bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative Use of Anticoagulant and Platelet-inhibiting Medications for Elective Spine Surgery: Results of a Nationwide Survey
Authors: Oberle Joachim , Grubhofer Florian , Schmid Samuel , Baschera Dominik
Published: July 2018

Background and Study Aims Perioperative use of anticoagulant and platelet-inhibiting agents by patients undergoing spine surgery poses the dilemma of increased risk of hemorrhage. We examined the standards of use for these medications and expert opinions through a nationwide survey.

Materials and Methods An online-based survey was conducted by invitation. A personal token to access the survey was sent to one representative of each neurosurgical and orthopaedic unit performing spine surgery and to all other active members of the Swiss Society of Neurosurgery and the Swiss Society of Spinal Surgery. A total of 97 e-mail invitations were sent to 19 representatives of neurosurgical or orthopaedic units and 78 registered neurosurgeons and orthopaedic surgeons who potentially perform spine surgery.

Results From February to April 2016, 40 surgeons (26 neurosurgeons, 14 orthopaedic surgeons) completed the survey (41%). Among the respondents, 55% prescribed prophylactic heparin preoperatively; depending on the procedure, 83 to 95% prescribed heparin postoperatively. Depending on the type of surgery, 23 to 48% discontinued acetylic acid preoperatively, and 80 to 87% always discontinued clopidogrel preoperatively. On average, platelet inhibition was resumed 4 ± 2.5 days postoperatively. Orthopaedic surgeons recommenced platelet inhibition earlier than neurosurgeons (p = 0.013). Anticoagulation with rivaroxaban was discontinued 3 ± 2 days before surgery. Depending on the indication, 72 to 98% of respondents temporarily replaced traditional anticoagulation therapy (vitamin K antagonists) with heparin perioperatively.

Conclusion Administration and discontinuation of anticoagulant and platelet-inhibiting medications in the perioperative setting of spinal surgery differ vastly between different units and surgeons. Recommendations from the spine surgeon societies may be helpful to develop nationwide guidelines.
Percutaneous Endoscopic Interlaminar Unilateral Ventral Dural Approach for Symptomatic Bilateral L5–S1 Herniated Nucleus Pulposus: Technical Note
Authors: Choi Sung , Adsul Nitin , Kim Ki , Kim Jeong , Chung Sung , Choi Jeong , Jang Jee , Jang Il , Oh Seong , Kim Hyeun
Published: July 2018

Background Percutaneous endoscopic lumbar diskectomy is a good treatment modality for lumbar disk herniation. However, when a patient complains of bilateral lower limb radicular pain with severe disk protrusion at the L5–S1 level, the transforaminal approach is often unable to resolve both lesions owing to anatomical limitations. It is also very difficult to resolve both lesions in an ipsilateral direction using the percutaneous interlaminar approach. We report our surgical technique and clinical results using a ventral dural approach of percutaneous endoscopic interlaminar lumbar diskectomy for L5–S1 herniated nucleus pulposus (HNP) in patients with bilateral radiculopathy due to a severe disk protrusion.

Methods Twenty-seven patients with severe L5–S1 HNP complaining of back pain and bilateral lower limb pain were included in the study. The unilateral ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy technique was used. The visual analog scale (VAS) and Macnab criteria were used for clinical evaluation. All assessments were completed 1 day before surgery, 1 week after surgery, 6 months after surgery, and at final follow-up after surgery.

Results The mean preoperative back and leg pain VAS scores decreased from 5.67 ± 0.78 and 7.81 ± 0.83 to 2.44 ± 0.58 and 2.26 ± 0.53 at 1 week, 1.78 ± 0.51 and 1.52 ± 0.58 at 6 months, and 1.56 ± 0.70 and 1.67 ± 0.96, respectively, at the final follow-up after surgery. With respect to the Macnab criteria, 51.85% of the results were excellent, 44.44% were good, and 3.70% were fair. Four cases recurred: three patients underwent conservative treatment and one patient operated with percutaneous endoscopic interlaminar lumbar diskectomy.

Conclusion According to the results of this study, the ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy in patients with L5–S1 HNP associated with bilateral lower limb pain due to a severely protruded HNP is a good option for a minimally invasive surgical approach.
Laminar Flow Induces Cell Polarity and Leads to Rearrangement of Proteoglycan Metabolism in Endothelial Cells
Authors: Grimm Johannes , Keller Ruprecht , Groot Philip G de
Published: July 2018

Bovine aortic endothelial cells in tissue culture were incubated with [35S]-sulfate to examine the pattern of proteoglycan production at various shear rates. It was observed that culturing bovine aortic endothelial cells under laminar flow changes the secretion pattern of proteoglycans to that observed in perfused organ cultures, induces polarity of secretion, down-regulates proteoglycan biosynthesis and decreases uptake of sulfate. These results indicate that surface shear is a major force influencing the endothelial cellular phenotype. The changed pattern of proteogly can release under static conditions may contribute to the anticoagulant effect of endothelial cells which is much needed when activated coagulation factors are not dispersed by flow.
The Mode of Action of Heparin in Plasma
Authors: Béguin Suzette , Lindhout Theo , Hemker H Coenraad
Published: July 2018

