Kutane Hämangiome finden sich bei acht bis zwölf Prozent aller Säuglinge bis zum Ende des ersten Lebensjahres. Die Behandlungsempfehlungen unterliegen einer regen Diskussion. In der vorliegenden Arbeit wurden 269 Kinder im Alter von 4 Wochen bis 15 Jahren mit 334 kutanen Hämangiomen untersucht, die in der Klinik und Poliklinik für Kinderchirurgie der Universitätsklinik Leipzig behandelt wurden. In einer retrospektiven Analyse wurde das Krankengut bzgl. ihrer Behandlungsbedürftigkeit und im Behandlungsfall hinsichtlich der erzielten Resultate, bezogen auf die gewählte Therapieform, beurteilt. Gleichzeitig wurde der Frage nachgegangen, ob patientenseitige Voraussetzungen (Alter, Geschlecht, Hämangiom-größe, Hämangiomlokalisation) oder therapeutische Parameter (Kryotherapie, Lasertherapie, Energieapplikation, Zahl der Sitzungen) das Behandlungsergebnis beeinflussen. Die Ergeb-nisse der Arbeit werden vor dem Hintergrund einer aktuellen Literaturrecherche diskutiert.

Thesis (M.A.)--Catholic Theological Union at Chicago, 2002. / Vita. Includes bibliographical references (leaves 82-86).

Executive functions are higher-order cognitive functions underlying self-regulation of behavior. That is, executive functions make it possible to resolve internal conflicts and behave according to future goals rather than acting on sudden impulses or going on automatic. Very similarly, the temperamental construct of effortful control is defined as being able to inhibit a dominant response, instead acting on a subdominant response. In children, poor executive functions and low levels of effortful control have both been associated with several negative outcomes, such as lower academic achievements and externalizing behavior problems. Although these self-regulatory functions seem to play a very important role in child development, little is still known about them during the first years of life. Furthering the knowledge of early executive functions and effortful control would likely increase the chances of early detection of risks of poor development. The present thesis aimed to investigate individual differences in executive functions and effortful control in infancy and toddlerhood, as well as the early development of, and the relation between, these two functions. The thesis further aimed to investigate the relationship between the self-regulatory functions and activity level, and the possibility of predicting toddlerhood self-regulatory functions with sustained attention in infancy. In Study I, individual differences in 10-month-olds’ rudimentary executive functions were found, and these were related to temperamental activity level. In Study II, individual differences in sustained attention in infancy were found to predict toddlerhood executive functions and effortful control. Both these self-regulatory functions improved significantly from infancy to toddlerhood although the individual stability was low. Executive functions and effortful control were related in toddlerhood but not in infancy. In Study III we replicated and extended the finding of a longitudinal relation between infant sustained attention and toddlerhood executive functions. In addition, partial support for the proposition that executive functions develop in a hierarchical fashion was found, with simple inhibition being predictive of more complex forms of working memory two years later. The results from the three studies combined contribute to a better understanding of the early development of the self-regulatory functions executive functions and effortful control.

This thesis is an examination of language and number in two atypically developing groups, Williams Syndrome (WS) and Down's Syndrome (DS). These groups were chosen because their cognitive profiles in adulthood differ significantly. It is already known that language is a relative strength in WS but that it is poorer than non-verbal ability in DS. The precursors to both language and number ability were studied in 24-36 month old infants and performance at this stage was compared with that in the steady state, by testing older children and adults, aged 9-35 years. Similar age-appropriate tests were used with both groups so that performance in the steady state could be compared with that in infancy. Specific subdomains of language and number were assessed to investigate whether the pattern seen in the adult steady state was also present in infancy, or whether the mature phenotype is a product of the different developmental trajectories followed by each group. The overall cognitive profile of infants with WS and DS did not differ significantly, despite clear distinctions between the adult profiles. However, their performance on number and language tasks did differ in infancy. While in adulthood WS performance on number tasks was poorer than that of DS, in infancy this pattern was reversed. For language, infants with DS exhibited a large discrepancy between productive and receptive vocabulary. A more even pattern was present for the WS group. In adulthood, vocabulary was better in WS than DS but both groups had problems with syntactic structures. Taken together these results suggest that it is not possible to derive the pattern of infant performance from the steady state in adulthood. The developmental trajectories from precursors to mature phenotype need to be thoroughly charted in atypical populations because the study of development, not just the characterisation of the endstates, is crucial.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Thesis (M.A.)--Catholic Theological Union at Chicago, 2002. / Vita. Includes bibliographical references (leaves 82-86).

