[Reduction of technology fears in psychosomatic rehabilitation--concepts and results based on a computer training for older employees]. / Verminderung von Technologieängsten in der psychosomatischen Rehabilitation-Konzepte und Ergebnisse zu einem Computertraining für ältere Arbeitnehmer*

A computer training program was developed specifically oriented toward middle-aged employees, their learning needs and their computer-related fears. This program was based on a pilot study showing a high degree of stresses associated with the introduction of computer technology at the workplace in this age group (50-59 years). A survey of 623 patients confirmed that these persons experienced technological change predominantly as disadvantageous or threatening. Based on 114 patients, concepts and results of the computer training are presented. Participation reduced avoidance behaviors, fears and increased interest and initiative based both on the patients' and their trainers' perspectives.

Measurement of the hydrostatic pressures of the cochlear compartments.

A micropressure transducer (sensitive 0.1 cm H2O) utilizing a manual servo nulling system and a micropipette (tip diameter 12-20 micron) was designed in order to measure endolymphatic and perilymphatic hydrostatic pressures in the inner ear of the guinea pig. Perilymphatic pressures were measured through the round window membrane in animals in which the ossicular structures had been removed and in those in which the middle ear structures were intact. Endolymphatic pressures were measured after removal of the middle ear structures. There was a significant (p less than 0.001) difference between perilymphatic pressures in the presence (4.7 +/- 0.36 cm H2O) and absence (2.43 +/- 0.22 cm H2O) of the middle ear structures. The endolymphatic pressure was 0.00 cm H2O when measured through the basilar membrane after disruption of the scala tympani, and was 3.34 +/- 0.57 when monitored through the spiral ligament and stria vascularis. In order to verify the accuracy of these measurements, we monitored pressures in animals whose perilymphatic pressures were artificially maintained by an external source. Recoveries were always 95-100% of the artificially applied pressure. The injection of purified cholera toxin into the scala media through the basilar membrane resulted in a significant (p less than 0.001) increase in endolymphatic pressure.

Correction of pectus excavatum without prostheses or splints: objective measurement of severity and management of asymmetrical deformities.

From 1949 to 1977, 254 children underwent surgical reconstruction of pectus excavatum by means of a variety of operations at The Johns Hopkins Hospital. From 1970 to 1977, 68 children had a modified Ravitch repair, with the addition of a tripod internal fixation technique for support of the sternum. These children obtained excellent cosmetic reconstruction without prosthetic support or splints. During an 18-month period we used a new system of caliper measurement of the spatial anatomy of the thoracic cage in more than 50 children. During the same period, we originated an operative step to correct the not uncommon asymmetrical excavatum that is usually deeper on the right and associated with a troublesome rotation of the sternum, found in 9 of the last 27 children seen. Correction was accomplished with an oblique anterior sternal osteotomy. The groups were analyzed and compared with respect to age, postoperative complications, and end results in order to identify trends in the management of children with this condition. On the basis of this experience, we feel confident in recommending a standardized operation for all forms of pectus excavatum at an elective age between 4 and 6 years and without prosthetic splints.