bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Colloid Cysts: Case Report and Literature Review
Authors: Bettag Martin , Rizk Ahmed
Published: July 2018

Background and Study Aim Colloid cysts usually occur in the anterior third ventricle at the level of the foramina of Monro. Colloid cysts may extend from the third toward the lateral ventricle. We present a rare case of multiple intraventricular colloid cysts, two of which were in the third ventricle and one in the lateral ventricle.

Clinical Description A 40-year-old female patient presented with three intraventricular cystic lesions: one cyst in the typical localization in the anterior rostral third ventricle, another cyst behind it in the same (third) ventricle, and a larger bulging cyst in the right lateral ventricle. A bilateral ventriculoperitoneal shunt had been inserted 26 years before to treat hydrocephalus. All three cysts had different magnetic resonance imaging (MRI) signal characteristics. We removed the cysts through an endoscopically assisted right transcortical transventricular microsurgical approach, using the right ventricular catheter as a guide to the lateral ventricle. After removal of the lateral ventricular cyst, we observed that the foramen of Monro was greatly enlarged (most likely as a result of the large cyst), which allowed us to remove the cysts in the third ventricle. During surgery, the cysts were found to have different consistencies. MRI 2 years following surgery showed complete removal and no hydrocephalus. The patient had no symptoms, and the clinical examinations were normal.

Conclusions Colloid cysts may become large and extend to the lateral ventricle, especially in patients treated with ventriculoperitoneal shunts. Studying the relevant pathoanatomy of these cysts is very important for preoperative planning including the choice of surgical approach.
Percutaneous Pedicle-Lengthening Osteotomy in Minimal Invasive Spinal Surgery to Treat Degenerative Lumbar Spinal Stenosis: A Single-Center Preliminary Experience
Authors: Basile Luigi , Gulì Carlo , Banco Aurelia , Giordano Giovanna , Giugno Antonella , Graziano Francesca , Giammalva Roberto , Iacopino Domenico , Maugeri Rosario
Published: July 2018

Background Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal due to spinal degeneration, and its main clinical symptom is neurogenic claudication. Surgical treatment is pursued for patients who do not improve with conservative care. Patients with symptomatic LSS who also have significant medical comorbidities, although clearly in need of intervention, are unattractive candidates for traditional open lumbar decompressive procedures. Thus it is important to explore minimally invasive surgical techniques to treat select patients with LSS.

Methods This retrospective case series evaluated the clinical and radiographic outcomes of a new minimally invasive procedure to treat LSS: pedicle-lengthening osteotomy using the ALTUM system ((Innovative Surgical Designs, Inc., Bloomington, Indiana, United States). Peri- and postoperative demographic and radiographic data were collected from a clinical series of seven patients with moderate LSS who were > 60 years of age. Clinical outcome was evaluated using visual analog scale (VAS) scores and the spinal canal area on computed tomography scans.

Results Twelve months after the procedure, scoring revealed a median improvement of 3.7 on the VAS for the back and 6.3 on the VAS for the leg, compared with the preoperative baseline (p < 0.05). The postoperative central area of the lumbar canal was significantly increased, by 0.39 cm2; the right and left neural foramina were enlarged by 0.29 cm2 and 0.47 cm2, respectively (p < 0.05).

Conclusions In this preliminary study, the ALTUM system showed a good clinical and radiologic outcome 1 year after surgery. In an older or high-risk population, a short minimally invasive procedure may be beneficial for treating LSS.
Hybrid Technique for Cranial Defect Reconstruction: Surgical Results over a 10-Year Period in a Single Institution
Authors: Guerrero-Suarez Pablo , Guerrero-López Paola , Ortiz-Leon Abarin , Sosa-Castillo Haydee , Velazquez-Gonzalez Lenny , Martinez-Anda Jaime
Published: July 2018

