[The internet presentation of medical departments: an example of a pediatric surgical department]. / Die Internet-Darstellung einer Klinikabteilung für Kinder am Beispiel einer Kinderchirurgie.

INTRODUCTION: In times of easy world wide information transfer and reduced economic resources of the community, the presentation of medical departments in the internet becomes more and more important. But realisation is often insufficient. METHOD: The welcome page is the most important element. It should be appealing and easy to understand. Menues should lead to further information like "employees", "premises", "approach" and "medical information". Quick loading times are neccesary to make surfing more comfortable. DISCUSSION: The internet presentation becomes more and more essential in our days. Legal restrictions, although being reduced in the last years, have to be observed.

Pansclerotic morphea in childhood: a case report.

Scleroderma can be differentiated into progressive systemic and circumscript forms. The extensive form with lethal outcome is known from case reports of children and adolescents. The present case report concerns a boy who died at 16 years of age. In the 5th year of life, he experienced weight loss and developed multiple, firm, partially atrophic plaques in the skin of the extremities. These plaques gradually became confluent and extended over the whole torso and head. Plaque ulceration resulted in massive mutilations to the body. Later the patient's cachexia worsened and he developed keratose, moderately differentiated squamous cell carcinoma of the right leg. The prognosis of pansclerotic morphea for children is worse than for adults. No successful therapy is known.

Jejunal feeding tubes via gastrostomy in children.

BACKGROUND: The implantation of a jejunal feeding tube, via percutaneous endoscopic gastrostomy (PEG), is a possible method for the treatment of inadequate oral feeding in patients who are affected by gastroesophageal reflux. PATIENTS AND METHODS: This study involves a retrospective analysis of all the patients up to 18 years of age, who were treated by means of jejunal feeding tubes at the Universitätsklinikum Benjamin Franklin, Berlin, between 15 September 1995 and 1 August 2000. RESULTS: In all, 76 patients received a PEG, and 12 of them were also given jejunal feeding tubes. One of these patients has experienced no complications. In the other 11 children, 52 changes of jejunal tube have been required. The most important reason for these changes was displacement of the tube into the gastrointestinal tract, resulting from technical problems with the connecting section. CONCLUSIONS: Jejunal feeding tubes in patients with gastrostomy are an alternative to fundoplication and drugs. However, a high rate of changes is to be expected.

Photolithographic synthesis of high-density oligonucleotide probe arrays.

High-density DNA probe arrays provide a massively parallel approach to nucleic acid sequence analysis that is transforming gene-based biomedical research and diagnostics. Light-directed combinatorial oligonucleotide synthesis has enabled the large-scale production of GeneChip probe arrays which contain several hundred of thousand oligonucleotide sequences on glass "chips" about one cm2 in size. Due to their very high information content, GeneChip probe arrays are finding widespread use in the hybridization-based detection and analysis of mutations and polymorphisms ("genotyping"), and in a wide range of gene expression studies. The manufacturing process integrates solid-phase photochemical oligonucleotide synthesis with lithographic techniques adapted from the microelectronics industry. The present-generation methodology employs MeNPOC photo-activatable nucleoside monomers with proximity photolithography, and is currently capable of printing individual 10 microns 2 probe features at a density of 10(6) probes/cm2.

Carcinoid tumors of the appendix in children--epidemiology, clinical aspects and procedure.

INTRODUCTION: Incidental detection of a carcinoid tumor of the appendix after appendectomy is often accompanied by uncertainty about the further procedure. The tumor frequency in our own patient population, the further course in these children and a practicable follow-up protocol have to be determined. PATIENTS AND METHODS: All appendectomies performed between January 1, 1982, and December 31, 1996, were retrospectively evaluated with regard to carcinoids, monitoring the clinical course, and follow-up of the patients involved. RESULTS: A total of 4747 appendectomies were performed, 8 children had a histologically manifest carcinoid (0.169%). All patients were symptom-free in the further course, no metastases or signs of a carcinoid were documented during a mean follow-up period of 6.6 years. CONCLUSION: The youngest patient with a metastasizing carcinoid tumor of the appendix reported in the literature was 19 years old. Nevertheless, all younger patients should undergo regular follow-ups; this is done in our department by serum serotonin and chromogranin A determination.

[Laparoscopy in the newborn infant--indications and procedure]. / Laparoskopie des Neugeborenen--Indikation und Durchführung.

UNLABELLED: The indications and technical features of minimal invasive surgery, which is of particular interest in neonates, are being discussed. Thirty-three laparoscopies had been performed as of 1997. The youngest child was 2 days old; the smallest one weighted 2150 g. The most frequent indications were clarification of cholestasis, cystic masses, pyloromyotomies and sigmoid resections. Three conversions were necessary (two choledochal cysts, splenic torsion). Complications were one postoperative incisional hernia and two rectal stenoses after sigmoid resection. CONCLUSION: Laparoscopy can even be performed in newborns and meets the requirements of minimally invasive surgery.

The results of 9 years of experience with a combined treatment with LH-RH and HCG for cryptorchidism.

During a period of time between 1984 and 1986, 79 boys with 91 cryptorchid testes were treated with a therapy which combined a LH-RH nasal spray followed by HCG. Kryptocur (LH-RH) was administered as a nasal spray at a dosage of 1.2 micrograms daily for a period of 14 days. HCG was injected intramuscularly, 5 times at 2-day intervals. The dosage was one-half the amount recommended by the WHF. This particular therapeutic strategy was more efficacious than those used previously. During the follow-up seven years later, 50.5% of the testes were in a scrotal position. The results during a five year follow-up of a second study were similar to those observed in the earlier study: 67% of the cryptorchid testes were in the scrotum.