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PoCoTo is known as a web-based interactive tool for the postcorrection of OCR-results on historical texts. In this paper we first introduce A-PoCoTo, a fully automated extension of PoCoTo designed for the use in large-scale digitization projects. Among other features, A-PoCoTo takes into account the recognition results of several OCR-engines on the given input text, and sentence context is used for refining rankings and decisions. Preliminary evaluation results are given. In view of the very high level of accuracy needed for many scholarly applications it is questionable if a fully automated process is always able to fully meet the standards expected by researchers in Digital Humanities. We describe the architecture of A-I-PoCoTo, a postcorrection system (under development) combining automated postcorrection as a first step and interactive postcorrection as an optional second step. In A-I-PoCoTo decisions and correction steps of the automated component are stored in a special protocol. Views offered by the graphical user interface help to efficiently confirm, reject, or improve these decisions as a first step of the manual postcorrection.

Im Gegensatz zu anderen mechanischen Unterstutzungssystemen werden komplette Kunstherzen („total artificial hearts“, TAH) orthotop implantiert. Typische Indikationen zur Verwendung eines TAH sind infarktbedingte Gewebezerstorungen nach Myokardinfarkten (z. B. ausgedehnter Vorderwandinfarkt und Infarktventrikelseptumdefekt) sowie die notfallmasige Stabilisierung eines Patienten im kardiogenen Schock infolge eines biventrikularen Pumpversagens. Ziele der TAH-Therapie sind also die Stabilisierung des Patienten und die Uberbruckung bis zur Transplantation. Eine primare Langzeittherapie ist mit den aktuell verfugbaren Systemen nicht sinnvoll, da die erwartete Laufzeit sehr limitiert ist. Die Lebensqualitat der Patienten am TAH ist im Vergleich mit aktuellen nichtpulsatilen linksventrikularen Unterstutzungssystemen durch hohe Gerauschentwicklung und sperrige Antriebseinheiten oft deutlich eingeschrankt. Aufgrund der bauartbedingten Grose konnen Erwachsene mit kleinem Thoraxdurchmesser und Kinder in der Regel nicht mit einem TAH versorgt werden. Der vorliegende Beitrag beschreibt die Entwicklung der TAH und behandelt die Indikationen/Patientenselektion sowie Kontraindikationen der TAH-Implantation. Besonderes Augenmerk wird auf das perioperative Management und potenzielle Komplikationen gerichtet.

Systemic therapy for advanced hepatocellular carcinoma (HCC) is still challenging. A biomodulatory therapy approach targeting the communicative infrastructure of HCC, including metronomic low-dose chemotherapy with capecitabine, pioglitazone and rofecoxib, has been evaluated in patients with non-curative HCC. Altogether 38 patients were evaluable in this one-arm, multicenter phase II trial. The primary endpoint, median progression-free survival was 2.7 months (95% CI: 1.6–3.79) for all evaluable patients and 8.4 months (95% CI: 0–18.13) for patients ≥ 6 weeks on protocol. Median overall survival (OS) was 6.7 months (95% CI: 4.08–9.31) and 9.4 months (95% CI: 4.82–13.97), respectively. Most common adverse events were edemas grade 3, which were commonly related to the advanced stage, with 66% of the patients suffering from liver cirrhosis. Exploratory data analyses showed significant impact of ECOG performance status grade 0 versus 1 and CLIP score 0/1 versus > 1 on OS, 9.8 months (95% CI: 4.24–15.35) versus 2.7 months (95% CI: 1.03–4.36; P = 0.002), and 9.8 months (95% CI: 3.23–16.37) versus 4.4 months (95% CI: 3.14–5.66; P = 0.009), respectively. Preceding tumor surgery had significant beneficial impact on survival, as well as maximal tumor diameter of

Die Vermeidung von Blutungs- und thrombembolischen Komplikationen ist immer noch ein zentrales Problem bei der Behandlung von Patienten mit einem „ventricular assist device“ (VAD). Probleme der etablierten gerinnungshemmenden Therapie werden diskutiert und neue Erkenntnisse uber „device-induzierte“ Storungen des Gerinnungssystems dargestellt. Die klinischen Erfahrungen mit dem weitverbreiteten Heart-Mate-II-System werden detailliert diskutiert. Die etablierten gerinnungshemmenden Therapien weisen Limitationen bzw. ausgepragte Nebenwirkungen auf. Neue direkte orale Antikoagulanzien und Thrombozytenaggregationshemmer sind in die klinische Praxis eingefuhrt worden. Die Ergebnisse sind vielversprechend. Daten zur speziellen Gruppe der Patienten mit VAD liegen bislang nicht vor. Die Erkenntnis, dass ein sehr hoher Prozentsatz dieser Patienten eine hamophile Komponente durch einen Mangel an den hochmolekularen Multimeren des Willebrand-Faktors entwickelt, konnte zu einem Paradigmenwechsel der etablierten gerinnungshemmenden Kombinationstherapie fuhren. Grosere klinische Studien sind notwendig, um die Implikationen eines erworbenen Willebrand-Syndroms auf die gerinnungshemmende Therapie bei Patienten mit VAD zu untersuchen. Die neuen direkten oralen Antikoagulanzien und Thrombozytenaggregationshemmer sollten bei dieser speziellen Patiengruppe eingehender untersucht werden.