Decompressive craniectomy is an urgent procedure that is increasingly used for treatment of intracranial hypertension. After recovery, reconstruction of the cranial defect is necessary. Cranioplasty is an elective procedure with a high potential for morbidity if care is not taken on different surgical factors such as the material used as the cranial flap. In Latin America, high costs in some materials used in cranioplasty make its use prohibitive for some patients and institutions, and looking for alternatives has become a priority in neurosurgical centers. An autologous bone flap is an excellent option possessing the characteristics of an ideal material for cranioplasty. Nevertheless, its use is associated with high morbidity and flap failure. We report our mono-institutional experience in a 10-year period of a hybrid technique for cranioplasty using an autologous bone flap with titanium plates. Sixty-five patients underwent the technique, with good cosmetic results in 89.2% and success in functional result in 90.8% of patients . No significant statistical differences were found on the timing of the surgery or the location of the cranial defect. We had a 1.5% rate of surgical site infection, less than that reported on previous series. We propose that the hybrid technique of cranioplasty is a safety and effective option for cranial defect reconstruction.
Diagnostic Accuracy of Fluoroscopy, Radiography, and Computed Tomography in Detecting Cement Leakage in Kyphoplasty
Authors: Palm Hans-Georg , Lang Patricia , Haentzsch Madlen , Friemert Benedikt , Hackenbroch Carsten , Riesner Hans-Joachim
Published: July 2018

Purpose Cement leakage is a typical complication of kyphoplasty for vertebral fractures. It is unclear if cement application intraoperatively can be improved by using other techniques of visualization and which kind of postoperative imaging should be recommended to detect cement extravasation accurately.

Objective To compare the rates of cement leakage detected by intraoperative fluoroscopy, postoperative radiography, and postoperative computed tomography (CT) in a retrospective study.

Patients and Methods The study included 78 patients (60 women and 18 men; 115 vertebral bodies) who were treated with two kinds of kyphoplasty. The patients underwent intraoperative fluoroscopy and postoperative radiography and CT. After surgery, the images were evaluated to compare cement leakage rates and locations in the three visualization techniques. Leakage locations were described as epidural, intradiskal, extravertebral, or intravascular.

Results Compared with CT, intraoperative fluoroscopy regularly detected intradiskal leakage (75%) but had a considerably lower sensitivity for visualizing epidural (21%), extravertebral (31%), and intravascular (51%) cement leakages. A comparison of radiography and CT showed that radiography had a high sensitivity for detecting intradiskal (82%) and intravascular (70%) cement extrusions but a lower sensitivity in identifying epidural (42%) and extravertebral (50%) leaks. Therefore, the CT scan overall was best in detecting location and accuracy.

Conclusion CT detected more cement leaks than any of the other investigated techniques, especially epidural, extravertebral, and intravascular cement leakages. To achieve the best accuracy, only CT provides complete information.
Increased Aggregation and Secretion Responses of Human Platelets when Loaded with the Calcium Fluorescent Probes Quin2 and Fura-2
Authors: Lanza Frarnçois , Beretz Alain , Kubina Martial , Cazenave Jean-Pierre
Published: July 2018

Incorporation into human platelets of the calcium fluorescent indicators quin2 or fura-2 at low concentrations used to measure intracellular free calcium leads to the potentiation of the effects of agonists on platelets. This was shown by increased aggregatory and secretory responses of quin2 or fura-2 loaded platelets after stimulation with ADP, PAP and with low concentrations of thrombin, collagen, the endoperoxide analog U-46619 and the calcium ionophore A 23187. Quin2 and fura-2 mediated platelet sensitisation could be due to altered arachidonic acid metabolism since it was inhibited by prior treatment with the cydooxygenase inhibitor acetylsalicylate. In contrast, platelets loaded with higher concentrations of calcium chelators exhibited diminished aggregation responses to all aggregating agents. This latter effect was accompanied by increased fluidity of the platelet plasma membrane bilayer and by the exposure of a new pool of membranes to the outer surface of platelets, as monitored with trimethylammonium- diphenylhexatriene (TMA-DPH) in platelets loaded with the non-fluorescent calcium probe analog MAPT. In contrast, low concentrations of quin2 did not potentiate shape change of platelets activated with ADP. Thus, shape change and aggregation can be influenced separately by intracellular Ca2+ chelators. We conclude that platelet responses are altered by the incorporation of intracellular calcium chelators at concentrations used to monitor intracellular calcium changes.
Receptor Mediated Binding of the Fibrinolytic Components, Plasminogen and Urokinase, to Peripheral Blood Cells
Authors: Miles Lindsey A , Plow Edward F
Published: July 2018

