Diaphragmatic palsy

Diaphragmatic palsy or paralysis (DP) due to phrenic nerve injury is a rare respiratory condition which may be life-threatening in newborn and young children (Affatato et al. 1988; Haller et al. 1979; de Leeuw et al. 1999). This entity was first described in 1906 in an adult (Stauffer 1979). In newborn patients in the middle of the last century, it was most often due to birth trauma. In the days of advanced neonatal and cardiac surgery, DP is mostly a complication of thoracic surgery (Greene et al. 1975; Schwartz and Filler 1978; Stauffer and Rickham 1972; Stone et al. 1987; Zhao et al. 1985). The incidence is described between 0.3 and 12.8 % and can be unilateral or bilateral (de Leeuw et al. 1999; Schwartz and Filler 1978; Kunovsky et al. 1993; van Onna et al. 1998). DP due to inflammation, neuropathic or idiopathic is rarely seen in this age group

Spatial heterogeneity in estuarine mud dynamics

The fate of mud in an estuary over an entire year was unravelled using complementary, independent, spatially explicit techniques. Sequential ERS-2 SAR and Envisat MERIS-FR data were used to derive synoptic changes in intertidal bottom mud and suspended particulate matter (SPM) in the top of the water column, respectively. These satellite data were combined with in situ measurements and with a high resolution three-dimensional cohesive sediment model, simulating mud transport, resuspension, settling and deposition under the influence of tides, wind, waves and freshwater discharge. The spatial distribution of both bottom mud and SPM as observed by in situ and satellite techniques was largely explained by modelled estuarine circulation, tidal and wind-induced variations in vertical mixing and horizontal advection. The three data sources also showed similar spring-neap and seasonal variations in SPM (all factor 1.5 to 2), but semi-diurnal tidal variations were underestimated by the model. Satellite data revealed that changes in intertidal bottom mud were spatially heterogeneous, but on average mud content doubled during summer, which was confirmed by in situ data. The model did not show such seasonal variation in bed sediment, suggesting that seasonal dynamics are not well explained by the physical factors presently implemented in the model, but may be largely attributed to other (internal) factors, including increased floc size in summer, temporal stabilisation of the sediment by microphytobenthos and a substantially lower roughness of the intertidal bed in summer as observed by the satellite. The effects of such factors on estuarine mud dynamics were evaluated.