Die optimale Betreuung vor, wahrend und nach der „Ventricular-assist-device“(VAD)-Operation, wahrend der Rehabilitation und nach der Entlassung aus der Klinik fuhrt in der Regel dazu, dass Komplikationen fruh erkannt oder vermieden werden und die Gesamtuberlebensraten sich verbessern. Anhand der langjahrigen Erfahrungen der multidisziplinaren Teamarbeit im Herz- und Diabeteszentrum (HDZ) NRW werden Patientenmanagement und Koordination erlautert. Im multidisziplinaren Team nehmen die „VAD-Koordinatoren“ zentrale Aufgaben wahr. Neben dem Koordinationsteam sind zahlreiche andere Disziplinen in die erfolgreiche und sachgerechte Versorgung eingebunden. Die wachsenden Unterstutzungszeiten am System gehen mit gestiegenen Anforderungen an die Versorgungsqualitat einher. Nicht nur in der Akutphase (pra-, intra- und fruh postoperativ) sind daher intensive Betreuungsbemuhungen unverzichtbar, sondern auch in der Phase der Rekonvaleszenz und Rehabilitation. Hier liegt der Fokus auf Patientenedukation und -schulung sowie der Uberwachung und Vermeidung von Komplikationen. Bei nach Hause entlassenen Patienten gehort hierzu auch die Etablierung eines Notfallalarmsystems unter Integration und entsprechender Schulung von Angehorigen und Hausarzten. Insgesamt stellt die Versorgung von VAD-Patienten hohe Anforderungen an die Professionalitat, Motivation und Interaktionfahigkeit der Teammitglieder. Die optimale interdisziplinare Betreuung gewahrleistet jedoch ein hohes Mas an Patientensicherheit und verbessert die Ergebnisse nachhaltig. Durch Bindung an die Teamansprechpartner ist eine zusatzliche Sicherheitsoption fur den Patienten gewahrleistet, die den Wechsel in die heimatnahe oder hausliche Versorgung erleichtert.

Purpose: The purpose of this study was to find out whether pneumothorax detection and exclusion is superior in expiratory digital chest radiography. Materials and Methods: 131 patients with pneumothorax with paired inspiratory and expiratory chest radiographs were analyzed regarding localization and size of pneumothorax. Sensitivity, specificity, negative (npv) and positive predictive value (ppv) as well as the positive (LR+) and negative likelihood ratio (LR-) were determined in a blinded randomized interobserver study with 116 patients. The evaluation was performed by three board-certified radiologists. Results: In 131 patients, there were 139 pneumothoraces, 135 (97.1 %) were located apical, 88 (63.3 %) lateral and 33 (23.7 %) basal. Sensitivity was 99 % for inspiratory and 97 % for expiratory radiographs. The interobserver study yielded a mean sensitivity of 86.1 %/86.1 %, specificity of 97.3 %/93.4 %, npv of 88.7 %/88.5 % and ppv of 96.7 %/92.1 % for inspiration/expiration. For inspiratory radiographs the LR+/LR- were 40.2/0.14 and for expiration 13.9 and 0.15. McNemar-Test showed no significant difference for the detection of pneumothoraces in in-/exspiration. Conclusion: Inspiratory and expiratory digital radiographs are equally suitable for pneumothorax detection. Inspiratory radiographs are recommended as the initial examination of choice for pneumothorax detection, an additional expiratory radiograph is only recommended in doubtful cases. Key Points: • Basal pneumothoraces during inspiration demonstrate a greater width than during expiration. • There is statistically no difference between inspiration/expiration for the diagnosis of pneumothorax. • An image taken during inspiration is recommended to confirm or rule out a pneumothorax. Citation Format: • Thomsen L, Natho O, Feigen U et al. Value of Digital Radiography in Expiration in Detection of Pneumothorax. Fortschr Rontgenstr 2014; 186: 267 – 273

UNLABELLED HISTORY AND INTERVENTION: A 52-year-old female patient underwent open abdominothoracic cardia and esophageal resection with gastric transposition because of histologically diagnosed Barrett metaplasia with "high-grade" intraepithelial neoplasia (HGIEN) and parts of an invasive adenocarcinoma. The anastomotic insufficiency on the 10th postoperative day including an esophagobronchial fistula prompted to a subsequent surgical re-intervention with suture of the fistula, lavage and additional drainage, an endoscopic stenting of the fistula from esophageal site, as well as repeated (n = 22) bronchoscopic applications of fibrin glue (1-3 ml each) into the lumen of the fistula after each bronchoscopic lavage of the fistula until the complete closure was achieved. The changeful clinical course of 77 days on the surgical ICU was characterized by secondary complications such as pneumonia, mediastinitis and respiratory insufficiency with long-term artificial respiration and creation of a percutaneous dilatation tracheotomy. CONCLUSION The application of fibrin glue can be considered a promising, minimally invasive therapeutic option in the management of postoperative fistula after esophageal resection, which requires expertise in decision-making and the finding-specific approach, in particular, if indicated inital steps of the sequential complication management such as surgical re-intervention and conventional endoscopic measures (stenting, Endo-VAC[-sponge]) do not provide great therapeutic potential any more due to the prolonged postoperative time course and the unfavorable local findings. In the presented case, modes of an assisted artificial respiration with low pressure and short phases of apnoe after fibrin glue application were the crucial predictions for an initial and favorable adhesion of this glue and finally for a successful sealing resulting in a sufficient closure of the fistula.

