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Hannovers Recht, 1

Hannovers Recht, 2

Leitfaden zum Studium des hannoverschen Privatrechts, 2

ZusammenfassungIm Zeitraum von 1981–2001 wurden an der Universitätskinderklinik Leipzig 177 Patienten mit invasiven Meningokokken-Infektionen behandelt. Die Anzahl der stationären Aufnahmen von Kindern mit diesem schweren Krankheitsbild nahm in diesem Zeitraum stark ab. Die meisten invasiven Meningokokken-Infektionen traten im 1. und 4. Quartal auf. Es erkrankten überwiegend Säuglinge und Kleinkinder. In dieser Altersgrupppe fand sich eine leichte Knabenwendigkeit. Die Letalität lag relativ konstant bei knapp 10%, am häufigsten bedingt durch ein Waterhouse-Friderichsen-Syndrom. Die Liegedauer der Patienten in der Klinik nahm von 1981–2001 kontinuierlich ab. Bis 1990 wurde der Großteil der Patienten in der Familie bzw. in einer Kinderkrippe betreut, nach 1990 nahm der Anteil der Kinder, die den Kindergarten bzw. die Schule besuchten, zu.

This is a review of the symptoms and signs of children with malignant diseases and septicemia due to viridans streptococci, treated during a 6-year-period (1990-1995) in the Departments of Pediatrics or Pediatric Surgery, University of Leipzig. All 11 children suffered from leukemia. Streptococcus mitis was the most frequently isolated streptococcal species. All patients had fever and malaise, in most cases we could find inflammatory signs of the respiratory tract. In two children we saw a severe course of the disease, one child had symptoms and signs of ARDS, the other died on septicemic shock. All 11 patients had neutropenia and a central venous line, 10 of them were treated by cytarabine before the streptococcal infection was diagnosed. Like others we could note during the last years an increase of systemic infections due to viridans streptococci in neutropenic patients with malignant diseases. Possibly there is an association between streptococcal infection and cytarabine therapy. The empiric antibiotic therapy in neutropenic patients with malignant diseases should cover also streptococcal infections.

Great mathematicians write for the future and Georg Friedrich Bernhard Riemann (1826–66) was one of the greatest mathematicians of all time. Edited by Heinrich Martin Weber, with assistance from Richard Dedekind, this edition of his collected works in German first appeared in 1876. Riemann's interests ranged from pure mathematics to mathematical physics. He wrote a short paper on number theory which provided the key to the prime number theorem, and his zeta hypothesis has given mathematicians the most famous of today's unsolved problems. Moreover, his famous 1854 lecture 'On the hypotheses which underlie geometry' set in motion studies which culminated in Einstein's general theory of relativity. Even Riemann's over-optimistic use of the Dirichlet principle to prove the conformal mapping theorem turned out to be immensely fruitful. The alert reader will further profit from finding here the seeds of modern distribution theory, algebraic topology and measure theory.

Objectives: To demonstrate nosocomial transmission of Enterococcus faeclum resistant to quinupristin/ dalfopristin and vancomycin/teicoplanin among paediatric patients in a German hospital ward. Materials and methods: Multiply-resistant E. faecium were isolated from three female patients aged 9 months, 2 and 15 years during a 10 day time span. Antibiotic susceptibilities were determined by microbroth dilution. Clonal relatedness among the isolates was investigated via Smal-macrorestriction analysis by PFGE, multilocus sequence typing (MLST), and plasmid profiling. Presence of virulence and resistance determinants was tested by polymerase chain reaction (PCR). Selected resistance genes were localized by Southern hybridizations. Results: A single E. faecium Isolate per patient was investigated. All exhibited resistances to quinupristin/ dalfopristin, vancomycin/teicoplanin, streptomycin (high-level), penicillin/ampicillin, erythromycin, oxytetracycline, chloramphenicol, rifampicin and fusidic acid. The isolates were susceptible to linezolid only and intermediately resistant to fluoroquinolones Including moxifloxacin. PFGE revealed identical patterns for all three Isolates. PCRs for virulence determinants hyaluronidase and enterococcal surface protein, esp, were negative, whereas PCR for the enterocin A gene was positive. MLST identified clonal type [8-5-1-1-1-1-1] belonging to a clonal subgroup C1 of hospital- and outbreak-related E. faecium. Southern hybridizations located several resistance genes (erm(B), va(D), vanA) on a large plasmid, which was transferable in mating experiments with an E. faecium recipient. Conclusions: These data show routes of dissemination of resistance to multiple antibiotics including streptogramins and glycopeptides in E. faecium via vertical and/or horizontal gene transfer. The isolates spread in the absence of a direct selective pressure, as none of the patients had received earlier streptogramin or glycopeptide therapy.