Glu-plasminogen binds to platelets; the monocytoid line, U937, and the human fetal fibroblast line, GM1380 bind both plasminogen and its activator, urokinase. This study assesses the interaction of these fibrinolytic proteins with circulating human blood cells. Plasminogen bound minimally to red cells but bound saturably and reversibly to monocytes, granulocytes and lymphocytes with apparent Kd values of 0.9-1.4 μM. The interactions were of high capacity with 1.6 to 49 × 105 sites/cell and involved the lysine binding sites of plasminogen. Both T cells and non-rosetting lymphocytes and two B cell lines saturably bound plasminogen. Urokinase bound saturably to gianulocytes, monocytes, non-rosetting lymphocytes and a B cell line, but minimally to T cells, platelets and red cells. Therefore, plasminogen binding sites of high capacity, of similar affinities, and with common recognition specificities are expressed by many peripheral blood cells. Urokinase receptors are also widely distributed, but less so than plasminogen binding sites. The binding ol plasminogen and/ or urokinase to these cells may lead to generation of cell- associated proteolytic activity which contributes to a variety of cellular functions.
A Selective Depression of Tissue Plasminogen Activator (t-PA) Activity in Euglobulins Characterises a Risk Group Among Survivors of Acute Myocardial Infarction
Authors: Gram Jørgen , Jespersen Jørgen
Published: July 2018

Among 29 patients recovering from a first-time acute myocardial infarction (AMI) 9 patients suffered reinfarction during a four year follow-up period. The 9 reinfarction patients were found to belong to a subgroup of 17 patients with a selective depression to near zero of euglobulin t-PA activity. None of the group of 12 patients with marked t-PA activity suffered a relapse. Euglobulin fibrinolytic activity as usually assayed did not distinguish between groups with or without relapse.
Prospective Series of Nine Long Noncoding RNAs Associated with Survival of Patients with Glioblastoma
Authors: Lei Bingxi , Yu Lei , Jung Thapa , Deng Yuefei , Xiang Wei , Liu Yawei , Qi Songtao
Published: July 2018

Objective To analyze the long noncoding RNA (lncRNA) expression profile of glioblastoma multiforme (GBM) and identify prognosis-related lncRNAs, as well as their related protein-coding genes and functions.

Method The lncRNA expression profiles were obtained by microarray in six samples each of GBM and normal brain tissue. The lncRNAs expressed were significantly different between the two groups and used to detect their associations with patient survival time by downloading the related data from The Cancer Genome Atlas (TCGA). The total RNA-sequencing data of 152 patients diagnosed GBM level 3 with complete clinic information was downloaded. The survival time–dependent lncRNAs were identified by multivariate Cox regression analysis. For the survival time–dependent lncRNAs, we used the Pearson correlation coefficient and z test to search their associated protein-coding genes downloaded from TCGA. Functions of these genes were annotated by the Database for Annotation, Visualization, and Integrated Discovery (DAVID) for gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis.

Results More than 1,000 antisense lncRNAs and enhancer lncRNAs were selected for analysis in this study. Data from 152 cases with RNA-seq of GBM level 3 with complete information on GBM were downloaded from the TCGA database. Univariate Cox regression analysis revealed 19 lncRNAs with survival time dependency. These nine lncRNAs were used to construct our survival model via multivariate Cox regression analysis: TP73-AS1, AC078883.3, RP11–944L7.4, HAR1B, RP4–635E18.7, HOTAIR, SAPCD1-AS1, AC104653.1, and RP5–1172N10.2. The nine lncRNAs associated with them were inputted into the DAVID database for gene ontology and KEGG function enrichment analysis. The result showed these genes were enriched with ion binding, transport, cell-cell signaling, plasma membrane parts, and more, and they were mainly related to neuroactive ligand-receptor interaction pathway, calcium signaling pathway, and the mitogen-activated protein kinase signaling pathway.