The influence of heparin on prothrombin conversion in plasma was estimated by measuring prothrombin disappearance with the aid of staphylocoagulase or by calculation from the thrombin generation curve, compensating for simultaneous thrombin inactivation by plasma protease inhibitors. In thromboplastin-activated plasma the effect of heparin on prothrombinase (factor Xa-factor Va-phospholipid) is negligible compared to that on thrombin probably because both the extrinsic factor X activating complex and phospholipid bound factor Xa are insensitive to AT III-heparin action. In contact-activated plasma prothrombinase generation is inhibited by heparin, because heparin lowers the ambient concentrations of thrombin so that the feedback activation of factor VIII by thrombin is diminished. Consequently, the delayed factor Xa generation causes a lag phase in prothrombinase generation. We conclude that heparin in plasma acts by its thrombin scavenging properties. No direct action on prothrombinase or on the factor X activating enzyme needs to be assumed if one takes into account the effect of thrombin depletion on thrombin-mediated feedback reactions
Antithrombin Milano, Single Amino Acid Substitution at the Reactive Site, Arg393 to Cys
Authors: Erdjument H , Lane D A , Ireland H , Di Marzo V , Panico M , Morris H R , Tripodi A , Mannucci P M
Published: July 2018

Antithrombin Milano is an unusual antithrombin variant, exhibiting an abnormal, fast moving component on crossed immunoelectrophoresis (in the absence of heparin). Antithrombin isolated from the propositus could be resolved into two peaks on anion-exchange chromatography; anti thrombin Milano peak 1 of Mr ∼60,000 which could inhibit thrombin, and antithrombin Milano peak 2 of Mr ∼120,000 which was inactive. The latter component also reacted with antisera to both antithrombin and albumin on immunoblotting. Under reducing conditions, the ∼120,000 Mr component migrated on SDS-PAGE as two distinct bands with Mr ∼60,000, one of which reacted with antiserum to antithrombin and the other (of slower mobility) of which reacted with antiserum to albumin only. These and other results established the ∼120,000 Mr component to be an inactive, disulphide-linked variant antithrombin and albumin complex. The variant antithrombin was isolated, following reduction and S-carboxy-methylation, by reverse-phase HPLC and then it was fragmented with CNBr. A major CNBr pool containing the sequence Gly339-Met423 was treated with trypsin, followed by V8 protease. The resulting peptides were analysed by fast atom bombardment mass spectrometry (Fab-MS) mapping. A peptide of molecular mass 1086, corresponding to the normal sequence Ala382-Arg393, was almost absent from the mass spectrum, but an additional peptide of mass number 1772 was present. These results are almost identical to those found in another variant antithrombin, North-wick Park (Erdjument et al., J Biol Chem, 262: 13381, 1987; Erdjument et al., J Biol Chem, 263: 5589-5593, 1988), indicating the same single amino acid substitution of Arg393 to Cys.
Normal Plasmic Cleavage of the γ-Chain Variant of “Fibrinogen Saga” with an Arg–275 to His Substitution
Authors: Yamazumi Kensuke , Matsuda Michio , Terukina Shigeharu , Onohara Shingo
Published: July 2018

We have identified a γ-Arg–275 to His substitution in an abnormal fibrinogen designated as “fibrinogen Saga” characterized by impaired fibrin monomer polymerization. By chromatofocusing chromatography, we isolated normal and abnormal fragment Dl populations separately from the plasmic-calcium digests of fibrinogen derived from the propositus, a heterozygote for the abnormality. We found that both normal and abnormal fragment D1’s were similarly protected from digestion by plasmin in the presence of calcium ions and further degraded to fragments D2 and D3 due to cleavage of the γ-chain remnant when calcium ions were replaced by chelating agents. Abnormal fragment D1 failed to inhibit both thrombin-clotting of normal fibrinogen and polymerization of normal fibrin monomer, while normal D1 exhibited marked inhibitory activities. In an aberrant peptide comprising residues γ–274–302 isolated by HPLC from the lysyl endopeptidase-digests of abnormal fragment D1, we identified a His substituting for an Arg at position 2, which corresponds to position 275 of the mutant γ-chain
5HT-Kinetics and Sensitivity of Human Blood Platelets: Variations with Age, Gender and Platelet Number
Authors: Pletscher Alfred , Fetkovska Natalia , Amstein Ruth , Ferracin Fabrizia , Regenass Martin , BÜhler Fritz R
Published: July 2018

Platelet shape change and aggregation as well as serotonin (5–hydroxytryptamine; 5HT) content in platelets, spontaneous release of 5HT, 5HT plasma levels, urinary excretion of 5–hydroxyindoleacetic acid (5HIAA) and plasma (3–thromboglobulin (β–TG) were investigated in 45 healthy subjects (27 men, 18 women). Platelets from women were more susceptible to aggregation (both by 5HT and ADP) than platelets from men. However, in men, 5HT-induced shape change and aggregation as well as plasma β–TG concentration increased with age. In men, 5HT–induced platelet aggregation correlated positively with 5HT plasma levels. An inverse relationship was found in men between platelet number on the one hand and platelet 5HT content, 5HT release, 5HT plasma levels and urinary 5HIAA excretion rates on the other hand. In all subjects 5HT-induced platelet aggregation correlated negatively with platelet number

These results indicate that age and gender must be considered in designing clinical studies on 5HT and in evaluating human platelet 5HT kinetics. The platelet number seems to be related to 5HT kinetics of platelets and their reaction to 5HT in men. An age-dependent change in the reactivity of platelets to 5HT (rather than their absolute 5HT sensitivity) may contribute to the enhanced platelet turnover and higher incidence of cardiac events in older men
Percutaneous Instrumentation of a Complex Lumbar Spine Fracture with Bilateral Pedicle Dissociation: Case Report and Technical Note
Authors: Urakov Timur , Vanni Steven , Luther Evan
Published: July 2018

Background and Study Objective Complex traumatic lumbar spine fractures are difficult to manage and typically occur in younger patients. Surgical immobilization for unstable fractures is an accepted treatment but can lead to future adjacent-level disease. Furthermore, large variations in fracture morphology create significant difficulties when attempting fixation. Therefore, a surgical approach that considers both long-term outcomes and fracture type is of utmost importance. We present a novel technique for percutaneous fixation without interbody or posterolateral fusion in a young patient with bilateral pedicle dissociations and an acute-onset incomplete neurologic deficit.

