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Biomedical subjects

E Hof

Publications and source records attributed to E Hof.

15 recordsLinked to original sources
PubMed2001

Localization of interictal delta and epileptiform EEG activity associated with focal epileptogenic brain lesions.

The present study was aimed at investigating the accuracy of electric source reconstruction in the presurgical evaluation of epilepsy patients. Spontaneous EEG activity of 14 patients with focal intracerebral epileptogenic lesions was analyzed by source reconstruction based on high-resolution EEG (64-channel system) and a boundary element method head model accounting for the individual head anatomy. Equivalent dipole modeling was applied to focal delta and interictal epileptiform activity. The localization results were validated quantitatively by comparison with the sites of the structural lesions. In 6 of 9 patients with focal delta activity, the maximum of dipole concentration was closer than 10 mm to the nearest lesion margin and mostly at the border or within pathologically altered cortical tissue. In all 11 patients showing interictal epileptiform activity, the localization results were found in the same lobe as the lesion. In almost half of them, they were closer than 10 mm to the lesion margin. Patients with larger distances (22-36 mm) mostly had hippocampal atrophy or sclerosis. Their dipole locations did not appear in the affected hippocampus, but in the adjacent temporal neocortex. In conclusion, electric source reconstruction applied to both abnormal slow and interictal epileptiform EEG activity seems to be a valuable additional noninvasive component in the multimodal presurgical evaluation of epilepsy patients.

Adult↗
PubMed2001

Students' and teachers' cognitions about good teachers.

BACKGROUND: Good teachers have been studied ever since Plato described how Socrates taught by asking questions of his audience. Recent findings shed light on two characteristics of good teachers: their personality and their ability. However, more attention has been paid to teachers' practices and opinions than to students' views. AIMS: The study reported here attempted to deepen our understanding of what students think about good teachers. SAMPLE: Students of four age groups (7, 10, 13, and 16 years of age) and teachers from primary and secondary schools were asked to write an essay on the good teacher. METHODS: The correspondence between conceptual items in the essays was investigated by determining the extent to which they were used in the same essays to describe good teachers. RESULTS: Correspondence analysis revealed two dimensions. The first dimension reflected the preference of students and teachers for describing the good teacher in terms of either personality or ability characteristics. The second dimension was interpreted as an orientation in the essays towards either attachment to, detachment from or commitment to school and teachers. Students and teachers were compared to establish the amount of (dis)agreement about what makes a good teacher. Primary school students described good teachers primarily as competent instructors, focusing on transfer of knowledge and skills, whereas secondary school students emphasised relational aspects of good teachers. Teachers, however, considered good teachers in the first place a matter of establishing personal relationships with their students. Consequently, primary school students and teachers disagreed about the characteristics of good teachers. In secondary education, disagreements between teachers and students were relatively small. CONCLUSIONS: The research method of collecting free essays and utilising correspondence analysis to represent conceptual items and groups of participants seems promising as long as a theoretical framework is available to interpret the resulting representation of similarities between items and groups of participants.

Adolescent↗
PubMed1995

Kartagener syndrome: an uncommon cause of neonatal respiratory distress?

We report a newborn with respiratory distress and situs inversus totalis. The diagnosis of primary ciliary dyskinesia was confirmed by both ultrastructural and functional investigations. The immotile cilia syndrome was suspected because of respiratory distress, situs inversus, abnormal nasal discharge and hyperinflated chest X-ray. We suggest that ultrastructural and functional investigations of the respiratory mucosa should be done in any newborn with respiratory distress without explanation for the respiratory problems. Establishment of the correct diagnosis at an early stage may allow to improve the prognosis provided prophylactic physiotherapy, vaccinations, and aggressive antibiotic treatment of intercurrent respiratory infections are instituted. CONCLUSION Despite its rarity, primary ciliary dyskinesia should be considered in unexplained cases of neonatal distress.

Bronchi↗
PubMed1994

Tracheostomy in children.