Conclusion The nine lncRNAs were a set of biomarkers for the prognosis of patients with GBM, enabling a more accurate prediction of survival and revealing more biological functions.
Rehabilitation after Clipping of Cerebral Aneurysms without Acute Subarachnoid Hemorrhage: Outcome Analysis of 100 Consecutive Cases
Authors: Bauer Karsten , Hajdukova Andrea , Jödicke Andreas
Published: July 2018

Background Discharge to rehabilitation is reported in large studies as one important outcome parameter based on hospital codes. Because neurologic outcome scores (e.g., the modified Rankin Scale [mRS]) are missing in International Classification of Diseases (ICD) databases, rehabilitation indirectly serves as a kind of surrogate parameter for overall outcome. Reported fractions of patients with rehabilitation, however, largely differ between studies and seem high for patients with aneurysm clipping. Variances in rehabilitation fractions seem to largely differ between treatments (clipping versus coiling) for unruptured intracranial aneurysms, so we analyzed our patients for percentage of and potential factors predicting rehabilitation.

Patients From July 2007 to September 2013, 100 consecutive patients with at least one cerebral aneurysm underwent aneurysm clipping. Aneurysms were classified as incidental, associated, pretreated (coil compaction after subarachnoid hemorrhage), and symptomatic (oculomotor nerve compression, microemboli), and they were assigned to their anatomical location. Complications (infection, hemorrhage, cerebrospinal fluid fistula, transient and permanent neurologic deficit, reoperation) and outcome (mRS at 6 months; clip occlusion rate by postoperative digital subtraction angiography) as well as frequency and type of rehabilitation were analyzed and correlated retrospectively. Multiple aneurysms clipped in one procedure were not counted separately regarding complications or outcome (i.e., one patient, one outcome).

Results The overall complication rate was 17% including 10% early and 3% permanent neurologic deficits and 7% reoperations. There were no deaths. Overall, 98% of patients had a good outcome (mRS 0–2). Clip occlusion rate was 97.9%. Multivariate logistic regression analysis identified aneurysm location as the only significant independent factor for risk of complication (p < 0.001) and complication as the only significant independent risk factor for rehabilitation (p = 0.003). Rehabilitation was indicated or requested by the patient as early neurologic rehabilitation (5%), inpatient follow-up (15%), and outpatient follow-up (15%). The long-term care rate was 2%.

Conclusion Microsurgery of unruptured and not acutely ruptured aneurysms (including post-coil and associated aneurysms) has a low rate of rehabilitation with a low risk of a permanent neurologic deficit, long-term care, or early neurologic rehabilitation. The rate of rehabilitation is well below reported risks from studies based on ICD-based health care analysis. Rehabilitation per se is not a good indicator for outcome.
Optimal Parameters for Intervertebral Disk Resection Using Aqua-Plasma Beams
Authors: Yoon Sung-Young , Kim Gon-ho , Kim Yushin , Kim Nack , Lee Sangheon , Kawai Christina , Hong Youngki
Published: July 2018

Objective A minimally invasive procedure for intervertebral disk resection using plasma beams has been developed. Conventional parameters for the plasma procedure such as voltage and tip speed mainly rely on the surgeon's personal experience, without adequate evidence from experiments. Our objective was to determine the optimal parameters for plasma disk resection.

Methods Rate of ablation was measured at different procedural tip speeds and voltages using porcine nucleus pulposi. The amount of heat formation during experimental conditions was also measured to evaluate the thermal safety of the plasma procedure.

