[english] German Medical Schools face a new challenge in the need to accomplish graded subject exams. In the Reformed Medical Curriculum at the Charité in Berlin graded exams are in place on a regularly basis since 1999. The aim of this paper is to report on their development and important results, focusing on a description of the organisational assessment structure and MCQ and OSCE. [german] Die Vergabe benoteter Leistungsnachweise ist für alle deutschen medizinischen Fakultäten eine neue Herausforderung. Der Reformstudiengang Medizin (RSM) der Berliner Charité führt bereits seit 1999 regelmäßig benotete Prüfungen durch. Ziel dieses Beitrags ist es, deren Entwicklung und wesentliche Ergebnisse darzustellen. Im Mittelpunkt steht dabei die Darstellung der zentralen Prüfungsorganisation, der MC- und OSCE-Prüfungen.

BACKGROUND The authors hypothesised that medical schools need to support their students by identifying the challenges inherent in the demanding study of medicine, especially during the transitional phase at the beginning of study. Therefore, a study was conducted to evaluate Year 1 students' perceptions on how well 2 different programmes - a reformed and a traditional programme - helped students make a good start to their studies.DESIGN Cross-sectional survey.METHOD AND PARTICIPANTS A questionnaire was distributed to Year 1 medical students on reformed (RT) and traditional track (TT) curricula. Its 5 subscales measured perceived stress and support.RESULT A total of 155 students (70% of the year group) responded. Significant differences between groups appeared in 4 of the 5 subscales. Students on the RT felt more supported than students on the TT in terms of study conditions, social support at university, perceptions of their own attitudes and competencies, and living conditions. No differences in perceptions of social support outside university were apparent.CONCLUSION Key aspects that were perceived as supportive included good contact with fellow students and teachers, high quality of courses, and a curriculum that fulfilled students' expectations and made sense to them. In identifying particular features that led to the positive judgement of the RT, the authors hypothesised that the following aspects were crucial: the specific orientation unit in the first 2 weeks, the problem-based learning workshop, the coursebooks and extracurricular social activities.

The eXtensible Markup Language (XML) is increasingly finding acceptance as a standard for storing and exchanging structured and semi-structured information. With its expressive power, XML enables a great variety of applications relying on such structures - notably product catalogs, digital libraries, and electronic data interchange (EDI). As the data schema, an XML Document Type Definition (DTD) is a means by which documents and objects can be structured. Currently, there is no suitable way to model DTDs conceptually. Our approach is to model DTDs and thus classes of documents on the basis of UML (Unified Modeling Language). We consider UML to be the connecting link between software engineering and document design, i.e., it is possible to design object-oriented software together with the necessary XML structures. For this reason, we describe how to transform the static part of UML, i.e. class diagrams, into XML DTDs. The major challenge for the transformation is to define a suitable mapping reflecting the semantics of a UML specification in a DTD correctly. Because of XML—s specific properties, we slightly extend the UML language in a UML-compliant way. Our approach provides the stepping stone to bridge the gap between object-oriented software design and the development of XML data schemata.

