9 die Behandlungskosten der Akuttherapie. Wir entwarfen ein Konzept zur Bewertung des mittleren Verlustes pro Grund- und Unfallversicherten, welche über Tagespauschalen abgerechnet werden und den überwiegenden Teil der hospitalisierten Patienten stellen. Die mittleren in Rechnung gestellten Behandlungskosten beliefen sich auf 128'135 Franken (31'266-310'358 CHF). Es zeigte sich, dass nach Verwendung des Gewinns von Zusatzversicherten zur Subvention der Grund-, Unfallversicherten und Sozialfällen, eine Differenz je nach Verletzungskombination und Versicherungsstatus zwischen 42% und 65%, in absoluten Zahlen 33'703 bis 138'829 Franken, bestand. Verlangt man von Spitälern kostendeckend zu arbeiten, so ist ein solcher Verlust, welcher durch das Grundversicherungssystem bedingt ist, nicht zu vernachlässigen. Bei der Einführung von neuen Abrechnungsformen müssen die hohen Kosten, die diese Patientengruppe verursacht, berücksichtigt werden.
Single Hemicerclage for Lateral Type B Malleolar Fracture - A Novel, Minimal and Reliable Osteosynthesis
Authors: Maurer  , Stamenic  , Stouthandel  , Ackermann  , Gonzenbach
Published: January 2006

Aim of study: To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. Methods: Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. Results: The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. Conclusion: The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.
Wintertime phytoplankton bloom in the subarctic Pacific supported by continental margin iron
Authors: Lam Phoebe J. , Bishop James K. B. , Henning Cara C. , Marcus Matthew A. , Waychunas Glenn A. , Fung Inez Y.
Published: January 2006

Heightened biological activity was observed in February 1996 in the high‐nutrient low‐chlorophyll (HNLC) subarctic North Pacific Ocean, a region that is thought to be iron‐limited. Here we provide evidence supporting the hypothesis that Ocean Station Papa (OSP) in the subarctic Pacific received a lateral supply of particulate iron from the continental margin off the Aleutian Islands in the winter, coincident with the observed biological bloom. Synchrotron X‐ray analysis was used to describe the physical form, chemistry, and depth distributions of iron in size fractionated particulate matter samples. The analysis reveals that discrete micron‐sized iron‐rich hot spots are ubiquitous in the upper 200 m at OSP, more than 900 km from the closest coast. The specifics of the chemistry and depth profiles of the Fe hot spots trace them to the continental margins. We thus hypothesize that iron hot spots are a marker for the delivery of iron from the continental margin. We confirm the delivery of continental margin iron to the open ocean using an ocean general circulation model with an iron‐like tracer source at the continental margin. We suggest that iron from the continental margin stimulated a wintertime phytoplankton bloom, partially relieving the HNLC condition.
Infrared dust spectral signatures from AIRS
Authors: DeSouza‐Machado S. G. , Strow L. L. , Hannon S. E. , Motteler H. E.
Published: January 2006

The Atmospheric Infrared Sounder (AIRS) on board NASA's Aqua satellite platform is a hypersectral IR temperature and humidity sounder for numerical weather prediction and climate change studies. We use the rich spectral information available in the AIRS thermal infrared radiances to study the spectral signatures of dust over ocean for four case studies, and to retrieve dust optical depths using a fast two‐stream radiative transfer model. Retrieved optical depths for one case, a dust storm spreading over the Eastern Mediterranean in October 2002, are compared with visible imagery and MODIS optical depth retrievals. This work represents a preliminary step to removing the effects of dust on the retrieval of temperature and water vapor from the AIRS measurements.
A Pacific Decadal Oscillation record since 1470 AD reconstructed from proxy data of summer rainfall over eastern China
Authors: Shen Caiming , Wang Wei‐Chyung , Gong Wei , Hao Zhixin
Published: January 2006