Results The ablation rate increased at slower procedural speeds and higher voltages. However, for thermal safety, the optimal parameters for plasma procedures with minimal tissue damage were an electrical output of 280 volts root-mean-square (Vrms) and a procedural tip speed of 2.5 mm/s.

Conclusion Our findings provide useful information for an effective and safe plasma procedure for disk resection in a clinical setting.
Klinische Applikationsmöglichkeiten der Fibrinklebung im Bereich der Haut
Authors: Rupp G.
Published: July 2018

Es werden vier verschiedene Fibrinkleberanwendungen im Bereich der Haut beschrieben: Wundklebun-gen, vor allem für glattrandige frische Wunden, Einklebungen von Hauttransplantaten bei großflächigen Wunden, Wundinfiltration bei z.B. Quetschwunden und Epithelbreiabdeckungen, vor allem zur vorläufigen Defektdeckung. Die diversen Techniken werden kurz erläutert, die resultierenden Wundveränderungen an Hand von dokumentierten Fällen aufgezeigt. Die vorgestellten Methoden sind vielfach erprobt und im Prinzip ohne größeren apparativen Aufwand durchführbar.
Evolution of Cellular Haemostasis
Authors: Gattermann N. , Schneider W.
Published: July 2018

Haemostasis in primitive organisms relies on simple mechanisms of wound re-pair. During evolution, haemostasis developed in parallel with rising metabolic activity, more complex circulatory systems, and increasing size of organisms. Thrombocytes are first found in lower vertebrates. However, these cells are nucleated and derive directly from haematopoietic progenitor cells, without an interposed megakaryocyte system. Megakaryocytes are an evolutionary innovation in mammalians and human beings. Their unique system of proliferation and differentiation provided the basis for an enormous increase in the production of the haemostatically active elements, the platelets. In contrast to nucleated thrombocytes, these fragments of megakaryocyte cytoplasm have improved haemostatic functions and show favourable rheologic features that facilitate their interaction with the vessel wall. The megakaryocyte system is susceptible to a variety of regulatory factors, in particular thrombopoietin and other haematopoietic and inflammatory cytokines. On the one hand, this enables the stem cell -megakaryocyte - platelet system to adapt its platelet production to increased haemostatic demand. On the other hand, acute or chronic overstimulation of megakaryocytopoiesis by infection, inflammation or malignant disease, can cause severe thromboembolic or thrombohaemorrhagic complications. Because these problems usually manifest themselves relatively late in life, namely after reproductive ages, they could not be eliminated during evolution.
Discovery, in vitro and in vivo Biology of c-mpl Ligand
Authors: Sheridan W. P. , Toombs C. F.
Published: July 2018

Since the announcement of the discovery of thrombopoietin in 1994, a tremendous amount of research has determined that recombinant c-mpl ligand (ML) is capable of producing the biological effects of a Meg-CSF and thrombopoietin. Thrombopoietin's effects include the stimulation of primitive hematopoietic stem cells, megakaryocyte progenitor cells, megakaryocyte production and maturation and leading to the formation of platelets both in vitro and in vivo. Animal models of chemotherapy-induced thrombocytopenia have yielded data which fore-shadows a beneficial effect of thrombopoietin in clinical thrombocytopenia. The signaling mechanisms transducing thrombopoietin's actions are currently under research but in progenitor cells most likely involve modulation of the expression of genes regulated by the Jak-STAT signaling pathways, given throm-bopoietin's similarity to erythropoietin. Remnants of the Janus kinase signaling system appear to be active in the platelet and mediate enhanced platelet aggre-gation in response to platelet agonists upon stimulation of the c-mpl receptor with ML. The observation of enhanced platelet aggregation in vitro has not translated to enhanced thrombosis in relevant in vivo animal models. Preliminary clinical reports are returning clear evidence that the lineage-dominant effects of rHuMGDF on megakaryocytopoiesis observed in experimental settings are also holding true in the clinic.
STA LIA vWF
Authors: Reimann Ute , Stötzer K.-E.
Published: July 2018

