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We report of an almost three-year-old boy with congenital heart defect (double inlet left ventricle - DILV) with completed Fontan circulation, who was admitted for a gastroscopic intervention. Due to a bronchomalacia and the needed insufflation of the stomach, high ventilation pressures became necessary and caused a significant decrease of the pulmonary perfusion. Apart from other measures, the situation was stabilized by intermittent, short-term discontinuation of the ventilation. This case report describes the particular cardiopulmonary physiology in Fontan circulations and their significance for the anaesthesiological care in general and for situations with increased intra-abdominal pressure. Knowledge of this particular circulation physiology may be required for every anaesthesiologist or emergency physician on account of the increasing likelihood of becoming responsible for such patients at the operating theatre or within emergency care structures.

The postanaesthetic care of children requires a suitable recovery room, which must meet specific structural and staffing requirements. Both the assessment of vital signs and pain as well as the handling of the small patient requires specialised knowledge and experience. Typical problems in a paediatric recovery room include emergence agitation, which is rarely observed in adults. Also the necessities concerning the room itself amongst other requirements must enable the presence of caregivers while providing sufficient intimacy to all Persons involved. Due to the often described fact that especially children with respiratory complications experience life-threatening conditions significantly earlier than adults, a complete and immediate support provided by a specially qualified physician (e.g. senior paediatric anaesthetist) is absolutely necessary in every single case.

Pre-operative tractography of the optic radiation (OR) has been advised to assess the risk for postoperative visual field deficit (VFD) in certain candidates for resective epilepsy surgery. Diffusion tensor imaging (DTI) tractography relies on a precise anatomical determination of start and target regions of interest (ROIs), such as the lateral geniculate nucleus (LGN) and the primary visual cortex (V1). The post-chiasmal visual pathway and V1 show considerable inter-individual variability, and in epilepsy patients parenchymatous lesions might further complicate this matter. A functionally based tractography (FBT) seems beneficial for precise OR identification. We assessed practicability of FBT for OR identification in a patient with occipital lobe epilepsy due to a temporo-occipital maldevelopmental tumor. The MRI protocol at 3 T included a T1-weighted sagittal 3D scan, a T2-weighted axial 2D scan and a DTI scan using an echo planar spin echo sequence. ROIs for fiber tracking of OR (LGN & V1) were determined with T2*-weighted fMRI-based retinotopic assessment. After DTI pre-processing and fiber tracking, paths with similar properties were combined in clusters for visual presentation and OR localization. Retinotopic phase maps allowed for the identification of V1 and LGN for a precise DTI-based reconstruction of OR, which was distant to the patient's tumor. Location and structure of ORs were comparable in each hemisphere. FBT could thus influence the human research of the extrastriate visual pathway and the risk management of post-operative VFD in epilepsy surgery.

Microreactors have attracted wide attention in the nano- and biotechnology fields because they offer many advantages over standard liquid phase reactions. We report the development of a magnetic microreactor for reliable, fast and efficient surface functionalization of superparamagnetic iron oxide nanoparticles (SPIONs). A comprehensive study of the development process in terms of setup, loading capacity and efficiency is described. We performed experimental and computational studies in order to evaluate the trapping efficiencies, maximum loading capacity and magnetic alignment of the nanoparticles. The results showed that capacity and trapping efficiencies are directly related to the flow rate, elution time and reactor type. Based on our results and the developed magnetic microreactor, we describe a model multistep surface derivatization procedure of SPIONs.