Bei einer 64-jahrigen Patientin wird aufgrund eines Plattenepithelzellkarzinoms eine Pneumektomie der rechten Lunge durchgefuhrt. Der postoperative Verlauf ist kompliziert durch die Entwicklung eines Empyems, das mehrfach drainiert werden muss. Eine mikrobiologische Untersuchung des Drainageeiters erbringt den Nachweis von Staphylococcus aureus mit normaler Antibiotikaempfindlichkeit. Deshalb wird auch eine Therapie zunachst mit Clindamycin 3-mal 600 mg/Tag i.v. begonnen, die nach einer Woche wegen der Besserung des klinischen Zustandes im Sinne einer Switchtherapie auf eine Gabe von 3-mal 300 mg/Tag p.o. umgestellt wird.

1. Es wird eine Methode zur Feststellung akuter Pankreaserkrankungen angegeben. 2. Die damit untersuchten Falle werden angefuhrt. 3. Der Verlauf der Pankreasschadigung nach anscheinender klinischer Heilung akuter Pankreaserkrankungen wird untersucht. 4. Dabei werden manchmal nach Jahren noch Storungen im Kohlehydrathaushalt gefunden. 5. Deshalb wird zur Vermeidung des Auftretens eines Diabetes Kohlehydrateinschrankung in der Nachbehandlung akuter Pankreaserkrankungen verlangt. 6. Die Methode zeigt einen Weg zur Vermeidung postoperativer Pankreatitiden bei radikalen Eingriffen am Magen, Duodenum und an den Gallenwegen.

Eine Vermehrung der atoxylfesten Lipase wurde bei 16 akuten Pankreaserkrankungen im Blutserum festgestellt.

Nach Choledochusunterbindung ist beim morphingewohnten Kaninchen gegenuber dem Normaltier eine erhohte Degenerationsbereitschaft der Leberzellen mit Neigung zur Nekrosebildung nachweisbar.

Die operative Behandlung des Lungenabscesses erfolgt im allgemeinen 6–8 Wochen nach Beginn der ersten klinischen Erscheinungen, nachdem die in den ersten Wochen erfahrungsgemas stark herabgesetzte Widerstandskraft sich wieder erholt hat, und nachdem die zunachst schwere Infektion uberwunden ist. Die Eroffnung der Abscesse zu diesem Zeitpunkt weist jedoch auch bei sachgemasem Vorgehen eine betrachtliche Sterblichkeit auf. Um die unbefriedigenden Ergebnisse zu verbessern, bestand schon immer das Bestreben zu noch fruhzeitigerem Eingreifen.

Technical innovation and extensive application of adaptive signal control at intersections have made turning flow information that provide more precise constraints for Origin-Destination matrix (O-D matrix) estimation easily available in great quantity and more accurate than ever. However, the influence of turning flow and duplication of information on the existing matrix estimation models and on the accuracy of O-D matrix estimation has not been broadly investigated. Also, traffic phenomenon in networks becomes complicated and difficult to explain with the increase in number of vehicles, variety of daily activities and sophisticated travel behaviors. As such, general congested traffic state as well as diverse travelers’ perception about travel time should be taken into consideration in O-D matrix estimation models. In this paper, the influence of applying finer and duplicated flow information as well as route choice proportion estimates on the performance of the Information minimization (IM) and the modified IM models were examined. It has shown that duplicate information has adverse effect on the accuracy of matrix estimation, whereas additional turning flow information can improve estimation accuracy. Based on the examination results a methodology using the IM model, the stochastic user equilibrium (SUE) assignment and the information screening process, was proposed to optimize the goodness of estimation and enhance the IM model to deal with the traffic situation more realistically. The respective convergence and required computation time were also examined. Furthermore, an empirical route choice study was conducted in order to help determining the size of a route set used in the SUE assignment model.