Recent studies indicated that the spatial pattern and temporal variability of summer rainfall over eastern China are well correlated with the Pacific Decadal Oscillation (PDO). Here we used a data set of the drought/flood index (a proxy of summer rainfall) since 1470 AD to reconstruct the annual PDO index. The reconstruction indicates that the PDO is a robust feature of North Pacific climate variability throughout the study period, however, the major modes of oscillation providing the basic PDO regime timescale have not been persistent over the last 530 years. The quasi‐centennial (75–115‐yr) and pentadecadal (50–70‐yr) oscillations dominated the periods before and after 1850, respectively. Our analysis suggest that solar forcing fluctuation on quasi‐centennial time scale (Gleissberg cycle) could be the pace‐maker of the PDO before 1850, and the PDO behavior after 1850 could be due, in part, to the global warming.
Time series of the stratosphere‐troposphere exchange of ozone simulated with reanalyzed and operational forecast data
Authors: van Noije T. P. C. , Segers A. J. , van Velthoven P. F. J.
Published: January 2006

To evaluate the quality and temporal consistency of the large‐scale Brewer‐Dobson circulation in meteorological data from the European Centre for Medium‐Range Weather Forecasts, the stratosphere‐troposphere exchange of ozone is calculated using a model with linearized stratospheric ozone chemistry. Simulations are performed with the 45‐year reanalysis ERA‐40 and with operational data (OD) for the period November 1999 to March 2005. In both hemispheres the ozone exchange fluxes are generally higher with ERA‐40 than OD. In the Northern Hemisphere this discrepancy appears to be exacerbated by the introduction of satellite observations into the ERA‐40 assimilation system in 1973. A comparison to a simulation with data from a run of the ERA‐40 system in which no radiance observations were assimilated for the period January–March 1973 serves to demonstrate this point. The ozone exchange flux was also analyzed as a function of the forecast range of the assimilated winds used to drive the model. For optimal comparison between the two assimilation systems, this is done for the year July 2001 to June 2002, when there is maximum overlap between the respective model cycles. The sensitivity to forecast time and update frequency of the forecast series is found to be much stronger for ERA‐40 than OD. For the later years of the reanalysis it is concluded that the circulation bias introduced by the assimilation of (satellite) observations is strongly reduced during forecast mode. From a chemistry transport modeling perspective the results imply that the stratospheric and upper tropospheric transport of tracers like ozone can be improved by using the forecasts of the reanalysis but is best represented with the operational data.
Analysis of hydraulic tomography using temporal moments of drawdown recovery data
Authors: Zhu Junfeng , Yeh Tian‐Chyi J.
Published: January 2006

Transient hydraulic tomography (THT) is a potentially cost‐effective and high‐resolution technique for mapping spatial distributions of the hydraulic conductivity and specific storage in aquifers. Interpretation of abundant well hydrographs of a THT survey, however, is a computational challenge. We take on this challenge by developing an estimation approach that utilizes the zeroth and first temporal moments of well hydrographs, instead of drawdown itself. The governing equations for the temporal moments are Poisson's equations. These equations demand less computational resources as opposed to the parabolic equation that governs drawdown evolution. Likewise, the adjoint equations for evaluating sensitivities of the moments for parameter estimation also take the same forms. Therefore a temporal moment approach is expected to expedite the interpretation of THT surveys. On the basis of this premise we extend our sequential successive linear estimator to use the zeroth moment and characteristic time of the drawdown‐recovery data generated by THT surveys. We subsequently investigate computational efficiency and accuracy of the moment approach. Results of the investigation show that the temporal moment approach yields results similar to those from the approach that uses transient heads but at significantly less computational costs. Limitations using temporal moments are discussed subsequently.
Happiness in the Face of Adversity: Reformulating the Dynamic and Modular Bases of Subjective Well-Being
Authors: Shmotkin Dov
Published: January 2006

Addressing diversity and apparent contradictions in manifestations of happiness, this article delineates subjective well-being (SWB) as a dynamic system in the face of possible adversity. SWB constitutes a favorable psychological environment that regulates the hostile-world scenario, defined as one's image of actual or potential threats to one's life or integrity. SWB operates in various modules: experiential, wherein private awareness of SWB dwells on relevant core themes; declarative, wherein public self-reports of SWB function as social behavior; differential, wherein synchronic dimensions of SWB form well-being types; and narrative, wherein diachronic valences of SWB construct trajectories along one's life story. By explicating the regulatory and configurational nature of SWB, the present conceptualization emphasizes the process, rather than the outcome, of pursuing happiness.
An Ecological Perspective on Leadership Theory, Research, and Practice
Authors: Wielkiewicz Richard M. , Stelzner Stephen P.
Published: January 2006

