[Severe degloving injury to both feet in a child]. / Schwere Degloving-Verletzung der Füße bei einem Kind.

Although rarely described, it is generally accepted that degloving injuries can successfully be treated by defatting the degloved skin and replacing it with a full-thickness graft. There have been few reports on the outcome of this reconstructive procedure in children. In this report, we describe the use of the VAC system to treat a case of degloving injury to both feet of a 4-year-old boy who was pulled into a luggage belt while standing on it.

X-ray transmission through nanostructured and microstructured CuO materials.

This study presents a comparison of the X-ray transmission through microsized and nanosized materials. For this purpose CuO nanoparticles, with 13.4 nm average grain size, and CuO microparticles, with a mean particle size of 56 µm, were incorporated separately to beeswax in a concentration of 5%. Results show that the transmission through the above material plates with microsized and nanosized CuO was almost the same for X-ray beams generated at 60 and 102 kV tube voltages. However, for the radiation beams generated at 26 and 30 kV tube voltages the X-rays are more attenuated by the nanostructured CuO plates by a factor of at least 14%. Results suggest that the difference in the low energy range may be due to the higher number of particles/gram in the plates designed with CuO nanoparticles and due to the grain size effect on the X-ray transmission.

Ambient dose equivalent and effective dose from scattered x-ray spectra in mammography for Mo/Mo, Mo/Rh and W/Rh anode/filter combinations.

In this study, scattered x-ray distributions were produced by irradiating a tissue equivalent phantom under clinical mammographic conditions by using Mo/Mo, Mo/Rh and W/Rh anode/filter combinations, for 25 and 30 kV tube voltages. Energy spectra of the scattered x-rays have been measured with a Cd(0.9)Zn(0.1)Te (CZT) detector for scattering angles between 30 degrees and 165 degrees . Measurement and correction processes have been evaluated through the comparison between the values of the half-value layer (HVL) and air kerma calculated from the corrected spectra and measured with an ionization chamber in a nonclinical x-ray system with a W/Mo anode/filter combination. The shape of the corrected x-ray spectra measured in the nonclinical system was also compared with those calculated using semi-empirical models published in the literature. Scattered x-ray spectra measured in the clinical x-ray system have been characterized through the calculation of HVL and mean photon energy. Values of the air kerma, ambient dose equivalent and effective dose have been evaluated through the corrected x-ray spectra. Mean conversion coefficients relating the air kerma to the ambient dose equivalent and to the effective dose from the scattered beams for Mo/Mo, Mo/Rh and W/Rh anode/filter combinations were also evaluated. Results show that for the scattered radiation beams the ambient dose equivalent provides an overestimate of the effective dose by a factor of about 5 in the mammography energy range. These results can be used in the control of the dose limits around a clinical unit and in the calculation of more realistic protective shielding barriers in mammography.

Comprehensive analysis of the spectrometric determination of voltage applied to X-ray tubes in the radiography and mammography energy ranges using a silicon PIN photodiode.

This work describes the analysis of factors which affect the results of estimation of the electron accelerating potential (kVp) applied to an X-ray tube, through determination of the end point of the energy spectrum of the emitted radiation beam. Measurements have been performed utilizing two spectrometers each with a silicon PIN photodiode: one operating at room temperature, and the other, a high resolution spectrometer, with a Peltier cooler. Both were directly irradiated by different X-ray beams. Both systems work at low voltage and without liquid nitrogen cooling, thus avoiding the drawbacks presented by germanium detectors. Each kVp value was determined by linear regression of the end of the spectrum, so as to give, simultaneously, the best fit to the experimental data and low standard deviation for the kVp value. Detector energy resolution and calibration, counting statistics and high voltage waveform ripple have been investigated in order to establish better experimental conditions and to optimize measurement time. Results of measurements carried out with X-ray tubes connected to single-phase, three-phase or constant potential units, using additional filtration of Cu, Al or Mo (for mammographic beams), are presented. The variations resulted in kVp uncertainties up to 0.1 kV.

Localization of the intestinal biopsy capsule in children by color-coded duplex sonography.

In 21 children from 3 months to 10 years and 5 months old, the position of the biopsy capsule before suction biopsy of the small intestine was examined by means of x-ray studies and both conventional and color-coded duplex sonography. In all cases, the biopsy capsule was correctly positioned under sonographic guidance. The sonographic finding was always confirmed by x-ray film and the histology of the tissue sample. The main obstacle for imaging the biopsy tube and capsule was intestinal gas due to crying and/or restlessness of infants under examination. However, it was always possible to define the position of the biopsy capsule sufficiently. These promising results allow us to recommend sonographic control of the intestinal tube before intestinal suction biopsy in infants and children. The advantages of this approach include lack of irradiation, which is especially important if the tube is an incorrect position after the first trial, bedside availability of sonographic equipment, lower risk of dislocation of the tube owing to shorter transport time, and continuous contact of medical staff with the infant.

[Virus-associated chronic autoimmune aggressive hepatitis (HBsAg seronegative) with pronounced diarrhea]. / Virusassoziierte autoimmune chronisch-aggressive Hepatitis (HBsAg-seronegativ) mit ausgeprägten Diarrhoen.

It is reported on a 17-year-old male patient who in 1982 fell ill with a HBsAg-seronegative hepatitis with therapy-resistant diarrhoeas of high frequency and in whom immunohistologically a virus-associated autoimmune chronic aggressive hepatitis was established. As cause of severe diarrhoeas which underwent involution only after 2 months as a sequel of the azathioprin-prednisolone therapy the proof of HBsAg in Lieberkühn's crypts of the small intestine performed by means of direct immunofluorescence is assumed.

Variability in the Proteus syndrome: report of an affected child with progressive lipomatosis.

In 1983 the Proteus syndrome was delineated by Wiedemann et al. [12]. We report a 10-month-old girl, a further child affected by the new syndrome. The typical signs are macrodactyly, hemihypertrophy, pigmented nevi, hyperkeratosis, and subcutaneous hamartomatous tumours. Our patient shows an aggressive lipomatosis on the trunk and local relapses after surgical interventions in the regions involved. Histology of the adipose tissue showed considerable anisocytosis and increased cell volume.

[Scalp infection caused by B-streptococci in a newborn infant following internal cardiotocography]. / Uber eine Kopfschwarteninfektion durch B-Streptokokken bei einem Neugeborenen nach interner Kardiotokographie.

The paper reports on a newborn developing a scalp abscess 10 days after birth due to fetal monitoring with scalp electrodes. B-streptococci were isolated from purulent material after surgical intervention. The recovery was uneventful after therapy with appropriate antibiotics and removal of the pus (incision). In a short review of literature the authors discuss some of the aspects of infections arising in connection with use of scalp electrodes for fetal monitoring.