Case Description A 20-year-old man involved in a motorcycle accident presented with unilateral right lower extremity paresis and sensory loss with intact rectal tone and no saddle anesthesia. Lumbar computed tomography (CT) demonstrated L2 and L3 fractures associated with bilateral pedicle dislocations. Lumbar magnetic resonance imaging showed draping of the conus medullaris/cauda equina anteriorly over the kyphotic deformity at L2 with minimal associated canal stenosis at L2 and L3. He was treated with emergent percutaneous fixation of the fracture segment without interbody or posterolateral fusion. Decompression was not performed because of the negligible amount of canal stenosis and high likelihood of cerebrospinal fluid leakage due to dural tears from the fractures. Surgical fixation of the L2 vertebra was achieved by cannulating the left pedicle with an oversized tap while holding the right pedicle in place with a normal tap and then driving screws into the left and right pedicles, respectively, thus reducing the free-floating fracture segment. At 18 months after surgery, a follow-up CT demonstrated good cortication across the prior pedicle fractures, and the instrumentation was removed without any obvious signs of instability or disruption of the alignment at the thoracolumbar junction.

Conclusion We present a novel technique for percutaneous reduction and fixation of bilateral pedicle fractures with significant dissociation from the vertebral body, associated neural compression from the kyphotic deformity, and minimal spinal canal stenosis. Furthermore, we argue that early fixation and reduction of the fracture prevented irreversible neurologic compromise, and the absence of interbody or posterolateral fusion ultimately preserved the spinal mobility of the patient once the hardware was removed.
Sporadic Schwannomatosis: A Systematic Review Following the 2005 Consensus Statement
Authors: Victor Jan , Poujade Thibault , Hollevoet Nadine , Chick Gregoire
Published: July 2018

Aims To identify the frequency of reports of sporadic schwannomatosis, the types of patients affected, and the nerves affected.

Patients and Methods We identified all case reports and case series that reported on patients with sporadic schwannomatosis according to established criteria.

Results The initial search yielded 1,597 studies, of which 15 were included. A total of 38 of 55 individuals met the inclusion criteria. The mean age of the patients was 48 years; 41% were male. Thirty-three patients had peripheral nerve tumors, and 17 had spinal tumors. Twelve had tumors in both locations. Tumor distribution was unilateral in 25 of 30 cases (83.3%) and segmental (limited to one limb or five or fewer contiguous segments of the spine) in 28 of 38 cases (73.7%).

Conclusion This systematic review quantified the number of individuals who meet the criteria for sporadic schwannomatosis and better described this population to facilitate the classification of neurofibromatosis in regard to the 2005 consensus statement. Unilateral or segmental distribution of nerve tumors are key aspects when dealing with multiple noncutaneous schwannomas without involvement of the vestibular nerve.
Calvian Endo-pen: New Coagulation Forceps for Endoscopic Endonasal Transsphenoidal Surgery
Authors: Rosahl Steffen , Kellner Geralf , Gerlach Rüdiger
Published: July 2018

Objective Over the past few years bipolar electrocoagulation techniques in neurosurgery have been continually improving. However, limited access during endoscopic endonasal transsphenoidal surgery (EETS) for central skull base pathologies and the requirement of very precise coagulation in that dedicated anatomical area requires further refinement of bipolar coagulation instruments. We describe our experience (effectiveness of coagulation, intraoperative handling, and the use as a dissecting tool) with a new type of coagulation forceps, the Calvian endo-pen (Sutter Medizintechnik, Freiburg, Germany) during EETS.

Method From June to August 2015, 12 patients with central skull base lesions (9 with a pituitary adenoma and 1 each with epidermoid, hemangioma, and juvenile angiofibroma) were operated on with the Calvian endo-pen.

Results The application of the Calvian endo-pen was feasible in all cases. The angled thin tips proved to be very effective and precise for soft tissue coagulation to achieve hemostasis. Even very small vessels could be occluded selectively. It was also helpful for outward dissection in separating normal from tumor tissue.

Conclusion The use of the Calvian endo-pen is safe and effective during EETS for central skull base pathologies. Its ease in intraoperative handling (maneuverability, cleaning) and precise coagulation makes it a promising instrument for EETS.
Persistent Iliosacral Joint Syndrome following Instrumentation to the Sacropelvis in Patients with Adult Spinal Deformity
Authors: Diesing Daniela , Franke Joerg , Tschoeke Sven , Schultheiß Rolf , Scheufler Kai
Published: July 2018

Background and Objective Persistent sacroiliac joint syndrome (PSIJS) may complicate adult spinal deformity surgery (ASDS). This study assesses the relationship between clinical/morphometric parameters and PSIJS following ASDS including pelvic fixation and the therapeutic efficacy of secondary iliosacral fusion (ISF).

Methods Perioperative health-related quality of life (HRQOL) outcomes (Oswestry Disability Index, Short Form 12-item health survey, version 2 scores) at 6, 12, and 24 months, and radiographic studies were analyzed retrospectively in a cohort of 71 consecutive patients undergoing ASDS. PSIJS was confirmed in nine individuals (12.7%) by placebo-controlled dual sacroiliac joint (SIJ) blocks. The relationships between global and regional spinopelvic morphometry, PSIJS, and HRQOL outcomes were assessed by logistic regression and receiver operating characteristic curve (ROC) analysis.