Current theories of leadership are based mainly on the industrial paradigm emphasizing the preeminence of positional leaders and the machine-like qualities of organizations. Evolutionary and attributional biases tend to reinforce the industrial paradigm. The authors propose an ecological theory of leadership that makes 4 important assertions: (a) Effective leadership processes involve temporary resolutions of a tension between the traditional industrial approach and the neglected ecological approach; (b) specific leaders are less important than they appear because the ecological context is more important than what leaders decide to do; (c) organizations are more adaptive when there is a diversity of genuine input into decision-making processes; and (d) leadership itself is an emergent process arising from the human interactions that make up the organization.
Emotional Responses to Art: From Collation and Arousal to Cognition and Emotion
Authors: Silvia Paul J.
Published: January 2006

The study of emotional responses to art has remained curiously detached from the psychology of emotions. Historically, the leading tradition has been Daniel Berlyne's psychobiological model, embodied by the “new experimental aesthetics” movement of the 1970s. That theory explained hedonic qualities of art by referring to arousal-modifying “collative properties” of art, such as complexity, novelty, uncertainty, and conflict. Berlyne's influence on the experimental study of aesthetics has been enormous, largely for the better but also for the worse. Berlyne's suspicion of cognitive psychology led to an unproductive perseveration on arousal as the mechanism of “aesthetic responses.” This article describes how appraisal theories of emotion inform the study of aesthetics. Appraisal theories make new predictions about emotional responses to art, expand the domain of aesthetic emotions beyond positive emotions such as interest and enjoyment, inform other theories (e.g., prototypicality models), and reinterpret past findings.
Why Psychology is/is Not Traditional Science: The Self-Referential Bases of Psychological Research and Theory
Authors: Hunt Harry T.
Published: January 2006

The hyperspecialization, fragmentation, curious faddishness of major research topics, and perceived incommensurabilities of theories and methods in contemporary psychology are often seen as a discipline-specific crisis over our status as a single, identifiable “science.” These features can, however, be understood as the contemporary expression of early discussions by Giambattista Vico and Wilhelm Dilthey on the inherently self-referential basis of psychology, based on its emergent, even paradoxical, combination of the methods of physical science with the underlying themes of the humanities. This defining tension between “explanation” and “understanding” can account for these features of ostensible disunity, along with the unique importance of “ecological validity” in empirical methodology and the roots of theory in largely implicit worldviews and the matrix of ordinary language, quite different from the explicit role of law in physical science. Current neuroscience, although exemplifying “high consensus, rapid discovery” physical science, also illustrates this broader “hermeneutic” perspective.
Low-temperature kinetic measurements of microsecond freeze–hyperquench (MHQ) cytochrome oxidase monitored by UV–visible spectroscopy with a newly designed cuvette
Authors: Wiertz F.G.M. , de Vries S.
Published: January 2006

A special cuvette was designed to measure optical changes of MHQ (microsecond freeze–hyperquench) powder samples [Wiertz, Richter, Cherepanov, MacMillan, Ludwig and de Vries (2004) FEBS Lett. 575, 127–130] at temperatures below approx. 250 K. Reduced cytochrome c oxidase from Paracoccus denitrificans was reacted with O2 for 100 μs, frozen as a powder and transferred to the cuvette. Subsequently, cytochrome oxidase was allowed to react further following stepwise increments of the temperature from 100 K up to 250 K while recording spectra between 300 and 700 nm. The temperature was raised only when no further changes in the spectra could be detected. The experiment yielded spectra of the A, PM, F and O intermediate states. This demonstrated that the catalytic cycle of cytochrome oxidase at low temperature is similar to that at room temperature and so verifies the suitability of this method for the study of enzymes with high catalytic-centre activity.
Sources of error in electronic structure calculations on small chemical systems
Authors: Feller David , Peterson Kirk A. , Crawford T. Daniel
Published: January 2006