Objectives Several plaque and lesion characteristics have been associated with an increased risk for procedural stroke during or shortly after carotid artery stenting (CAS). While technical advancements in stent design and cerebral protection devices (CPD) may help reduce the procedural stroke risk, and anatomy remains important, tailoring stenting procedures according to plaque and lesion characteristics might be a useful strategy in reducing stroke associated with CAS. In this descriptive report of the ongoing Asymptomatic Carotid Surgery Trial-2 (ACST-2), it was assessed whether choice for stent and use or type of CPD was influenced by plaque and lesion characteristics. Materials and methods Trial patients who underwent CAS between 2008 and 2015 were included in this study. Chi-square statistics were used to study the effects of plaque echolucency, ipsilateral preocclusive disease (90–99%), and contralateral high-grade stenosis (>50%) or occlusion of the carotid artery on interventionalists' choice for stent and CPD. Differences in treatment preference between specialties were also analysed. Results In this study, 831 patients from 88 ACST-2 centres were included. Almost all procedures were performed by either interventional radiologists (50%) or vascular surgeons (45%). Plaque echolucency, ipsilateral preocclusive disease (90–99%), and significant contralateral stenosis (>50%) or occlusion did not affect the choice of stent or either the use of cerebral protection and type of CPD employed (i.e., filter/flow reversal). Vascular surgeons used a CPD significantly more often than interventional radiologists (98.6% vs. 76.3%; p < .001), but this choice did not appear to be dependent on patient characteristics. Conclusions In ACST-2, plaque characteristics and severity of stenosis did not primarily determine interventionalists' choice of stent or use or type of CPD, suggesting that other factors, such as vascular anatomy or personal and centre preference, may be more important. Stent and CPD use was highly heterogeneous among participating European centres.

Systeme zur biventrikularen Herzunterstutzung spielen in Relation zu den Linksherzunterstutzungssystemen quantitativ eher eine nachrangige Rolle. Fur ausgewahlte Patienten stellen sie jedoch oft die einzige mittel- und langfristige Therapieoption dar. Daher werden in diesem Kapitel sowohl kommerziell erhaltliche, komplette Kunstherzen als auch zusammengestellte Systeme aus univentrikularen Einzelkomponenten fur die intra- und parakorporale Anwendung dargestellt.

In the absence of ground truth it is not possible to automatically determine the exact spectrum and occurrences of OCR errors in an OCR'ed text. Yet, for interactive postcorrection of OCR'ed historical printings it is extremely useful to have a statistical profile available that provides an estimate of error classes with associated frequencies, and that points to conjectured errors and suspicious tokens. The method introduced in Reffle (2013) computes such a profile, combining lexica, pattern sets and advanced matching techniques in a specialized Expectation Maximization (EM) procedure. Here we improve this method in three respects: First, the method in Reffle (2013) is not adaptive: user feedback obtained by actual postcorrection steps cannot be used to compute refined profiles. We introduce a variant of the method that is open for adaptivity, taking correction steps of the user into account. This leads to higher precision with respect to recognition of erroneous OCR tokens. Second, during postcorrection often new historical patterns are found. We show that adding new historical patterns to the linguistic background resources leads to a second kind of improvement, enabling even higher precision by telling historical spellings apart from OCR errors. Third, the method in Reffle (2013) does not make any active use of tokens that cannot be interpreted in the underlying channel model. We show that adding these uninterpretable tokens to the set of conjectured errors leads to a significant improvement of the recall for error detection, at the same time improving precision.

INTRODUCTION: Knowledge on potentially pathogenic microbes including characteristics of their antibiotic resistance in septic patients as well as on the ward- and department-specific microbial spectrum can be considered essential for an efficient initiation of an adequate antimicrobial treatment, which turns out to become pivotal for patient outcome. Permanent changes in microbial patterns and antibiotic resistance can only be identified by a continuous investigation of various microbiological specimens. AIM: Based on the retrospective evaluation of prospectively collected data on microbiological investigations of the surgical ICU in 1996, 2002, 2004 and 2005, the short- and long-term changes by trend of microbial spectrum and antibiotic resistance following reorganisation and restructuring of the University Hospital from the more traditional pavillon-based system to a multidisciplinary complex building in 2003 were investigated. MATERIAL AND METHODS: Twice a week, routine microbiological testing of blood and urinary cultures as well as swabs from wound areas and endotracheal swabs were initiated in septic patients (suspect, manifestation) or in case of their clinical impairment. The microbial spectrum was sub-divided according to Gram-staining (Gram-posi-tive / -negative), various species and fungi with descriptive absolute and relative data values. -Various groups and time periods were statisti-cally compared using χ 2 test as appropriate. P val-ues < 0.05 were considered statistically significant. RESULTS: In total (n Total = 4 899), microbiological testing resulted in the detection of microbes in 699 and 833 blood and urinary cultures (14.3 % and 17 %, respectively) as well as 1 232 wound swabs (25.1 %) together with 2 135 samples from the endotracheal sites (43.6 %). During the short- (2002 vs. 2004) and long-term analyses (1996 vs. 2005), the proportion of Gram-positive microbes increased. Al-though Gram-positive bacteria can be considered the most frequent microbes for bacteriemia, there was a shift onto urinary and wound infections as well as pneumonias through the observation period. Despite the decreasing incidence of Enterococcus and the consistent proportion of MRSA, the increase of resistant Enterococcus strains (0 % vs. 43.2 %; P < 0.05) is critical. However, in the Gram-negative microbial spectrum there was an increase of the bacteraemia rate but a fall of the detection rate in wound and endotracheal swabs. In parallel, an increase of the detection rate of E. coli in blood (6.5 % vs. 45.5 %; P < 0.05) and endotracheal swabs (9.2 % vs. 16.2 %; P < 0.05) is associated with an increase of multiresistant Enterobacteriaceae strains (0 % vs. 30.7 %; P < 0.05). The portion of multiresistant strains of Pseudomonas with 31 % stayed the same through the 10-year time period. While Candida-based colonisation showed a decreased incidence (25 % vs. 15 %; P < 0.05) during the whole investigation period, there was a relative rise in the frequency of candidemia. CONCLUSION: ICU relocation from the pavillon-based system to a new complex clinic building was not associated with any significant alteration of the microbial spectrum on the surgical ICU. Increasing incidences of resistant Enterococcus and Gram-negative problematic microbes may indicate a general spread of multi-resistant microbes under the steady selecting pressure of a not always adequately initiated antibiotic / antimicrobial therapeutic regimen and underline the required but specific and selected microbiological screening.