We reviewed the records of 108 patients who had a tracheostomy performed over a 10-year period from July 1979 to April 1989. Median age at tracheostomy was 6 months (1 week-15 years). Indications for surgery were acquired subglottic stenosis (31.4%), bilateral vocal cord paralysis (22.2%), congenital airway malformations (22.2%) and tumours (11.1%). No epiglottis and no emergency situation had to be managed by tracheostomy. Operation was uneventful in all, but 8 patients (7.4%) developed a pneumothorax in the postoperative period. Twenty-one (19.5%) had severe complications during the cannulation period (tube obstruction in 11 patients with cardiorespiratory arrest in 4; dislocation of the tube in 6 patients). Fifteen patients (13.8%) had severe complications after decannulation (2 had a cardiorespiratory arrest); all 15 had to be recannulated. At the end of the study period 85 patients (78.7%) were successfully decannulated with a median period of tracheostomy of 486 days (8 days-6.6 years). The median hospital stay was 159 days (13 days-2.7 years). All patients could be discharged. Eight patients (7.4%) died but no death was related to tracheostomy. In summary the mortality rate is lower than reported in previous reviews and tracheostomy is a safe operation even in small children but cannula-related complications may lead to life-threatening events. The management of tracheostomized small children and infants in a highly staffed and monitored intensive care unit has allowed better handling of complications and has resulted in a reduction in cannula-related deaths.

Adolescent↗
PubMed1994

Management of petrous bone fractures in children: analysis of 127 cases.

Petrous bone fractures (PBF) in children are relatively frequent. They are mostly diagnosed after collisions and falls. The complications typically associated with PBF were different types of hearing disorders in 69.1% of the patients who had audiometry, liquorrhea in 16.5%, palsy of cranial nerves in 10.8% (facial nerve palsy in 9.4%), bacterial meningitis, stenosis of the external ear canal, and posttraumatic cholesteatoma in 0.7% of the fractures each. Most complications were transient; 8.6% of the patients underwent surgery because of PBF-related complications and 9.4% suffered from severe, irreversible sequelae. Management of PBF in children requires an interdisciplinary approach between pediatric surgeons and pediatric ear, nose, and throat (ENT) specialists. It basically includes daily examination for cranial nerve palsy, liquorrhea, and meningitis during hospitalization as well as routine audiometric examination and antibiotic prophylaxis. Routine vaccination against Streptococcus pneumoniae as a new standard procedure and subtotal petrosectomy after transverse fracture as a new surgical modality are strongly recommended in order to lower the incidence of posttraumatic meningitis. Severe complications such as persistent hearing loss, persistent liquorrhea, cranial nerve palsy, and posttraumatic meningitis require aggressive diagnostic and therapeutic measures in order to minimize further morbidity and irreversible deficits.

Adolescent↗
PubMed1993

Squamous-cell carcinoma arising in a non-irradiated child with recurrent respiratory papillomatosis.

We describe a patient with recurrent respiratory papillomatosis (RRP) associated with human papilloma virus (HPV), who developed a fatal squamous cell carcinoma of the lung. At the age of 1 year he presented with hoarseness, dyspnoea and inspiratory stridor but the diagnosis of RRP was made only 1 year later. At the age of 4 years he was tracheostomized because of upper airway obstruction. In spite of multiple surgical excisions and topic treatment with 5-fluorouracil the papillomata extended to the lung parenchyma. At the age of 16 years he developed a squamous-cell carcinoma of the lung and died 4 months later. Transformation to pulmonary carcinoma is a rare complication in non-irradiated patients with lung papillomatosis. We found only 11 similar cases in the literature.

Adolescent↗
PubMed1990

Familial congenital laryngeal abductor paralysis: different expression in a family with one male and three females affected.

A brother and two sisters of remotely consanguineous parents had congenital laryngeal abductor paralysis and moderate mental retardation. In the two older sibs, mental deficiency could have resulted from birth asphyxia, but the youngest girl was already microcephalic at birth and had no apparent asphyxia. The mother, who was healthy and of normal intelligence, was found on laryngoscopy to have unilateral laryngeal abductor paralysis. This is the first family with both mentally retarded and nonretarded affected members with congenital laryngeal abductor paralysis. Inheritance is most likely autosomal dominant with variable expression, but autosomal recessive inheritance, with both parents carriers and the mother an affected homozygote, and X linked inheritance are also possible.