Results PSIJS, independently causing significantly reduced improvement in HRQOL scores (p < 0.001) 6 months postoperatively, warranted secondary ISF in nine patients (12.7%) within 12 months of index surgery, without evidence of progressive SIJ arthrosis, pseudarthrosis, or hardware issues. Eight of nine patients undergoing secondary ISF reported≥ 70% pain reduction at 24 months. Logistic regression/ROC analysis revealed a close association between PSIJS and nonharmonious postoperative L4–S1 fractional lordosis (p < 0.0001), pelvic incidence angle > 53 degrees, hip arthrosis, and preexistent advanced SIJ arthrosis (p < 0.01).

Conclusion PSIJS may negatively impact the clinical outcome of ASDS. Recurrent preoperative SIJ syndrome requiring interventional treatment, preexisting hip and SIJ arthrosis, insufficient restoration of L4–S1 fractional lordosis, and high pelvic incidence predispose to PSIJS. PSIJS may potentially be avoided by restoring physiologic lumbosacral geometry and S2 sacral alar-iliac screw fixation during index surgery. Secondary ISF appears to be effective in reducing pain and physical impairment due to PSIJS.
Metastasis from Intracranial Mesenchymal Chondrosarcoma: Report of a Rare Case
Authors: Singh Daljit , Saran Ravindra , Singh Hukum , Srivastava Arvind , Jagetia Anita , Dutta Gautam
Published: July 2018

Chondrosarcoma is a rare malignant tumor originating from cartilaginous tissue with a tendency to localize in the epiphysis of long and pelvic bones. Only 7% of all chondrosarcomas originate in the craniocervical region. Metastasis from intracranial chondrosarcoma is extremely rare with only two previously reported cases. We report on a young patient with intracranial chondrosarcoma who presented with extracranial metastasis 2 years after surgical excision of the primary lesion. Gross total excision combined with radiotherapy so far has led to a favorable outcome.
Langerhans Cell Histiocytosis of the Adult Cervical Spine: A Case Report and Literature Review
Authors: Hewer Ekkehard , Ulrich Christian , Schär Ralph
Published: July 2018

A 36-year-old man was diagnosed with Langerhans cell histiocytosis (LCH) of the cervical spine with a unifocal expansive osteolytic lesion of C4. The surgical management with a 2-year follow-up and a review of the literature on LCH of the cervical spine are presented. Although a rare condition, LCH is an important differential diagnosis of any osteolytic lesion in the cervical spine with localized pain in a young adult patient. Review of the literature suggests a higher prevalence of LCH lesions affecting the cervical spine as compared with the thoracic or lumbar spine than historically reported.
Vertebral Arteriovenous Fistula: A Rare Complication Following Transpedicular Occipitocervical Fixation in a Patient with Atlantoaxial Dislocation
Authors: Li Zhixiao , Li Ming , Qian Rongjun
Published: July 2018

Vertebral arteriovenous fistula (AVF), a complication of a vertebral artery injury (VAI), is a rare but serious complication of upper cervical spine fixation surgery. We report a case of a 59-year-old female patient who had a vertebral AVF following transpedicular occipitocervical fixation surgery. Endovascular embolization of the AVF was successfully performed using ethylene vinyl alcohol. From this case we learned that preoperative evaluation of the course of the vertebral artery is necessary, and vertebral artery embolism is an effective and safe method to treat vertebral AVF after proof of a patent second vertebral artery.
Mpl-Ligand and the Regulation of Megakaryocytopoiesis
Authors: Debili Najet , Villeval J.-L. , Vainchenker W. , Wendling Françoise , Cohen-Solal Karine
Published: July 2018

After 35 years of research, the physiological regulator of platelet production has been isolated and its gene cloned. This discovery originates from studies performed with the myeloproliferative leukaemia virus (MPLV), a murine retrovirus which induces an acute myeloproliferative syndrome in adult mice. MPLV carries the v-mpl oncogene in its genome. This oncogene corresponds to a truncated form of the c-mpl proto-oncogene. c-mpl encodes a cytokine receptor (Mpl-R) belonging to the hematopoietin receptor superfamily. Among the hematopoietic cell lineages, Mpl-R is preferentially expressed on late MK progenitors, megakaryocytes and platelets. The ligand for Mpl-R, called Mpl-L, thrombopoietin (TPO), megakaryocyte growth and development factor (MGDF) or megapoietin, is a gly-cosylated hormone of 322 amino acids in man which comprises two domains; the N-terminus domain shares 50% similarity with erythropoietin and is respon-sible for the biological activity; the C-terminus part is required for secretion. In vitro Mpl-L is capable of directly inducing both the proliferation of MK progenitors and the terminal maturation of megakaryocytes. MK grown in vitro in presence of Mpl-L can shed platelets. Notwithstanding its major action on megakaryocytopoiesis and thrombocytopoiesis, Mpl-L also potentiates the action of other cytokines on early hematopoietic progenitors. The plasma level of Mpl-L inversely correlates with the platelet and MK mass. However, in the two major organs (liver and kidney) which synthesize Mpl-L, there is no regulation at the transcription level of the synthesis of Mpl-L by the platelet demand, suggesting that regulation of the plasma level occurs by uptake and consumption at the level of platelets. A deregulation of Mpl-L synthesis obtained by infecting, murine hematopoietic stem cells by a retrovirus containing the coding sequence for Mpl-L induces a disease which has many common features with idiopathic myelofibrosis in man. Therefore, Mpl-L might be a very useful therapeutical cytokine to treat thrombocytopenia, but these data emphasize that chronic exposure to Mpl-L may lead to a severe disease. Thus, human clinical trials will require well controlled administration protocols.
Spontane Faktor-VIII-Inhibitoren
Authors: Lechner K. , Huhmann Iris
Published: July 2018