Due to the large number of spelling variants found in historical texts, standard methods of Information Retrieval (IR) fail to produce satisfactory results on historical document collections. In order to improve recall for search engines, modern words used in queries have to be associated with corresponding historical variants found in the documents. In the literature, the use of (1) special matching procedures and (2) lexica for historical language have been suggested as two alternative ways to solve this problem. In the first part of the paper, we show how the construction of matching procedures and lexica may benefit from each other, leading the way to a combination of both approaches. A tool is presented where matching rules and a historical lexicon are built in an interleaved way based on corpus analysis. In the second part of the paper, we ask if matching procedures alone suffice to lift IR on historical texts to a satisfactory level. Since historical language changes over centuries, it is not simple to obtain an answer. We present experiments where the performance of matching procedures in text collections from four centuries is studied. After classifying missed vocabulary, we measure precision and recall of the matching procedure for each period. Results indicate that for earlier periods, matching procedures alone do not lead to satisfactory results. We then describe experiments where the gain for recall obtained from historical lexica of distinct sizes is estimated.

Hintergrund Diese Studie ist eine vorab geplante Sekundaranalyse der deutschen Daten einer multinationalen multizentrischen Beobachtungsstudie. Ziel dieser retrospektiven Studie war es, die Alltagswirksamkeit („effectiveness“) von Caspofungin bei organtransplantierten Patienten mit wahrscheinlicher oder nachgewiesener invasiver Pilzerkrankung zu evaluieren.

INTRODUCTION: Retroperitoneal soft-tissue sarcomas (RSTS) represent a rare and heterogeneous class of diseases for which the clinical management is still largely non-standardised. Based on a selective review of recent publications, it was the purpose of the present review article to summarize the current concepts of disease classification, diagnostics and surgical as well as multimodal therapy for these tumors. METHOD: A clinically based empirical review derived from a literature search focusing on publications from the past 5 years was carried out. RESULTS: Due to the paucity of randomised-controlled trials, therapy for RSTS is largely based on personal experience, retrospectively gathered data and historical controls. Pre-therapeutic planning requires precise information on the localisation, extension, and texture of the tumor through cross-sectional imaging (CT, MRI) as well as histological diagnosis through percutaneous or open biopsy. Complete tumor resection is crucial. Recent studies have confirmed the importance of microscopically negative resection margins which has subsequently led to a trend towards more radical resection. Chemotherapy does not play a role in the adjuvant setting except in clinical trials; however, radiotherapy has been controversely debated in adjuvant RSTS therapy. Efforts to limit radiation toxicity include modern techniques as well as a strategy of using pre-resection radiotherapy instead of postoperative radiation. Surgery is also the treatment of choice for locally recurrent RSTS and pulmonary metastases. The prognosis of RSTS depends on the quality of surgical care and several disease-specific factors (histological type, grading). CONCLUSION: The clinical management of RSTS is complex and can only partly be considered as evidence-based. Due to the required level of experience in the treatment of these tumor lesions and the involvement of several subspecialties, pre-therapeutic planning, treatment and follow-up should be limited to high-volume surgical centres. In order to achieve microscopically negative resection margins, multivisceral resections are a valuable option after thorough consideration of the risks and benefits. Adjuvant radiotherapy needs to be decided upon on an individual basis, taking into account patient- and tumor-specific factors as well as resection status.

Lymphoid hyperplasia of the intestine has been associated with multiple diseases and symptoms. This study was undertaken to analyze the number and topographical distribution of the lymphoid follicles. A total of 302 adult consecutive patients were enrolled when they underwent elective colonoscopy. Standardized pictures from terminal ileum and colon were taken using video colonoscopes. In each picture, the number, size, and mucosal elevation of lymphoid follicles were analyzed in relation to histological and immunological findings and medical history. Lymphoid hyperplasia was found to be most extensive in the terminal ileum and cecum. Patients with untreated gastrointestinally mediated allergy (GMA) showed the highest number of lymphoid follicles per visible field in the terminal ileum ( P < 0.001) and cecum ( P = 0.003) vs. the control group. Patients with infectious colitis also showed a high number of lymphoid follicles per endoscopic visible field in the transverse colon ( P = 0.020). The presence of lymphoid hyperplasia is a frequent finding during colonoscopy. It may indicate an enhanced immunological mucosal response to antigenic stimulation such as GMA or infection.