g hjilkCh7mRnomWkZpKiZn2qsr2p/q4kNrlt`uwvyx)z|{ t kZ}T~iN€ p4rnoiC‚N}Tqƒnoi € iZ„…„†mR‡Prˆt`u‰r2pKtRn2qƒ€ Š"m € {&‚N}jiZn2‡ qƒ€ Š‹r2}jkŒh{ t kZ}T~iN€ p4rZŽ  }jiZn2q4iNrt €l‘CtRpƒhp’iŒ“Wp }jm ”ykCt € pKiZ€jp)mR€ {"r2p/n2}jkZp }Tnom ”ymPr2• – iCkZp4r~—}br2p ‘Ci˜rC} – – tRn2pKiC{wi/™škNq4iZ€jp ”›‡WŽœN€žpƒhTqsr – m – iZnCŸ „†i – noiNrZiN€ p= †nCrCp noiNr2}T”›p4rˆt¡u¢t }Tn-t € Š t qƒ€bŠ£noiNrNiCmRnokŒhtR€ – hb‡Pr2q4kCm ”*r2pKtRnomZŠ i¤qƒ~ – ”¥iN~iZ€jp’m p q4t €-t¡u¦v§x zw{ t kZ}T~iN€ p4rZŽ g hji ̈kCh7m ”ƒ”©iN€bŠ i ̈t¡ur2} –W– t n2p qƒ€ Š-pah7i qƒ€ pKiKŠWnom p q4t €wt`u)«PmRn2qƒ• t }br¬mPr – iCkNp/r¬t`u­‚N}jiZn2‡ qƒ€ Š§v§x z"{Wt kN}T~iZ€jp/r¦tR€ pah7i – hb‡Pr2• q4kŒmR”y”¥iZ«PiZ”ynoiNrC}T”®pKiC{"qƒ€žpƒhji˜{WiZ«PiZ”¥t – ~iN€ p t¡uˆpah7i~t {WiZ” t`u§pah7i§ ̄°kCkCi2rCr­± } – – tRn2p§g7noiCi¤m € {¢g io“ pa ̄¬n2nom ‡ 24 ̄­±3g7 ́ g ̄ ~9t {WiZ” μWŽ;g h7i ‘CmPr2q4k q4{WiCmt`u pƒhji9 ̄§± g7 ́ g ̄~t {WiZ”†qsr p’t rNi – m nomRpKi9pah7i—”¥tŒŠWq4kŒmR” r2p/n2}jkZp/}TnŒi—t¡u—m {Wt kN}T~iZ€jpIuCnotR~·qƒp4r ̧ « qsr2q4‘N”¥i ̧ pKiŒ“ p­kCt € pKiZ€jp§m € { ̈p’t noi – noiNrZiN€ p¬pah7i)p’io“ p­kCtR€j• pKiZ€jp1mPr¤m9r2qƒ€ ŠW”¥i9kCt € p/qƒ€ }jt }br­rCp n2qƒ€ Š Ž

We present the concept and implementation of a communication infrastructure for a distributed database system referring to the agent-based database query evaluation system AQuES. Within this model we use system components that build a federated multi agent system (MAS). We present those parts of the message transport layer that provide an "easy to handle", scalable architecture based on the "plug & play" building block principle. Furthermore, we present a generic dialog manager that enables each agent to communicate in multiple concurrent threads of execution. Based on this concept, AQuES agents keep track of a complex evaluation environment in a dynamic, multi-query scenario.

Qualitative EEG studies using computer assisted spectral analysis have been performed in a small number of migraineurs, especially in children. In a recent study we established the usefulness of the EEG computer analysis in differentiating migraine children from aged-matched controls (1). However, severe disturbances of the EEG background activity were only found in children suffering from migraine with aura. In clinical EEG evaluation changes of the background activity in epileptic patients are known. Using computer assisted spectral analysis we described some minor changes in the composition of the EEG background activity of children with idiopathic epilepsies during the introduction of therapy as well as during the long-term antiepileptic treatment (2). In the present study we set to compare the EEG background activity in the interictal period of patient suffering from migraine with aura and children with benign focal epilepsy.

A 15 year-old girl who had c-ALL diagnosed in 1982 was presented in our clinic suffering from an ascendend flaccid paresis and dysaesthesia of both legs. These are typical symptoms of polyradiculitis of the nerve roots L2-S2. A lumbal puncture revealed a pleocytosis with lymphoblasts which were up to 40% CD10 (cluster of differentiation) up to 70% CD19 and TdT (terminal transferase) positive. The diagnosis of late isolated CNS relapse was made. It is assumed that local residual infiltrations of leukemic cells into the nerve roots L2-S2 got into cell cycle and caused these rare CNS leukemia symptoms. Therefore the value of a craniospinal irradiation to prevent a CNS and systemic relapse is discussed.