Als spontane (nichthämophile) Faktor-Vlll-lnhibitoren werden Antikörper gegen Faktor VIII bei zuvor gerinnungsnormalen Patienten bezeichnet. Meist ist der F-Vlll-Mangel schwer und dementsprechend die Blutungsneigung ausgeprägt. Die Pathogenese ist heterogen. Laborchemisch findet sich typischerweise eine verlängerte aPTT und ein isolierter F-Vlll-Mangel. Die Antikörper sind polyklonal und zumeist Typ-Il-Inhibitoren. Die Therapie gliedert sich in die Beherrschung der akuten Blutung (hochkonzentrierte humane F-Vlll-Konzentrate, porciner F VIII, aktivierte Prothrombinkomplexpräparate, rekombinanter F Vlla, evtl. zusätzlich Plasmapherese und Immunadsorption - zur Reduktion des Inhibitors) und in die Langzeitreduktion des Titers mit Immunsuppressiva.
Erworbene Faktor-V-Inhibitoren
Authors: Tribl B. , Lechner K. , Knöbl P.
Published: July 2018

Erworbene Faktor-V-Inhibitoren sind eine seltene Gerinnungsstörung. Weltweit wurden bisher 72 Fälle publiziert. Die Inzidenz scheint jedoch zuzunehmen, was wahrscheinlich auf den gehäuften Einsatz von Fibrinklebern zurückzuführen ist. Diese Metaanalyse untersucht die prädiponierenden Faktoren, die Pathogenese, diagnostische Methoden, klinisches Erscheinungsbild, therapeutische Möglichkeiten und den langfristigen Verlauf aller bisher publizierten Fälle von Faktor-V-Inhibitoren.
Therapieergebnisse der chronischen Autoimmunthrombozytopenie bei Erwachsenen
Authors: Barz D. , Reinhardt K. M. , Freund M. , Anders O.
Published: July 2018

Zusammmenfassung

In einer retrospektiven Untersuchung wurden die klinischen Befunde und der Therapieerfolg von 131 Patienten mit chronischer Autoimmunthrombozytopenie (97 Frauen, Altersmedian 29 Jahre, und 34 Männer, Altersmedian 32 Jahre, Range 20 bis 80 Jahre), die in einem Zeitraum von 36 Jahren (1960 bis 1995) be-handelt wurden, ermittelt. Es wurden die therapeutische Ansprechrate, die Re-misssionsrate und die Langzeiterfolgsrate nach verschiedenen Therapieregimen der chronischen Autoimmunthrombozytopenie erfaßt.

Die Splenektomie ergab die besten Ergebnisse mit einer Ansprechrate von 90% und einer Langzeiterfolgsrate von 74%. Die Ansprechrate und die Langzeiterfolgsrate betrug nach der Behandlung mit Prednisolon 69% und 16%, nach Azathioprin 52% und 27%, nach Vinchstin 36% und 10%. Mit Ascorbinsäure wurde keine Remission erzielt. Nach der Therapie mit Prednisolon, nach Splenektomie und nach immunsuppressiver Behandlung erreichten 110 Patienten (84%) eine Remission. 21 Patienten (16%) sprachen nicht mit einem dauerhaften Thrombozytenanstieg an. Die Therapie der refraktären chronischen Autoimmunthrombozytopenie mit Blutungskomplikationen ist heute noch ein therapeutisch mitunter schwierig zu lösendes Problem.
Gene Polymorphisms in FAS (Rs3740286 and Rs4064) Are Involved in Endometriosis Development in Brazilian Women, but not those in CASP8 (rs13416436 and rs2037815)
Authors: Pissetti Cristina Wide , Tanaka Sarah Cristina Sato Vaz , Hortolani Andrezza Cristina Cancian , Marqui Alessandra Bernadete Trovó de
Published: July 2018

Objective The present study aims to investigate the association between caspase-8 (CASP8) (rs13416436 and rs2037815) and Fas cell surface death receptor (FAS) (rs3740286 and rs4064) polymorphisms with endometriosis in Brazilian women.

Methods In the present case-control study, 45 women with a diagnosis of endometriosis and 78 normal healthy women as a control group were included. The genotyping was determined by real-time polymerase chain reaction (PCR) with Taqman hydrolysis probes (Thermo Fisher Scientific, Darmstadt, Germany). Genotypic and allelic frequencies were analyzed using Chi-squared (χ2) test. In order to determine the inheritance models and haplotypes ,SNPStats (Institut Català d'Oncologia, Barcelona, Spain) was used. Levels of 5% (p = 0.05) were considered statistically significant.

Results No significant difference was observed in genotypic or allelic frequencies between control and endometriosis groups for rs13416436 and rs2037815 (CASP8 gene). On the other hand, a significant difference between rs3740286 and rs4064 (FAS gene) was found. Regarding polymorphisms in the FAS gene, a statistically significant difference was found in co-dominant and dominant models. Only the haplotype containing the rs3740286A and rs4064G alleles in the FAS gene were statistically significant.