M. Winkler, J. Pratschke, U. Schulz, S. Zheng, M. Zhang, W. Li, M. Lu, D. Sgarabotto, G. Sganga, P. Kaskel, S. Chandwani, L. Ma, J. Petrovic, M. Shivaprakash. Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study. Transpl Infect Dis 2010: 12: 230–237. All rights reserved Objective. This study was designed to determine clinical outcomes with caspofungin in patients with proven or probable invasive fungal infection (IFI) after a solid organ transplant (SOT) procedure. Methods. In this retrospective observational study, data were collected for a single episode of IFI in patients with an SOT between January 2004 and June 2007. Response was determined by the investigator as favorable (complete or partial) or unfavorable (stable disease or failure) at the end of caspofungin therapy (EOCT). The primary effectiveness population was the proportion of patients who received ≥5 doses of caspofungin (modified all-patients-treated population). Safety was assessed for patients who received ≥1 dose of caspofungin. Results. A total 81 of patients from 13 sites in China, Germany, Italy, and the United Kingdom were enrolled, including 49 (60%) liver, 22 (27%) heart, 5 (6%) lung, 2 (2%) kidney, 2 (2%) liver and kidney, and 1 (1%) pancreas and kidney recipients. Candidiasis was diagnosed in 64/81 patients (79%) and aspergillosis in 22/81 patients (27%). Most patients received caspofungin monotherapy (75%). Caspofungin was given as first-line therapy to 59 (73%) patients. The overall favorable response at EOCT was 87% (58/67; 95% confidence interval [CI]: 76%, 94%), with favorable responses in 88% (43/49; 95% CI: 75%, 95%) of patients receiving caspofungin monotherapy and 83% (15/18; 95% CI: 59%, 96%) of patients receiving combination therapy with caspofungin (modified all-patients-treated population). Response by type of SOT was as follows: liver 87% (39/45), heart 93% (14/15), kidney 100% (5/5), and lung 50% (2/4). An overall survival rate (all-patients-treated) of 69% (56/81; 95% CI: 59%, 79%) was observed at 7 days post EOCT. No serious drug-related adverse events were reported. Conclusion. In this study, caspofungin was effective and well tolerated in the treatment of IFIs involving SOT recipients.

PURPOSE: Ovarian hyperstimulation syndrome (OHSS) is a complication during ovarian stimulation. Patients with moderate and severe OHSS usually require inpatient or intensive-care support. There are scarce data regarding the course of laboratory parameters and no data concerning AB0 blood groups in patients with OHSS. MATERIAL AND METHODS: 174 patients with OHSS were hospitalized in the period of January 2000 to December 2005. Morbidity, pregnancy rate, course of laboratory parameters, blood groups and treatment options were collated. Frequency of AB0 blood groups were compared with 3 distinct control groups. RESULTS: Of 174 patients 32 had OHSS grade I, 71 grade II and 71 severe grade III. 40.8 % of all patients had a clinical pregnancy. The most frequent symptoms were ascites, pain and abdominal tension. Almost all patients received infusion therapy with anticoagulation. 20 - 50 % were treated with diuretics, analgesics or required ascites drainage. Highly significant changes of laboratory parameters in the course stationary treatment were found. Comparing blood group subtypes to the control groups revealed an increased risk to develop OHSS for non-0 or blood group A. The calculated odds ratios (OR) were between 1.52 and 1.65. These findings were significant or nearly significant. CONCLUSION: The morbidity of women suffering from OHSS is high, with marked changes in laboratory findings. Treatment options comprise intravenous therapy with crystalloids, fluid balancing, anticoagulation and ascites drainage. There is evidence that determination of AB0 blood groups may be a helpful tool to identify women with a predisposition for OHSS undergoing IVF treatment.

Given a specific information need, documents of the wrong genre can be considered as noise. From this perspective, genre classification helps to separate relevant documents from noise. Orthographic errors represent a second, finer notion of noise. Since specific genres often include documents with many errors, an interesting question is whether this “micro-noise” can help to classify genre. In this paper we consider both problems. After introducing a comprehensive hierarchy of genres, we present an intuitive method to build specialized and distinctive classifiers that also work for very small training corpora. Special emphasis is given to the selection of intelligent high-level features. We then investigate the correlation between genre and micro noise. Using special error dictionaries, we estimate the typical error rates for each genre. Finally, we test if the error rate of a document represents a useful feature for genre classification.

Since the Web by far represents the largest public repository of natural language texts, recent experiments, methods, and tools in the area of corpus linguistics often use the Web as a corpus. For applications where high accuracy is crucial, the problem has to be faced that a non-negligible number of orthographic and grammatical errors occur in Web documents. In this article we investigate the distribution of orthographic errors of various types in Web pages. As a by-product, methods are developed for efficiently detecting erroneous pages and for marking orthographic errors in acceptable Web documents, reducing thus the number of errors in corpora and linguistic knowledge bases automatically retrieved from the Web.

Wir berichten uber den Fall einer 19-jahrigen Patientin mit akuter Promyelozytenleukamie, bei der es wahrend der Neutropenie nach Konsolidierungschemotherapie zu einer fieberhaften Monarthritis des rechten Kniegelenks durch Geotrichum capitatum gekommen ist. Hierbei handelte es sich wahrscheinlich um eine hamatogene Reaktivierung, da es bereits in der Induktion zu einer Fungiamie mit Geotrichum capitatum gekommen war. Unter breiter antimykotischer Therapie mit Voriconazol, Flucytosin und Caspofungin sowie einer zweimaligen arthroskopischen Synovialektomie und Spulung im rechten Kniegelenk konnte die Infektion kontrolliert und die volle Funktionsfahigkeit des Kniegelenks erhalten werden.

Awake craniotomy in tumor and epilepsy surgery or for the implantation of electrodes for deep brain stimulation requires specific anesthesiological strategies. Propofol allows for quick emergence and has little effect on the respiratory function of the usually spontaneously breathing patient. Pain control may be instituted by hemiscalp block for trepanation or local infiltration for deep brain electrode implantation. In addition, low dose remifentanil is recommended for trepanation (i.e. tumor or epilepsy surgery). The airway may be secured by an ordinary Magill tube placed transnasally with its tip underneath the epiglottis. To protect the patient against vomiting an adequate antiemetic prophylaxis is required.

