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Fortschritte der Kieferorthopädie 04/2012; · 0.89 Impact Factor
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ABSTRACT: The objective of this prospective longitudinal study was to investigate the reaction of facial soft tissues to treatment with a Herbst appliance. We aimed to quantify three-dimensionally (3D) the isolated effect of the Herbst appliance and volume changes in the lip profile.
The 3D data of the facial soft tissues of 34 patients with skeletal Class II (17 female and 17 male, mean age 13.5 ± 1.8 years) were prepared in a standardized manner immediately before (T1) and after (T2) treatment with a Herbst appliance. Anthropometric evaluation was carried out in sagittal and vertical dimensions. To quantify volume changes, pretherapeutic and posttherapeutic images were superimposed three-dimensionally and the difference volumes calculated. Following testing for normal distribution, a statistical analysis was carried out using the paired t test.
We observed ventral development of the soft tissues of the lower jaw with flattening of the profile curvature and anterior displacement of the sublabial region in a total of 27 patients. Anterior facial height was lengthened and the facial depth at the lower jaw increased. The largest percentage changes were noted in the lip profile, with a reduction in the red margin of the upper lip and an increase in lower lip height. We also observed a reduction of the sublabial fold in conjunction with a simultaneous increase in volume.
The influence of the Herbst appliance on the facial soft tissues is expected to result in a positive treatment outcome, particularly in patients with a convex profile, a retrusive lower lip, and a marked sublabial fold. We observed a broad clinical spectrum of individual reactions in the facial soft tissues. It is, thus, not possible to detect a linear relationship between the Herbst treatment and soft tissue changes, making soft tissue changes difficult to predict.
Fortschritte der Kieferorthopädie 03/2012; 73(2):116-25. · 0.89 Impact Factor
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ABSTRACT: In this study, sparse modeling is introduced for the estimation of propagation patterns in intracardiac atrial fibrillation (AF) signals. The estimation is based on the partial directed coherence function, derived from fitting a multivariate autoregressive model to the observed signal using least-squares (LS) estimation. The propagation pattern analysis incorporates prior information on sparse coupling as well as the distance between the recording sites. Two optimization methods are employed for estimation of the model parameters, namely, the adaptive group least absolute selection and shrinkage operator (aLASSO), and a novel method named the distance-adaptive group LASSO (dLASSO). Using simulated data, both optimization methods were superior to LS estimation with respect to detection and estimation performance. The normalized error between the true and estimated model parameters dropped from 0.20 ± 0.04 for LS estimation to 0.03 ± 0.01 for both aLASSO and dLASSO when the number of available data samples exceeded the number of model parameters by a factor of 5. For shorter data segments, the error reduction was more pronounced and information on the distance gained in importance. Propagation pattern analysis was also studied on intracardiac AF data, the results showing that the identification of propagation patterns is substantially simplified by the sparsity assumption.
IEEE transactions on bio-medical engineering 02/2012; 59(5):1319-28. · 2.15 Impact Factor
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Klinische Pädiatrie 11/2011; 223(6):374-5. · 1.77 Impact Factor
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ABSTRACT: The present study investigates spatial properties of atrial fibrillation (AF) by analyzing VCG loops synthesized from 12-lead ECGs. The atrial signal is extracted using spatiotemporal QRST cancellation, and spatial properties are characterized through joint analysis of successive fixed-length signal segments. The significance of spatial (loop morphology) parameters is studied in relation to AF frequency, hypothesizing that more organized AF, being expressed by lower frequency, is associated with decreased variability in loop morphology. The results showed that loop orientation can be determined from global analysis (i.e., the entire 60-s segment is used) or the mean of segment-based analysis, both types of analysis leading to similar results. The hypothesis that more organized AF is associated with decreased variability in loop morphology was to some extent confirmed for the parameters planarity and planar geometry; for 1-s segments, the correlation to AF frequency was 0.608 (ples0.001) and 0.543 (ples0.005).
Computers in Cardiology, 2007; 11/2007
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ABSTRACT: Pediatric palliative care is still in its beginning. Most children with life-threatening disorders succumb with incomplete symptom control under in-patient conditions. Due to the limited number of patients and large hospital-home distances the realization of out-patient concepts of palliative care especially for children and adolescents with cancer is purposeful and beneficial. In a pilot project such an a aforementioned concept of pediatric palliative care proved successfully working despite insufficient conditions. Guidelines of pediatric palliative care are to be defined at short notice in order to ascertain autonomy and mobility of patients aiming at highest possible quality of life. The recently initiated program of integrating ambulatory and in-patient care within the regulations set forth in Germany's last health care system reform offers the chance of palliative home care of children in their terminal phase of life.
Klinische Pädiatrie 216(3):183-8. · 1.77 Impact Factor
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ABSTRACT: In Germany annually 1,500-3,000 children die from life-limiting diseases. Symptoms and course of disease differ considerably depending on the character of the underlying disease. Due to the desire of the children and their families to spend the end of life at home a paediatric palliative home care service was founded at the university children's hospital of Duesseldorf. In the last 20 years a specialised paediatric palliative team evolved from an unstructured voluntary activity. Prospective aims are an area-wide professional supply of all paediatric palliative patients and the improvement of the cooperation with the resident paediatrician and paediatric palliative nursing services. Furthermore the establishment of networks as well as a proper communication among the professionals is inalienable.
Klinische Pädiatrie 221(3):186-92. · 1.77 Impact Factor