Consanguinity↗
PubMed1989

Hereditary distal muscular atrophy with vocal cord paralysis and sensorineural hearing loss: a dominant form of spinal muscular atrophy?

In 1980 Young and Harper described a family with an unusual form of distal spinal muscular atrophy associated with vocal cord paralysis. We report a family with three similarly affected subjects. Progressive sensorineural hearing loss was an additional feature in our patients. Electrophysiological and histological investigations did not exclude an involvement of sensory neurones. Whether the classification of this dominant disorder with the spinal muscular atrophies is justified will depend on additional studies in further families.

Acoustic Impedance Tests↗
PubMed1987

Surgical correction of laryngotracheal stenoses in children.

A modified surgical technique according to Rhéti is described: the cricoid and the uppermost tracheal rings are longitudinally dissected ventrally and dorsally. The enlargement of the lumen is stabilized by interposition of a notched piece of costal cartilage into the dissected posterior wall of the cricoid. A total of 63 children with laryngotracheal stenosis have been operated on by this method in Zurich since 1973 and in Munich since 1982. Laryngotracheal plasty is successful in over 80% of small children in whom the procedure is necessary. The voice becomes a little hoarse, but respiration is adequate, as demonstrated by our juvenile patients, some of whom have been decannulated for over 10 years. The earlier opinion that laryngoplasty performed in small children might impair laryngeal growth and result in severe stenoses has been disproved by the results presented. Our experience shows that prognosis is worse in children with tracheal stenosis and associated anomalies, such as paralysis of the vocal cord.

Child↗
PubMed1987

Deleterious consequences of gastroesophageal reflux in cleft larynx surgery.

Our series of 17 children with laryngotracheal clefts is reported. In three of four cases with a complicated postoperative course, gastroesophageal reflux (GER) has been found. Three breakdowns of the surgical repair opposed to be due to GER. Only one child with a cleft type III died, although a mortality rate of 93% is reported in the literature. GER has to be excluded before tracheoesophageal cleft surgery is undertaken.

Child, Preschool↗
PubMed1979

Hearing impairment following therapy of Haemophilus influenzae meningitis.

From 97 children with bacteriologically confirmed Haemophilus influenzae meningitis, 39 were treated with chloramphenicol (before 1970) and 58 with ampicillin (since 1970). In 1977 all patients were followed up with history, clinical examination, and audiometry. Sensorineural hearing defect was found in 5 chloramphenicol patients and in 10 ampicillin patients. Of the 82 patients for whom treatment was begun within 48 h of onset of symptoms, only two showed hearing deficit, while 13 of the 15 patients in whom treatment was begun later suffered from hearing impairment. It appears that it is not the antibiotic, but the delay between onset of symptoms and start of therapy, that is decisive for the occurrence of inner ear impairment.

Ampicillin↗
PubMed1978

[Laryngotracheal stenosis: results of surgery (author's transl)].

Between 1973 and 1977 seven adults and five children with severe larynx stenosis were operated upon successfully with a modification of Rhéti's technique. The main features of this new technique are: 1. The cricoid and the upper tracheal rings are split longitudinally in their anterior and posterior portion. 2. The stabilisation of the enlarged laryngeal lumen by the interposition of a piece of notched costal cartilage in the posterior wall of the split cricoid.

Adolescent↗
PubMed1976

[Meningitis and labyrinthitis in childhood].

The Haemophilus influenzae meningitis is the most common cause of deafness following meningitis. Five of 22 children (23%) had this complication in spite of antibiotic treatment (ampicillin). The question must be raised whether a different antibiotic treatment could avoid the inner-ear problems occurring in Haemophilus influenzae meningitis. Early decompression of the internal auditory canal has reversed deafness in one of four children.

Adolescent↗