In clinical EEG-evaluation changes of the background activity following epileptic seizure o r related to antiepileptic medication are known. By using EEG computer analysis, minor changes have also been described. Until now there have been only a few reports dealing with EEG spectral analysis in patients with migraine, especially in children. In a previous study we found differences of the EEG development between groups of children with and without migraine (1). In the present study we set to compare the characteristics of EEG background activity of migraine patients with epileptic children. The following questions were posed: Is there any generalized o r localized difference in the composition of the background activity between migraine and epileptic patients? Is there a relation between the clinical course (cessation of seizures); type of the epilepsy/migraine and the composition of EEG background activity? We studied two groups of patients. The first was made up of patients with migraine headache, the second comprised epileptics from the outpatient clinic in Heidelberg. Group I included 19 children (12 boys, 7 girls) aged 6 . 1 17.2 years. Five of them had common migraine, 8 had classic migraine and 6 had migraine accompagnee. The patients had had migraine for at least 2 years. In the second group (Group 11) we investigated the EEGs of 9 1 epileptic children ( 6 1 boys, 30 girls), aged 4 to 15 years patients after three years of anticonvulsive medication. They had epilepsies of unknown origin: 46 of then having a generalized, 45 a partial idiopathic epilepsy. Each patient is represented by one EEG. Results of the EEG analysis were compared with those of a control group of 96 healthy children, 4 to 17 years old (47 boys, 49 girls) (2). The EEGs were registered in a symptom-free period, at rest, eyes closed, while the proband was awake. Spectral analysis was performed with four leads (C3, C4, 01, 02) of monopolar EEG records, which were free from artifacts and paroxysmal discharges. Relative power concerning the conventional frequency bands were computed for every lead within the

In 34 children with phenylketonuria (PKU) treated early the prognostic value of the age on institution of the diet (within the first 3 months of life) and of the quality of dietary treatment was determined in two different ways: 1) following intelligence closely (IQ) and (2) evaluating the EEG development up to their 12th (n=34) and 15th (n=18) years of life as appropriate. In general, IQ scores were found to be normal from the 4th–15th years of life. In our group of patients there was no effect on the IQ of the timing of diet onset. Children with “strict” dietary control showed a significantly higher IQ than those with “loose” control. One hundred and fifty-four EEGs (10/20 system, awake with eyes closed) were recorded at intervals of 2 years and conventionally evaluated. The development of alpha-activity was found to be normal. Beta-activity was enhanced. Abnormal EEG findings like general slowing and generalized paroxysmal activity (GPA) with or without spikes were more frequent in children with PKU than in controls, with the exception of focal abnormalities. EEG abnormalities increased with advancing age independently of IQ development and showed no relation to either the age at the onset nor the quality of dietary treatment.

Thirteen children with acute lymphoblastic leukemia (ALL) were investigated before and during cytotoxic therapy. EEG findings were correlated with the clinical course and the therapy protocol and compared with normal data obtained from 295 healthy children. Frequency analysis of the background activity of the EEG revealed an initial slowing of the background activity prior to therapy and further slowing each time a combination of vincristine (VCR), daunorubicin (DAU) or adriblastine (ADR), prednisone (PRED), and L-asparaginase (L-ASP) was administered. The slowing of the background activity correlated only with the administration of these drugs. DAU, ADR, and PRED are not known to influence the EEG; therefore, VCR and L-ASP remain the primary candidates responsible for the central nervous system alteration.

I N T R O D U C T I O N I n p a t i e n t s w i t h m i g r a i n e or o t h e r h e a d a c h e w i t h o u t r e c o g n i z e d p r i m a r y d i s e a s e , E E G a b n o r m a l i t i e s h a v e o f t e n b e e n r e p o r t e d . I n t e r i c t a l E E G a b n o r m a l i t i e s i i avc Seen d e s c r i b e d i n a b o i i t 5 0 % o f p e d i a t r i c m i g r a i n e p a t i e n t s ( 4 ) . H o w e v e r , t h e r e h a v e b e e n f e w o b j e c t i v e EEG c r i t e r i a f o r m i g r a i n e , t h e u s e o f t h e e l e c t r o e n c e p h a l o g r a m ( E E G ) t o d i a g n o s e m i g r a i n e h a s b e e n s u g g e s t e d b e c a u s e i t i s n o n i n v a s i v e , i s r o u t i n e l y p e r f o r m e d , a n d m i g h t p r o v i d e o b j e c t i v e d i f f e r e n t i a l d i a g n o s t i c d a t a ( 7 ) . U n t i l now t h e r e h a v e b e e n o n l y a f e w r e p o r t s d e a l i n g w i t h E E G b a c k g r o u n d a c t i v i t y i n c h i l d r e n w i t h m i g r a i n e ( 2 , 3 , 6 ) . The a i m o f t h e p r e s e n t c r o s s s e c t i o n a l s t u d y i s t o i n v e s t i g a t e t h e c o m p o s i t i o n o f t h e b a c k g r o u n d a c t i v i t y i n c h i l d r e n w i t h m i g r a i n e i n s y m p t o m f r e e p e r i o d c o m p a r e d w i t h h e a l t h y c o n t r o l s .