The sources of error in electronic structure calculations arising from the truncation of the one-particle and n-particle expansions are examined with very large correlation consistent basis sets, in some cases up through valence 10-ζ quality, and coupled cluster methods, up through connected quadruple excitations. A limited number of full configuration interaction corrections are also considered. For cases where full configuration interaction calculations were unavailable or prohibitively expensive, a continued fraction approximation was used. In addition, errors arising from core∕valence and relativistic corrections are also probed for a number of small chemical systems. The accuracies of several formulas for estimating total energies and atomization energies in the complete basis set limit are compared in light of the present large basis set findings. In agreement with previous work, the CCSD(T) method is found to provide results that are closer to the CCSDTQ and full configuration-interaction results than the less approximate CCSDT method.
Low-energy electron scattering from DNA and RNA bases: Shape resonances and radiation damage
Authors: Tonzani Stefano , Greene Chris H.
Published: January 2006

Calculations are carried out to determine elastic-scattering cross sections and resonance energies for low-energy electron impact on uracil and on each of the DNA bases (thymine, cytosine, adenine, and guanine), for isolated molecules in their equilibrium geometry. Our calculations are compared with the available theory and experiment. We also attempt to correlate this information with experimental dissociation patterns through an analysis of the temporary anion structures that are formed by electron capture in shape resonances.
Quantum chemical modeling of electrochromism of tungsten oxide films
Authors: Broclawik E. , Góra A. , Liguzinski P. , Petelenz P. , Witek H. A.
Published: January 2006

A cluster model is proposed to describe the excitations in solid tungsten oxide. The density-functional theory approach is used to calculate the ground-state electronic structure of the model cluster and its optimum geometry; subsequently, time-dependent density-functional theory calculations are performed to obtain the oscillator strengths and energies of the excited states. The results are reported both for the electrically neutral cluster and for the cluster with an extra electron (mimicking the effect of electron injection from the cathode). They correctly locate the electrochemically active transition. The corresponding wave functions are delocalized, suggesting that electron localization at one tungsten center is rather unlikely, thereby shedding doubt as to the validity of the polaron model. Local lattice distortions presumably created at the stage of sample preparation are found to affect the excitation energies to a considerable extent, which explains the experimentally observable large width of optical absorption responsible for electrochromism.
The spectrum minimum for random Schrödinger operators with indefinite sign potentials
Authors: Najar Hatem
Published: January 2006

This paper sets out to study the spectral minimum for an operator belonging to the family of random Schrödinger operators of the form Hλ,ω=−Δ+Wper+λVω, where we suppose that Vω is of Anderson type and the single site is assumed to be with an indefinite sign. Under some assumptions we prove that there exists λ0>0 such that for any λ∊[0,λ0], the minimum of the spectrum of Hλ,ω is obtained by a given realization of the random variables.
Pair-correlation functions and phase separation in a two-component point Yukawa fluid
Authors: Hopkins P. , Archer A. J. , Evans R.
Published: January 2006

We investigate the structure of a binary mixture of particles interacting via purely repulsive point Yukawa pair potentials with a common inverse screening length λ. Using the hypernetted chain closure to the Ornstein-Zernike equations, we find that for a system with “ideal” (Berthelot mixing rule) pair-potential parameters for the interaction between unlike species, the asymptotic decay of the total correlation functions crosses over from monotonic to damped oscillatory on increasing the fluid total density at fixed composition. This gives rise to a Kirkwood line in the phase diagram. We also consider a “nonideal” system, in which the Berthelot mixing rule is multiplied by a factor (1+δ). For any δ>0 the system exhibits fluid-fluid phase separation and remarkably the ultimate decay of the correlation functions is now monotonic for all (mixture) state points. Only in the limit of vanishing concentration of either species does one find oscillatory decay extending to r=∞. In the nonideal case the simple random-phase approximation provides a good description of the phase separation and the accompanying Lifshitz line.
Spectroscopic characterization of the C2–Ne van der Waals complex
Authors: Han Jiande , Philen Dana , Heaven Michael C.
Published: January 2006