Conclusion The polymorphisms in the CASP8 gene were not associated with endometriosis. The results indicate an association between FAS gene polymorphisms and the risk of developing endometriosis.
Psychosomatische und psychische Erkrankungen bei Musikern
Authors: Spahn C.
Published: July 2018

Musizieren ist modellhaft für das Zusammenwirken von Körper, Psyche und Geist. Störungen der Musikausübung wirken sich demnach zwangsläufig auf allen drei Ebenen aus. Somit sind Behandler von Musikerpatienten in starkem Maße mit psychosomatischen Aspekten konfrontiert. Darüber hinaus sind Musiker als Personen in leidenschaftlicher Weise mit der Musik verbunden, sodass Störungen der Musikausübung sie als gesamte Person, mit “Leib und Seele” erfassen. Im engeren Sinne gehören die Auftrittsangst und die somatoforme Schmerzstörung zu den häufigen psychosomatischen musikerspezifischen Erkrankungen.

Die Auftrittsangst stellt eine Unterform der sozialen Phobie dar ist und ist abzugrenzen vom nicht pathologischen Lampenfieber, welches regelhaft bei Musikern auftritt und Teil der Berufsrealität ist. Die Behandlung der Auftrittsangst sollte nach einem multimodalen Behandlungsmodell mit unterschiedlichen Therapieansätzen – wie kognitiv-verhaltenstherapeutischen, tiefenpsychologischen, körperorientierten –, Entspannungsverfahren, mentalen Techniken sowie Bühnenexposition und Video-Feedback erfolgen. Die somatoforme Schmerzstörung ist Ausdruck zugrundeliegender, häufig musikbezogener Konflikte.
Musik in der Neurorehabilitation nach einem Schlaganfall
Authors: Evers S. , Speth F.
Published: July 2018

In diesem Übersichtsartikel wird der Stand der Forschung zu Effekten und Wirkweisen musiktherapeutischer Anwendungen in der Neurorehabilitation mit einem Fokus auf Schlaganfallrehabilitation dargestellt. Daran anknüpfend werden offene Untersuchungsfelder beschrieben, die sich aus dem zunehmenden Einsatz von robotergestützten Systemen, die klangliche Umgebungen nutzen, ergeben.
Musik in der Schmerztherapie
Authors: Spintge R.
Published: July 2018

Musik in der Schmerztherapie wird in diesem Beitrag anhand des Konzepts der Musik-Medizin bzw. der anxiolytischen Musik dargestellt. Dabei handelt es sich überwiegend um den therapeutischen Einsatz bei operativen Verfahren. Der Beitrag spricht sich für einen evidenzbasierten Gebrauch der Musik in der Schmerztherapie aus. Beispielhaft werden die schmerztherapeutischen Konzepte der Sportklinik Hellersen dargestellt. Auch die klinischen Studien zum Einsatz von Musik in der Schmerztherapie werden aufgelistet.
Research on aging parameters of XLPE cable based on isothermal relaxation current
Authors: Zhao Ai-xuan , Xu Long , Zhang Xing , Deng Jun-bo , Zhang Guan-Jun , Zhao Xue-Feng
Published: July 2018

Dielectric response is closely related to the aging status of XLPE cables, and the isothermal relaxation current (IRC) has been applied to find out the change trend of cable insulation as a non-destructive method. In this paper, 4 groups of XLPE cable samples (16 cables in total) are artificially acceleratedly aged with different time interval at 120, 140 and 160°C, respectively, and their IRC curves are measured by a micro-current device. The results show that with the increasing aging time, IRC curves decrease slower and the absolute values of steady current become larger. In order to quantify the aging characteristics of XLPE cables, the trap parameters calculation theory is employed to work out the peak trap level of different polarization types. The experiment results show that the peak trap level of bulk polarization (type 1) remains stable and is around 0.76eV which is considered to be independent of aging degree. As the aging time increases, the peak trap level of amorphous crystalline relaxation (type 2), which is from 0.785eV to 0.82eV, increases at low temperature (120°C) due to the breaking of molecular chain and decreases at high temperature (more than 140°C) due to the over cross-linking. The peak trap level of impurities interface relaxation (type 3) is highly influenced by aging temperature, which is most sensitive to the aging degree of power cable. It is considered that IRC can be used as a practical way to judge cable insulation in the future.
Roll-to-roll fabrication of hierarchical superhydrophobic surfaces
Authors: Khandavalli Sunilkumar , Rogers Patrick , Rothstein Jonathan P.
Published: July 2018

In this letter, we report a roll-to-roll fabrication method to develop a hierarchical nanopatterned superhydrophobic surface. The hierarchical pattern includes a primary micropattern with an overlayed secondary nanopattern. The primary pattern of 15–30 μm length scales was fabricated through UV nanoimprint lithography. The secondary nanopattern of 20 nm size was generated through a subsequent scalable spray coating with hydrophobic silica nanoparticles to create a nanoscale random roughness over the primary pattern. The secondary nanocoating over the primary pattern resulted in an enhanced contact angle resulting in superhydrophobicity and reduced hysteresis. Freezing droplet measurements performed have demonstrated a fivefold increase in the time for the droplet to freeze on a superhydrophobic surface compared to a primary hydrophobic structure.
In-situ observation of instability of a crystal–melt interface during the directional growth of pure antimony
Authors: Shiga Keiji , Billaut Léo , Maeda Kensaku , Morito Haruhiko , Fujiwara Kozo
Published: July 2018

The instability of a crystal–melt interface during the directional growth of pure antimony was studied using an in-situ observation technique. The morphology of the crystal–melt interface was planar at a low growth velocity, while the interface transitioned to wavy and then zig-zag faceted at 60 μm s−1. Calculating the thermal field at the crystal–melt interface using a diffusion equation showed that the temperature gradient in the melt becomes negative when the moving velocity of the interface is higher than 52 μm s−1. These results demonstrate that perturbations introduced into the planar interface are amplified by a negative temperature gradient and these amplified perturbations result in zig-zag facets.
Strides in resolution and sensitivity bring solid-state NMR technology closer to mainstream use
Authors: Liebendorfer Adam
Published: July 2018

