Craniectomy in severe, life-threatening encephalitis: a report on outcome and long-term prognosis of four cases

OBJECTIVE

To report the feasibility of craniectomy with duraplasty in four patients with life-threatening encephalitis and, in particular, their long-term outcome.

DESIGN

Report of four cases, analysis of the acute clinical course and neurological long-term sequelae.

RESULTS

Generous craniectomy with duraplasty was performed in four patients with life-threatening encephalitis leading to decortication and decerebration. This treatment approach reduced intracranial pressure. The long-term sequelae (1.5-8 years after craniectomy) confirmed its appropriateness, having led to full neurological (cerebral) function, resocialization, and reintegration into their professional life in all four patients.

CONCLUSION

Craniectomy with dural augmentation is a treatment approach in cases of severe space-occupying encephalitis, not only saving the patient's life but also leading to favorable long-term outcome.

High-resolution optical position encoder with large mounting tolerances

A high-resolution optical position encoder is described that consists of a scale as encountered in a standard moiré-based system, a simple imaging system with stabilized magnification and a novel segmented phase detector integrated circuit. Compared with encoder systems of comparable resolution and accuracy, the encoder presented offers large mechanical tolerances in the alignment of the reading head to the scale, while an interpolation accuracy of better than 0.1 mum is preserved. The system is especially well suited for high-resolution linear encoders as well as for the cost-effective fabrication of compact high-resolution rotary encoders.

Characterization of two class II chitinase genes from peanut and expression studies in transgenic tobacco plants

Two different genes encoding class II chitinases from peanut (Arachis hypogaea L. cv. NC4), A.h.Chi2;1 and A.h.Chi2;2, have been cloned. In peanut cell suspension cultures, mRNA levels of A.h.Chi2;2 increased after ethylene or salicylate treatment and in the presence of conidia from Botrytis cinerea. The second gene, A.h.Chi2;1, was only expressed after treatment with the fungal spores. Transgenic tobacco plants containing the complete peanut A.h.Chi2;1 gene exhibited essentially the same expression pattern in leaves as observed in peanut cell cultures. Expression characteristics of transgenic tobacco carrying a promoter-GUS fusion of A.h.Chi2;1 are described.

Absolute, high-resolution optical position encoder

Modern computer-controlled manufacturing machinery requires the absolute and highly accurate measurement of the linear position. Such an absolute, optical linear position encoder is described here. It is based on the transilluminance of a glass scale with an inexpensive light-emitting diode. The scale has two code tracks, one based on a pseudo-random binary sequence for the coarse determination of position and another periodic code for accurate fine-position measurement. A single-lens telecentric optical system images the code tracks in a mechanically insensitive way onto a custom photodetector. This special detector IC is capable of determining the components of the (complex) Fourier transform for the spatial frequency of the periodic code. The absolute optical position encoder shows a resolution of 10 nm and an absolute accuracy of better than 100 nm over short distances, verified with a commercial laser interferometer.

Passive focus sensor

<p>A focus-sensor module for large-format photographic cameras has been developed that permits the measurement of defocus at any location of interest in the image field. The focus sensor employs passive triangulation through a split imaging aperture. The main difference between commercial autofocus modules with fixed-measurement positions and the new module is that the imaging aperture is subdivided into more than two fields to compensate for the unknown location of the defocus measurement.</p> <p>At ƒ/5.6 the focus sensor shows a maximum resolution in defocus of approximately 0.1mm at the image side at levels of illuminance in the recording plane ≥0.01 lx.</p>

Optimum color filters for CCD digital cameras

A procedure for the definition of optimum spectral transmission curves for any solid-state (especially silicon-based CCD) color camera is presented. The design of the target curves is based on computer simulation of the camera system and on the use of test colors with known spectral reflectances. Color errors are measured in a uniform color space (CIELUV) and by application of the Commission Internationale de l'Eclairage color difference formula. Dielectric filter stacks were designed by simulated thermal annealing, and a stripe filter pattern was fabricated with transmission properties close to the specifications. Optimization of the color transformation minimizes the residual average color error and an average color error of ~1 just noticeable difference should be feasible. This means that color differences on a side-to-side comparison of original and reproduced color are practically imperceptible. In addition, electrical cross talk within the solid-state imager can be compensated by adapting the color matrixing coefficients. The theoretical findings of this work were employed for the design and fabrication of a high-resolution digital CCD color camera with high calorimetric accuracy.