The replacement of textual units by synonymous canonical forms is an important prerequisite for many variants of automated text analysis. In scientific texts, one common normalization step is the consistent replacement of acronyms by their definitions. For many acronyms, the definition is found at a certain position of the text where the acronym is introduced and “expanded” to a synonymous sequence of full words. A recent approach to detecting acronym-expansion pairs by Park and Byrd [19] describes possible graphical correspondences between acronyms and expansions by means of fine-grained rules. Here we show how rule sets as used in [19] can be translated into hidden Markov models that abstract from details of the graphical correspondence and improve recall in a significant way. Stability in terms of precision is ensured by exploiting simple properties of the expansion with an optional reinforcement of linguistic knowledge. With this extension of the original formalism, the introduction of large rule sets can be avoided and a fixed model can be applied to a large variety of texts without retraining, with good values both for recall and precision.

This article reports on the XML retrieval system x2 that has been developed at the University of Munich over the last 5 years. In a typical session with x2, the user first browses a structural summary of the XML database in order to select interesting elements and keywords occurring in documents. Using this intermediate result, queries combining structure and textual references are composed semiautomatically. After query evaluation, the full set of answers is presented in a visual and structured way. x2 largely exploits the structure found in documents, queries and answers to enable new interactive visualization and exploration techniques that support mixed IR and database-oriented querying, thus bridging the gap between these three views on the data to be retrieved. Another salient characteristic of x2 that distinguishes it from other visual query systems for XML is that it supports various degrees of detailedness in the presentation of answers, as well as techniques for dynamically reordering, grouping and ranking retrieved elements once the complete answer set has been computed.

Obstructive jaundice is a common clinical sign in patients with pancreatic cancer. 52% of all patients with a potentially resectable pancreatic cancer suffer from painless obstructive jaundice. There are no prospective studies showing a beneficial effect of preoperative drainage in patients with resectable pancreatic cancer. Morbidity (53%) and mortality (15%) in patients without preoperative biliary drainage are not significantly different from those who had endoscopic drainage preoperatively (morbidity 41%; mortality 15%). However, there are some logistic reasons for preoperative drainage, especially if surgery is delayed. In cases of nonresectable pancreatic cancer endoscopic drainage for palliation of obstructive jaundice is the method of choice. The decision between metallic and plastic stents for palliation is based on expected survival time and quality of life. Implantation of metal stents is the method of choice in patients with life expectancy exceeding six months. Scheduled three months exchange of plastic stents is recommended to avoid complications. After a six months interval about 70% of patients with scheduled exchange are without symptoms, compared to about 40% of patients who had exchange of plastic stents on demand. Scheduled three months exchange of plastic stents leeds to a patency rate of plastic stents comparable to those of metallic stents.

When applied to historical texts, OCR engines often produce a non-negligible number of OCR errors. For research in the Humanities, text mining and retrieval, the option is important to improve the quality of OCRed historical texts using interactive postcorrection. We describe a system for interactive postcorrection of OCRed historical documents developed in the EU project IMPACT. Various advanced features of the system help to efficiently correct texts. Language technology used in the background takes orthographic variation in historical language into account. Using this knowledge, the tool visualizes possible OCR errors and series of similar possible OCR errors in a given input document. Error series can be corrected in one shot. Practical user tests in three major European libraries have shown that the system considerably reduces the time needed by human correctors to eliminate a certain number of OCR errors. The system has been published as an open source tool under GitHub.

During the last decade, a huge amount of OCRed historical texts has been made available on the Internet. For most of these documents meta data are missing that assign topic categories from library classification systems to texts. Data of this form would offer a much better access to these collections. We report on an experiment where we used a completely automated system for topic assignment, originally designed for modern texts, and apply it to OCRed texts from an 18th century German lexicon (Zedler). Lexicon pages/images used in the experiment lead to poor OCR quality and are full of historical spelling variants. In order to measure the influence of OCR errors and historical orthography on topic detection, we created ground truth versions and in addition ground truth versions with modernized orthography for all texts. We found that automated topic assignment leads to useful results for both the OCR output and the two ground truth versions. Difficulties arise from a "changing world" in a (e.g., technical) field as well as language changes beyond simple orthography.

METHODS The pancreas of 24 male Wistar rats was perfused extracoporally by modified Krebs-Ringer-buffer for 80 minutes (including a 20 minutes equilibration period). To verify any organ damage we measured the activity of pancreatic enzymes like amylase, lipase and lactatdehydrogenase in the portal effluent. Furthermore histological changes were analysed after perfusion. Organ damage was induced by adding cerulein in a physiological dose (10(-10) M, n = 6) and in a supramaximal dose (10(-8) M, n = 6) and by intraductal injection of taurocholate (3.5 %, n = 6). RESULTS Already 10 minutes after stimulation with cerulein (10(-8) M) and after intraductal injection of taurocholate increased activities (p < 0.01) of amylase and lipase were measured in the portal effluent compared to the group without any treatment. Lactatdehydrogenase levels did not changed. Apart from marked oedema in both groups considerable zones of necrosis could be noticed especially in the taurocholate group. CONCLUSION Our data suggest that the isolated perfused rat pancreas (IPRP) is a valuable experimental tool to verify pathophysiological changes in the early phase of acute pancreatitis (AP). Various established models of AP such as by cerulein hyperstimulation or intraductal injection of taurocholate, could be applied to the IPRP. We conclude that this method enlarges the spectrum of established experimental models of acute pancreatitis.