New techniques, including combining solid-state NMR with computational methods and dynamic nuclear polarization, look to boost their ability to determine new material structure information.
Lithography leads to highest resolution yet in magnetic atomic trap lattices
Authors: Liebendorfer Adam
Published: July 2018

Molecular beam epitaxy and electron beam lithography allow for lattice resolutions finer than wavelengths of visible light to be used in quantum simulation experiments.
Scoping review of claimants’ experiences within Australian workers’ compensation systems
Authors: Dean Anne-Marie , Matthewson Mandy , Buultjens Melissa , Murphy Gregory
Published: July 2018

Objective The aim of this scoping review was to map the literature on the lived experiences of injured workers in Australia in order to better understand the factors that inhibit the transition back to work and improved health. The ultimate aim of the study was to identify areas for further research into workers’ compensation systems and practices that are associated with improved occupational rehabilitation outcomes. Methods PubMed, ProQuest, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for eligible articles published in English in peer-reviewed journals from 2001 to 2017. Narrative data synthesis was used to analyse the data collected from included articles. Results Twelve articles examining injured workers’ experiences within Australian workers’ compensation systems were identified. Injured workers reported similar experiences across states and territories in Australia. Four common themes and three subthemes were noted, namely: (1) relationships and interactions; (2) injured workers’ perceptions (subthemes: mental health effects, social effects and financial effects); (3) the workers’ compensation process; and (4) independent medical evaluations. Conclusions There are common difficulties that injured workers experience within Australian workers’ compensation systems that are reported to impede rehabilitation and return to work. A less harmful, more cooperative approach to worker rehabilitation and compensation is needed. What is known about the topic? Different workers’ compensation systems exist throughout Australia. Little is known about injured workers’ perceptions of their experiences within these systems in Australia and whether these experiences are similar or different across systems. What does this paper add? This scoping review synthesises available evidence showing that injured workers report negative experiences of workers’ compensation systems, and that this experience is similar across the different systems. This review also identified a clear need for future research on workers’ compensation systems in order to promote evidence-based approaches to best support the occupational rehabilitation of injured workers. What are the implications for practitioners? Evidence suggests a more holistic, biopsychosocial approach is required by practitioners when facilitating an injured worker’s recovery and return to work. This approach is also vital when considering legislative reforms, such as workers’ compensation systems, processes and practices.
Sabellaria reefs as reservoirs of preferential species: the case of Eulalia ornata Saint-Joseph, 1888 (Annelida: Phyllodocidae)
Authors: Bonifazi Andrea , Ventura Daniele , Mancini Emanuele
Published: July 2018

Sabellaria alveolata is a widespread coastal engineer species that builds sandy bioconstructions in coastal marine habitats, which host a rich associated fauna. Some of these associated species are quite common on rocky or sandy substrates, but few taxa are strictly linked to Sabellaria reefs. In this study, we report, for the first time, the phyllodocid worm Eulalia ornata in the Tyrrhenian Sea and highlight its high-fidelity link with S. alveolata bioconstructions. Despite being included in the European Red List of Habitats, little is known about Sabellaria reefs, their associated fauna and their ecological role in the Mediterranean Sea. For these reasons, studies aiming at improving our knowledge of S. alveolata reefs and their associated fauna can be regarded as an important step towards more appropriate management plans for sensitive coastal habitats.
Devil women
Authors: Fox Samantha , Hogg Carolyn J. , Grueber Catherine E. , Belov Katherine
Published: July 2018

The Tasmanian devil, an iconic carnivorous marsupial, is at risk of extinction due to a contagious cancer called devil facial tumour disease. Saving any species from extinction requires strong partnerships between government agencies, zoo bodies and academia. The Devil Tools & Tech project brought these groups together under a single banner to achieve a common goal. The project has strong leadership from women. Here we tell our personal stories as to how we came to be involved in saving the devil and emphasise the importance of strong networks for women to reach their full potential.
Woodland birds and rural towns: artificial clutch survival in fragmented Box-Ironbark forests
Authors: Meney B. , Cunningham S. , Weston M.A. , Whisson D.A.
Published: July 2018

Woodland birds are declining throughout the agricultural landscapes of south-eastern Australia, but the specific mechanisms driving these declines remain unclear. Reproductive failure via clutch depredation could conceivably contribute to these declines. Although site-scale habitat may influence the risk of clutch failure, larger-scale influences, such as whether a landscape contains a rural town or not (‘landscape type’), may also play a role. This study monitored artificial open-cup nests deployed in three pairs of the two landscape types and: 1) indexed clutch survival and predator assemblage; and 2) determined if clutch survival was influenced by landscape type and/or local habitat characteristics. High levels of clutch depredation were observed in both landscape types and for all landscapes, with no evidence to suggest that landscape type or habitat characteristics influenced clutch survival or the time-to-first-predator visit. Predator assemblage also was consistent between landscape types. Generalist avian predators were the most common egg predators. Such egg predators may be ubiquitous throughout the fragmented Box-Ironbark woodlands of south-eastern Australia.
Examining dispatching practices for Interagency Hotshot Crews to reduce seasonal travel distance and manage fatigue
Authors: Belval Erin J. , Calkin David E. , Wei Yu , Stonesifer Crystal S. , Thompson Matthew P. , Masarie Alex
Published: July 2018