Thesis (M.A.)--Catholic Theological Union at Chicago, 2002. / Vita. Includes bibliographical references (leaves 82-86).

An investigation into the distinction between identity conservation and equivalence conservation, as presented by Elkind (1967) was examined in the content area of solid continuous quantity. One group of subjects received the tasks as outlined by Elkind (Group I) while another group of subjects received modified versions of the tasks (Group II). Each conservation task was presented at two levels of transformation; moderate and extreme. In addition transitivity of solid continuous quantity was examined in relationship to conservation. The sample consisted of 144 subjects; 48 Kindergarten, Grade one and Grade two students. Half of the subjects within each grade level were assigned to Group I, the other half was assigned to Group II. Within each group half of the children were male and half were female. An analysis of variance performed on the conservation tasks indicated that identity and equivalence conservation were of equal difficulty. The main effects of Group and Age were significant and the interaction of Sex x Grade was significant. The criterion factor of judgment only vs. judgment plus explanation was found to have a significant effect, with more trials passed with a judgment only criterion. Data were scored according to two different procedures; oneyprocedure required that subjects be consistent in their answers in each phase of the task in order to receive non-zero scores. This procedure employed a three-point scale with values of 0, 1, and 2. The other procedure used a scale with values ranging from 0 to 6 inclusive. Subjects were given a point for each of the six questions answered correctly in the conservation tasks, regardless of the consistency of the answers. The method with the 0, 1, and 2 scale showed that' identity and equivalence conservation were equally difficult, while the method which employed the 0-6 scale showed that identity was easier than equivalence. It was shown that the latter method yielded these results because of an artifact in the questions asked. Furthermore it was shown that scale scores which resulted from an application of the 0-6 scale were an ambiguous reflection of the level of concept attainment. An analysis of variance was performed on the transitivity tasks. The main effects for Group and Age were significant. The transitivity tasks were significantly easier than all conservation tasks at all grade levels. The implications of this and the co-occurrence of identity and equivalence conservation were discussed in relation to Elkind's (1967) analysis. / Arts, Faculty of / Psychology, Department of / Graduate