Postoperative irradiation was done in 12 female patients with granulosa cell tumours between 1962 and 1981. The average follow-up period was 10 years and 10 females were alive without evidence of renewed tumour growth. A further patient died of cardiac infarction after 7 years. At the time of death she was free of recurrence or metastases. Only in one case multiple filiae developed in the lung, liver and skeleton 8 months after cessation of irradiation. The progression of these could not be arrested. Following the first therapeutic step, i.e. abdominal hysterectomy and bilateral adnectomy , radiotherapy represents an important additional therapeutic measure. Thus the unfavourable long-term prognosis of granulosa cell tumours can be beneficially influenced particularly in far-advanced cases or in recurrences.

Oral drug treatment of detrusor overactivity often causes undesirable side effects in other organs. For some patients, in particular those with neurogenically induced detrusor overactivity (detrusor hyperreflexia), the tolerance level for adverse effects is low and oral treatment may become ineffective. Intravesical administration of the drug can diminish the side effects or increase treatment effectivity in patients who are (partially) refractory to oral treatment because the relative concentration of the drug is increased in the target organ and decreased in the circulation. Six men (19-34 years old) with traumatic spinal cord lesions between C2 and Th11 were randomized to intravesical instillation with 15 or 30 mg trospium chloride in 40 ml saline into the empty bladder. Catheterization was postponed until at least 3 h after instillation, and fluid intake was not allowed during the first 4 h. Blood samples were taken before and 11 times after instillation; the last sample 12 h post instillation. Four positive samples were found in three patients: 0.10 ng/ml after 1 h and 0.13 ng/ml after 2(1/2) h in two patients with 15 mg, and 0.24 ng/ml after 30 min and 0.70 ng/ml after 6 h in one patient with 30 mg instilled trospium chloride. Three adverse effects were reported and were rated as probably not related to the drug. It is concluded that intravesically instilled trospium chloride is not absorbed into the circulation in significant amounts and, thus, it may be expected that this mode of administration will improve the efficacy of trospium chloride therapy by reducing the side effects. Neurourol. Urodynam. 18:447-453, 1999.

Summary Objective It was the aim of this prospective randomized multicenter study to compare chemotherapy and radiotherapy as consolidation treatments in patients achieving complete remission (CR) after 6 cycles of doxorubicin-containing chemotherapy in advanced-stage Hodgkin's disease (HD). Methods A total of 288 previously untreated patients aged 18–60 years with stage IIIB or IV HD received induction chemotherapy with 3 × (COPP + ABVD). Patients achieving CR were eligible for randomisation to either 20 Gy radiotherapy to initially involved fields (RT-arm) or to an additional 1 × (COPP + ABVD) (CT-arm). Patients with nodal PR were allocated to more intense radiotherapy (IRTarm: 20 Gy IF, 40 Gy to persisting tumor). Four patients with persisting organ involvement after induction received salvage chemotherapy. Results Of 288 patients, 171 (59%) achieved CR after induction chemotherapy. Of these, 100 patients were successfully randomized to RT or CT. In the CT arm relapses were observed in 10 of 49 patients compared with 13 of 51 patients in the RT arm (p = n.s.). Fifty patients refused randomisation and for them a treatment was chosen, and 21 patients refused any further treatment. Of these 21 patients with no consolidation therapy, 9 relapsed, indicating an approximately 3-fold increased relapse risk compared with those receiving either of the consolidation therapies. No relapse was observed in initially involved lung or liver sites. Adverse prognostic factors for freedom from treatment failure and survival were low hemoglobin and large mediastinal mass at initial presentation. Conclusions No statistically significant differences in treatment efficacy were detected between 20 Gy IF radiotherapy and 1 × (COPP + ABVD) chemotherapy following CR after six cycles of alternating chemotherapy in patients with advanced-stage HD. However, limited observations in a non-randomized cohort indicate that patients without consolidation treatment of CR after 6 cycles of chemotherapy may have an elevated risk for relapse.

The square of ultrasound transmission velocity in a material is related to the modulus of elasticity, which is known to be an indicator of stability in bone. The aim of our study was to use ultrasound transmission velocity to obtain information about the material properties of bone tissue, keeping other factors possibly influencing ultrasound transmission as constant as possible. Apparent phalangeal ultrasound transmission velocity (APU) measured in 54 isolated, fresh pig phalanges was shown to be independent of bone mineral density (BMD) measured by SPA. Fastest sound transmission led exclusively through cortical bone so that intertrabecular connectivity in spongious bone could not influence the result. In humans APU was measured in the mediolateral direction at the midphalanx of the middle finger. In 53 healthy subjects (15–81 years old; 27 women, 26 men), there was a decrease of APU with age (r=−0.30, p

In actual practice, digitisation and text recognition (OCR) refers to a processing chain, starting with the scanning of original assets (newspaper, book, manuscript, etc.) and the creation of digital images of the asset’s pages, which is the basis for producing digital text documents. The core process is Optical Character Recognition (OCR) which is preceded by image enhancement steps, like deskewing, denoising, etc., and is followed by post-processing steps, such as linguistic correction of OCR errors or enrichment of the OCR results, like adding layout information and identifying semantic units of a page (e.g. page number). In this paper, the focus lies on the post-processing steps. Two selected research areas of the European project IMPACT (IMProving ACcess to Text) will be outlined. Firstly, we present a technology for OCR and information retrieval on historical document collections, and discuss the potential use of fuzzy logic. Secondly, we present the Functional Extension Parser, a software that implements a fuzzy rule-based system for detecting and reconstructing some of the main features of a digitised book based on the OCR results of the digitised images.