Interagency Hotshot Crews (IHCs) are a crucial firefighting suppression resource in the United States. These crews travel substantial distances each year and work long and arduous assignments that can cause accumulated fatigue. Current dispatching practices for these crews are supposed to send the closest resource while adhering to existing fatigue-management policies. In this research, we designed a simulation process that repeatedly implements an optimisation model to assign crews to suppression requests. This study examines the potential effects of using an optimisation approach to shorten seasonal crew travel distances and mitigate fatigue. We also examine the potential benefits of coordinating crew-dispatch decisions to meet multiple requests. Results indicate there is substantial room for improvement in reducing travel distances while still balancing crew fatigue; coordinating crew dispatching for multiple requests can increase the assignment efficiency, particularly when both fatigue mitigation and travel distances are jointly optimised. This research indicates implementing an optimisation model for dispatching IHCs is promising.
Effect of friction stir welding tool design on welding thermal efficiency
Authors: Li Hongjun , Gao Jian , Li Qinchuan , Galloway Alexander , Toumpis Athanasios
Published: July 2018

Enhancing the heat transfer to the material being welded, instead of the tool, will improve the welding thermal efficiency. Friction stir welding of 5 mm thick 6061-T6 aluminium alloy plates was carried out with the newly produced tools. It was found that the thermal efficiency increased by 4.2% using a tool with all the new design features (i.e. hollow, fluted and thermally insulated) compared to the conventional tool for aluminium welding. To assess the benefits of the new tool design on steel FSW, a finite element numerical simulation study was undertaken. In this case, the simulation results yielded a welding thermal efficiency increase of 10–15% using a thermally coated tool, thereby offering potential productivity gains.
Towards attaining dissimilar lap joint of CuCrZr alloy and 316L stainless steel using friction stir welding
Authors: Sahlot Pankaj , Nene Saurabh S. , Frank Michael , Mishra Rajiv S. , Arora Amit
Published: July 2018

CuCrZr alloy (Cu-0.8wt-%Cr-0.1wt-%Zr) and 316L stainless steel (Fe-0.03wt-%C-16wt-%Cr-10wt-%Ni) plates were successfully friction stir lap welded resulting in significant mechanical mixing of the two matrix elements, Cu and Fe, in the stir zone. The severe mixing not only led to improved load bearing response but also leads to form Cu-rich and Fe-rich regions in the weld nugget. The formation of these phases governs the failure mechanism of the joint. Tensile properties of the weld showed promising response when compared with joints made for the similar alloy pair by other welding techniques. This suggests strong feasibility of applying FSW for joining Cu and steel for nuclear applications.
The impact of exercise training on the lipid peroxidation metabolomic profile and respiratory infection risk in older adults
Authors: Silva Diana , Arend Eduardo , Rocha Silvia M. , Rudnitskaya Alisa , Delgado Luís , Moreira André , Carvalho Joana
Published: July 2018

Aging is associated with oxidative stress that may increase susceptibility to respiratory infections (RIs). We aimed to assess the impact of exercise training on the risk of RIs in older adults and on a targeted metabolomic profile of stress oxidative lipid peroxidation‐related metabolites. Methods: In an 8‐month clinical trial, 38 participants over 60 years of age were allocated to an exercise group (EG), in which participants underwent 90‐min training sessions three times/week(n = 20), or a control group (CG), in which participants maintained daily physical activities(n = 18). Daily respiratory symptoms and RIs number and severity were collected. Serum by‐products were assessed by comprehensive two‐dimensional gas chromatography coupled to mass spectrometry with time of flight analyzer. Serum metabolomic profiling comprised 76 metabolites (alcohols, aldehydes, alkanes, and ketones). Principal components analysis and ANOVA‐simultaneous component analysis were used to evaluate the metabolomic profile change. Results: The odds ratio of RIs for the EG was 2.0 CI 95% [0.2;25]. The incidence of RIs was 47% [23;70] in the EG vs. 44%[12;77] in the CG. The metabolomic profiling showed that alkanes and aldehydes classes differed between the EG and the CG before and after intervention. A calibration model showed a relation between the metabolites from four main classes (ketones, alcohols, alkanes and aldehydes) and the prediction of the number of RIs. Conclusion: Moderate exercise training, in older adults, compared with no exercise in controls, did not show a difference in the risk of RIs. A pattern of lipid peroxidation was associated with the number of RIs.
Ooplasmic flow cooperates with transport and anchorage in Drosophila oocyte posterior determination
Authors: Lu Wen , Lakonishok Margot , Serpinskaya Anna S. , Kirchenbüechler David , Ling Shuo-Chien , Gelfand Vladimir I.
Published: July 2018

The posterior determination of the Drosophila melanogaster embryo is defined by the posterior localization of oskar (osk) mRNA in the oocyte. Defects of its localization result in a lack of germ cells and failure of abdomen specification. A microtubule motor kinesin-1 is essential for osk mRNA posterior localization. Because kinesin-1 is required for two essential functions in the oocyte—transport along microtubules and cytoplasmic streaming—it is unclear how individual kinesin-1 activities contribute to the posterior determination. We examined Staufen, an RNA-binding protein that is colocalized with osk mRNA, as a proxy of posterior determination, and we used mutants that either inhibit kinesin-driven transport along microtubules or cytoplasmic streaming. We demonstrated that late-stage streaming is partially redundant with early-stage transport along microtubules for Staufen posterior localization. Additionally, an actin motor, myosin V, is required for the Staufen anchoring to the actin cortex. We propose a model whereby initial kinesin-driven transport, subsequent kinesin-driven streaming, and myosin V–based cortical retention cooperate in posterior determination.