The Vascular system of the human spinal cord at birth has been investigated, and a report is submitted on the detailed pattern of the arterial and arteriolar vessels in 27 cadavers. In 21 instances, the anterior median spinal arterial trunk and in 9 instances the postero-lateral spinal arterial trunks have been recorded. Selection of cadavers has been on the basis of the absence of obvious congenital deformity or disease of the spine and spinal cord. Particular attention has been paid to the feeder arteries which contribute to the main longitudinal channels, both anteriorly and posteriorly. The number of feeder vessels, their ;.., sources of origin .and their approximate size~ have been determined. In 21 specimens the anterior vessels have been recorded and charted in detail. (Plates I - VII). In 9 specimens the posterior vessels have been recorded and the detailed charts of 3 of the latter are presented. (Plate X, p.46). Material and Methods Newborn cadavers, obtained on average 3-5 days after death from various causes such as prematurity, cerebral trauma, pneumonia and pulmonary hyaline membrane have been used. In each case the body was warmed to room temperature, before the introduction into the right femoral artery of a plastic tubular cannula of appropriate gauge. Dilute Ammonia, 2-3 ml., was introduced to promote the flow of the injection material and the specimens were injected with latex under pressures which varied from 5 lbs per square inch to 20 lbs per square inch. The manometric readings of intra-arterial pressure were between 300 mms. Hg and 1200 mms. Hg, and the optimal pressure of delivery was 15 lbs per square inch. Both the arterial and the venous sides of the circulation were well-filled by the injection material, which in all instances was administered via the femoral artery. Rupture of vessel walls with leakage of injection material was not excessive. The number of cadavers rejected on account of inadequate filling or excessive leakage was less than 10 out of approximately 50 cadavers. The injection material consisted of a prevulcanised latex, "Revultex", coloured red with an appropriate dye, and stained through fine muslin before use to ensure freedom from solid particles which could cause obstruction of vessels of fine calibre. The injection material was allowed to penetrate the vascular tree for periods varying from 5 to 15 minutes and the cadaver was then embalmed, injecting the body cavities and infiltrating the limbs as far as possible with a standard embalming fluid consisting of: White Industrial Spirits, 45%; Glycerine, 35%; Formaldethyde, 15%; Thymol, q.s. The cadaver was preserved in a 50% solution of the embalming fluid, and dissections were commenced not less than 14 - 21 days after preparation. Use was made in all instances of the binocular surgical microscope, and magnifications of 10 or of 16 were found to be optimal. Photographic reproductions were made in colour, and the dissected specimens have been preserved. The findings in respect of the anterior arterial system of supply of the cord have been consistent with those of a number of workers, in particular Woollam and Millen (1958) of Cambridge. Additional findings have been reported in respect of the smaller arteries (arteries of the 4. 4th order) including the perforating arteries of the median sulcus. The value of a computerised "average" for the vascular pattern of the cord is disputed. In the opinion of the author, it is likely to be misleading to the clinician and to the surgeon. Reliance upon an average picture in an individual case is liable to be harmful; in the present series of 21 specimens, the average picture as offered by Suh and Alexander (1939) was, in some respects only, applicable to 1 case. The presence of arterio-arterial anastomoses as a common feature in the spine is reported, and the possible significance discussed. Reference is made to a "critical narrow zone" which the author has determined by the radiological examination of 50 vertebral columns in people of all ages. When the region of the "narrow critical zone" is related to the regional blood supply of the spinal cord, then a significant factor in the post-operative development of paraplegia in scoliosis cases has been found to emerge. Vascular factors have been sought in the etiology of idiopathic scoliosis, but not found.

The investigation of an abdominal mass in a child is a common problem in the radiology department of the Red Cross Children's Hospital. The majority of these masses involve the urinary tract. The commonest neoplasm is a Wilms' tumour of the kidney. Against a pathological and clinical background, the investigation of Wilms' tumour by diagnostic imaging is presented. The imaging modalities currently utilised are the intravenous urogram (IVU), ultrasound (US), computed tomography (CT) and magnetic resonance (MR). Using the material available in the last decade, the principles, techniques and imaging characteristics of these modalities are investigated and compared. These results are reflected against those reported in the medical literature. This literature is not yet extensive as the current technology has only been available for the last six to seven years. The IVU has in the past been the main imaging modality and we still use it extensively. Its strengths and weaknesses are discussed. In the last five years US has taken its place as the primary method of diagnostic imaging. We have found that with our increasing experience that this is justified. The use of US and IVU in a practiced hand is a powerful diagnostic combination. CT as a primary investigation is not readily available at our institution. We have used it for comparative purposes in about 20% of our recent cases. CT has not added greatly to our initial diagnostic impression. However, it has been most useful for follow up of metastasis and for assessing the normality of the lungs before ceasing chemotherapy. Our experience with MRI is limited and confined to unusual presentations in the last year. Other modalities such as arteriography and nuclear medicine have special indications which are to be discussed. The remaining tumours of the upper urinary tracts are all rare, but are reported and the literature researched. In the lower urinary tract the main pelvic lesion is a rhabdomyosarcoma. The comparative advantages of the IVU, US, CT and MRI are also noted. In the pelvis, US has also become the primary imaging modality, and is replacing contrast medium cystography. However, examples of the latter are included as it still has a place, particularly in the less sophisticated institutes. CT and MRI, when available, have imaging advantages in the pelvis and are becoming the methods of choice for follow up. The main objective of this document has been to investigate the available imaging techniques, but, against this overall theme, the clinical care of the child is most important. With this in mind the treatment protocols that are used at our hospital are noted in the appendices to the thesis.