Erroneous tokens in the output of an OCR engine can be roughly divided into two categories. For less serious OCR errors typically human readers - in many cases also text correction systems - are able to reconstruct the correct original word, or to suggest a small set of plausible corrections. Sometimes, however, the OCR output contains "garbage" output tokens for which it is completely impossible to predict the correct word. Garbage tokens are for example caused by graphics occurring in images misinterpreted as text by the OCR engine. In this paper we report on the development of a classifier for garbage tokens in OCR output on historical documents. The classifier is based on a specific feature set and implemented as a support vector machine. In our experiments it clearly outperformed simple rule-based predecessor solutions for OCR garbage detection.

The square of ultrasound transmission velocity in a material is correlated to the modulus of elasticity, which is an indicator of its mechanical properties. This might make the measurement of ultrasound transmission velocity useful in the noninvasive diagnosis of bone diseases. Bone, however, is not an isotropic material but is architecturally structured. The aim of our study was to investigate and especially to quantify the influence of architecture in cortical bone on ultrasound transmission velocity. Twenty-two rectangular, flat specimens of cortical bone were prepared from diaphysis of fresh pig radius. Ultrasound transmission velocity was measured parallel and perpendicular to direction of Haversian channels. It was found to be 3647 +/- 41 m/s parallel to and 2821 +/- 29 m/s perpendicular to Haversian channels respectively (p0.001). Our results clearly indicate that there is an important influence of architecture in cortical bone on ultrasound transmission velocity which has to be taken into account in its clinical use.

worldwide, orthotopic heart transplantation (HTx)remains an accepted therapeutic option in the treatment ofheart failure. As cardiac transplantation evolved, malignantdisorders in the postoperative course became a seriouscomplication after solid organ transplantation. With im-proved survival, the first reports on postoperative lympho-proliferative disorders

Due to the large number of spelling variants found in historical texts, standard methods of Information Retrieval (IR) fail to produce satisfactory results on historical document collections. In order to improve recall for search engines, modern words used in queries have to be associated with corresponding historical variants found in the documents. In the literature, the use of (1) special matching procedures and (2) lexica for historical language have been suggested as two ways to solve this problem. In the first part of the paper we show how the construction of matching procedures and lexica may benefit from each other, leading the way to a combination of both approaches. A tool is presented where matching rules and a historical lexicon are built in an interleaved way based on corpus analysis. A crucial question considered in the second part of the paper is if matching procedures alone suffice to lift IR on historical texts to a satisfactory level. Since historical language changes over centuries it is not simple to obtain an answer. We present experiments where the performance of matching procedures in text collections from four centuries is studied. After classifying missed vocabulary, we measure precision and recall of the matching procedure for each period. Our results indicate that for earlier periods historical lexica represent an important corrective to matching procedures in IR applications.

Many European libraries are currently engaged in mass digitization projects that aim to make historical documents and corpora online available in the Internet. In this context, appropriate lexical resources play a double role. They are needed to improve OCR recognition of historical documents, which currently does not lead to satisfactory results. Second, even assuming a perfect OCR recognition, since historical language differs considerably from modern language, the matching process between queries submitted to search engines and variants of the search terms found in historical documents needs special support. While the usefulness of special dictionaries for both problems seems undisputed, concrete knowledge and experience are still missing. There are no hints about what optimal lexical resources for historical documents should look like. The real benefit reached by optimized lexical resources is unclear. Both questions are rather complex since answers depend on the point in history when documents were born. We present a series of experiments which illuminate these points. For our evaluations we collected a large corpus covering German historical documents from before 1500 to 1950 and constructed various types of dictionaries. We present the coverage reached with each dictionary for ten subperiods of time. Additional experiments illuminate the improvements for OCR accuracy and Information Retrieval that can be reached, again looking at distinct dictionaries and periods of time. For both OCR and IR, our lexical resources lead to substantial improvements.

Lexical text correction systems are typically based on a central step: when finding a malformed token in the input text, a set of correction candidates for the token is retrieved from the given background dictionary. In previous work we introduced a method for the selection of correction candidates which is fast and leads to small candidate sets with high recall. As a prerequisite, ground truth data were used to find a set of important substitutions, merges and splits that represent characteristic errors found in the text. This prior knowledge was then used to fine-tune the meaningful selection of correction candidates. Here we show that an appropriate set of possible substitutions, merges and splits for the input text can be retrieved without any ground truth data. In the new approach, we compute an error profile of the erroneous input text in a fully automated way, using so-called error dictionaries. From this profile, suitable sets of substitutions, merges and splits are derived. Error profiling with error dictionaries is simple and very fast. As an overall result we obtain an adaptive form of candidate selection which is very efficient, does not need ground truth data and leads to small candidate sets with high recall.

Most systems for correcting errors in texts make use of specific word distance measures such as the Levenshtein distance. In many experiments it has been shown that correction accuracy is improved when using edit weights that depend on the particular symbols of the edit operation. However, most proposed approaches so far rely on high amounts of training data where errors and their corrections are collected. In practice, the preparation of suitable ground truth data is often too costly, which means that uniform edit costs are used. In this paper we evaluate approaches for deriving symbol dependent edit weights that do not need any ground truth training data, comparing them with methods based on ground truth training. We suggest a new approach where special error dictionaries are used to estimate weights. The method is simple and very efficient, needing one pass of the document to be corrected. Our experiments with different OCR systems and textual data show that the method consistently improves correction accuracy in a significant way, often leading to results comparable to those achieved with ground truth training.