An ABA and GA modulated gene expressed in the barley embryo encodes an aldose reductase related protein

In most higher plants a period of desiccation is the terminal event in embryogenesis. Excised barley embryos acquire desiccation tolerance at a precise developmental stage and cDNA clones have been isolated which are temporally linked with desiccation tolerance. One such clone (pG22-69) with a putative gene product of 34 kd displays high structural homology to mammalian genes encoding an NADPH dependent aldose reductase involved in the synthesis of sorbitol. This first aldose reductase gene of plants is expressed constitutively during embryo maturation and is modulated by the plant hormones abscisic acid (ABA) and gibberellic acid (GA). Immunohistochemistry showed that the protein is preferentially expressed in tissues formed at early stages in embryogenesis. Measurements of enzymatic activity indicate that pG22-69 encodes an active aldose reductase. The finding of this reductase activity and the cloning of the corresponding gene supports the existence of a metabolic pathway in plants playing a role in the synthesis of osmolytes like sorbitol. The significance of this work is that genes of related structure and functions are being used in diverse organisms to fulfil stress related biological requirements.

Acquisition of 3-D data by focus sensing utilizing the moire effect of CCD cameras

A new technique was recently presented for finding the 3-D shape of diffusely reflecting object surfaces [Appl. Opt. 27, 4684-4689 (1988)]. The technique is based on grid projection with small depth of focus, confocal observation, and focus sensing by evaluation of the local grating contrast. In this paper a modification of the measuring system is demonstrated that allows the use of a 2-D CCD array instead of a vidicon as the detector. In this modification the moire effect between the projected grid and the CCD array is utilized. Depth resolution is increased, and almost no unwanted moire terms arise in the detector output as long as the grating frequency is chosen above the Nyquist frequency of the array. The technique can be useful in robot vision.

Acquisition of 3-D data by focus sensing

A range sensing technique is demonstrated that finds the 3-D shape of diffusely reflecting objects. The technique works sequentially in depth direction and is based on structured illumination and focus sensing. A TV camera and analog electronics are used to find the locations in focus of each step of a focus series in TV real time. The depth resolution is not very high, however, the technique is simple, rapid, and well suited to get an overview of a scene in robot vision.

[Prognostic factors in acute lymphoblastic leukaemia--with special consideration of pre-diagnostic duration of signs (author's transl)]

It is concluded from the prognostic factors of acute lymphoblastic leukaemia, as far as they have become known up to now, such as initial leukocyte count, extent of organ infiltration, etc, that the pre-diagnostic duration of signs, representing a measure of the proliferation activity of the leukaemia cells, could also represent a relevant prognostic characteristic. A check conducted in 90 children treated between 1966--1975 yields a correlation only between a very short pre-diagnostic duration of signs (less than 2 weeks) and the duration of the first complete remission (as well as the survival time). However, even those prognostic factors which are already generally recognised, possess merely limited reliability, because they do not take the individual response to therapy into account. Hence, improvement of prognosis of the course of the disease can be expected only if the continuous decrease of the remaining population of blasts during the early phase of remission can be determined with greater accuracy than before.

[Adverse reactions to drugs in hospitalized medical patients (author's transl)]

Prospective research showed that unwanted side-effects resulting from medical therapy were found in 20,6% of all patients hospitalized in our medical clinic during a period of one year. Part of these side-effects was considered a possible reason for admission to the hospital and a cause of complications during the clinical treatment. The side-effects were classified according to their severity, duration, symptomatology and pathogenesis. Furthermore, the frequency of side-effects was studied with regard to age, sex and groups of drugs. It was possible to predict about 80% of the side-effects by considering pharmacological properties and individual risk-factors. The careful integration of these criteria into the treatment plan and the observation of the course of the disease is the basis for calculating the probability of occurrence of side-effects.

[Leptospirosis epidemic (L. grippothyphosa) in the Mainz area, concerning the pediatric age group (author's transl)]

31 children, presenting with rather uncharacteristic symptoms of an infectious disease and being referred to this clinic mostly because of lymphadenitis of the neck (81%) and/or signs of meningitis (45%), were seen within a period of only eight weeks and proved to suffer from Leptospirosis (L. grippotyphosa). The majority of the patients belonged to the age group of one to six years and lived in rural environs. Our observation is considered to relate to a Leptospirosis epidemic and suggests, as opposed to the general acceptance, a much higher incidence of Leptospirosis in this country and, moreover, in children.