Binary complexes of C2 with rare-gas atoms (C2–Rg) have attracted theoretical interest as their potential-energy surfaces are predicted to support linear equilibrium geometries, without the local minimum for the T-shaped geometry that would be expected using a standard pair-potential model. In the present work we have explored the properties of C2–Ne using laser-induced fluorescence detection of the DΣu+1-XΣg+1 transition. Bands of the complex were observed in association with the monomer 0-0 and 1-1 transitions. Rotationally resolved data yielded rotational constants of B′=0.099(3)cm−1 and B″=0.100(3)cm−1 for the excited and ground states, respectively. Analysis of the rovibrational energy-level structure for C2(D)–Ne indicates that the complex has a linear equilibrium structure with a barrier to internal rotation of approximately 15cm−1. Data for the ground state validate a recent high-level ab initio calculation of the potential-energy surface for C2(X)–Ne.
Fabrication and microstructure of high coercivity FePt thin films at 400 °C
Authors: Zhao Z. L. , Chen J. S. , Ding J. , Yi J. B. , Liu B. H. , Wang J. P.
Published: January 2006

L 1 0 phase FePt thin films deposited on MgO (100) single-crystal substrate with good (001) texture were investigated. Epitaxial growth of the FePt (001) films was observed with a deposition temperature of 400 °C. With ultrathin Ag intermediate layers deposited between FePt layers, the film structures changed from an interconnection network to an isolated-island character. The perpendicular coercivity of the FePt film dramatically increased from 6.5 to 32.5 kOe. The improvement of the magnetic properties may be attributed to the formation of island structures by the additive Ag in the FePt films.
High-resolution actinic defect inspection for extreme ultraviolet lithography multilayer mask blanks by photoemission electron microscopy
Authors: Neuhäusler U. , Oelsner A. , Slieh J. , Brzeska M. , Wonisch A. , Westerwalbesloh T. , Brückl H. , Schicketanz M. , Weber N. , Escher M. , Merkel M. , Schönhense G. , Kleineberg U. , Heinzmann U.
Published: January 2006

We report on the development and first experimental results of a “at wavelength” full-field imaging technique for defect inspection of multilayer mask blanks for extreme ultraviolet (EUV) lithography. According to the International Semiconductor Roadmap by Sematech, less than 5×10−3 defects per cm2 should be present on such multilayer mask blank to enable mass production of microelectronics using EUV lithography, thus fast high-resolution methods for mask defect inspection and localization are needed. Our approach uses a photoemission electron microscope in a normal incidence illumination mode at 13 nm to image the photoelectron emission induced by the EUV wave field on the multilayer mask blank surface. We show that by these means, buried defects in the multilayer stack can be probed down to a lateral size of 50 nm.
Nonbolometric photoresponse in (La,Pr)0.67Ca0.33MnO3 thin films
Authors: Kolagani Rajeswari M. , Overby M. A. , Smolyaninova V. N. , Davidson A. , Cox D. E.
Published: January 2006

We have studied light-induced resistance changes (photoresponse) in the colossal magnetoresistive manganite material (La,Pr)0.67Ca0.33MnO3. The metal-insulator transition in this material is understood to be driven by the percolation of the metallic channel in an inhomogeneous matrix of insulating and metallic components. Our experiments reveal a nonthermal (nonbolometric) component of the light-induced resistance change, in addition to the expected resistance change related to heating (bolometric effect). This nonthermal component is seen only in the metal-insulator transition region. Our results suggest that this component may be associated with the light-induced resistance decrease in the insulating regions through an electronic mechanism.
cw and tunable laser operation of Yb3+ in Nd:Yb:CaF2
Authors: Petit V. , Camy P. , Doualan J.-L. , Moncorgé R.
Published: January 2006

We report here the spectroscopy and the cw and tunable laser operation of Yb3+ in a CaF2 single crystal codoped with Nd3+ and Yb3+ ions. Laser emission is obtained between 1030 and 1055 nm after pumping into the Nd3+ ions around 795 nm and efficient Nd3+→Yb3+ energy transfers. The efficiency of the energy transfers is attributed to the particular Nd3+–Yb3+ clusters formed in CaF2 because of charge compensation.