Die immunologische Bestimmung der von-Willebrand-Faktor-Konzentration ist ein wichtiger Baustein in der Strategie zur Diagnostik des von-Willebrand-Syn-droms. Mit dem hier vorgestellten Test, STA LIA vWF (Boehringer Mannheim GmbH) kann diese Bestimmung in der Routineanalytik innerhalb von 10 Minuten an den Gerinnungssystemen STA und STA compact (Boehringer Mannheim GmbH) durchgeführt werden. Die Reagenzien sind gebrauchsfertig, 15 Tage im Gerät stabil, und alle Arbeitsschritte wie Probenvorverdünnung, Kalibration, Qualitätskontrolle werden vom Gerät automatisch durchgeführt. Die Methodenvergleiche mit etablierten Methoden wie ELISA zeigen, daß mit STA LIA vWF identische Ergebnisse erhalten werden. Damit ist es dem Labor jetzt möglich, mit minimalem Zeitaufwand, ohne zusätzliche apparative Ausrüstung und ohne Probensplitting praktisch rund um die Uhr diese Analytik für den Kliniker vorzuhalten.
Safety and Efficacy of Preoperative Embolization in Patients with Meningioma
Authors: Manaka Hiroshi , Tatezuki Junya , Shinohara Tadao , Shimohigoshi Wataru , Yamamoto Tetsuya , Sakata Katsumi
Published: July 2018

Preoperative embolization for intracranial meningioma has remained controversial for several decades. In this study, we retrospectively reviewed our experience of embolization using particulate embolic material and coil to clarify the therapeutic efficacy, safety, and risk of complication.

Methods We reviewed 69 patients who underwent embolization with particulate embolic material followed by surgical resection. An additional 6 procedures were included for patients in whom recurrence was treated, for a total of 75 procedures of preoperative embolization. We analyzed the following clinical data: age, sex, tumor size pathology, complications related to embolization, and surgeon's opinion on the intraoperative ease of debulking and blood transfusion. Embolization was performed mainly from the branches of the external carotid artery.

Results No allogenic blood transfusions were needed for any patients. The surgeon had the opinion that whitening and softening of the tumor allowed for easy debulking during decompression of the tumor in most of the patients. Hemorrhagic complications were seen in two patients after embolization. Emergency tumor removal was performed in both of those patients, and they were recovered well after surgery. Transient cranial nerve palsy was seen in one patient. One ischemic complication and one allergic complication occurred.

Conclusion Preoperative embolization could give us an advantage in surgery for meningioma. The procedure reduces intraoperative blood loss and operating time by softening the tumor consistency. However, we must pay attention to the possibility of embolic complications and keep the preparation of emergency craniotomy, particularly in patients with large meningiomas.
Terminal end Variations and Common Pathological Abnormalities of the Basilar Artery among the Ugandan Population: a Human Autopsy Study
Authors: Nagawa E. , Okello M. , Kiryowa H. , Mwaka E.
Published: July 2018

Introduction Morphological variations at the basilar artery terminal end are documented risk factors for cerebral vascular complications like atherosclerosis, thromboembolisms, and aneurysms that further predispose to fatal arterial occlusions. Pathological abnormalities of the basilar artery are usually ignored on diagnosis in third world countries despite their role in brain ischemia. There is a paucity of literature on the gross anatomy of cerebral vasculature in the Ugandan population. Therefore, this study set out to determine the terminal end variations and common pathological abnormalities of the basilar artery among the Ugandan population.

Materials and Methods This was a cross sectional study that accessed intact basilar arteries from 115 human autopsy brains (77 males and 33 females) at the Kampala City Council Authority mortuary. Arachnoid matter was removed and arteries perfused with clear water for visibility. The arteries were checked for variations including bifurcations, trifurcations, quadrifurcation, hexafuraction and pathological abnormalities. Representative photographs were taken and results presented as proportions and percentages.

Results The average age of the human cadavers was 38 years (Range 18–85 years). Normal bifurcation of the basilar artery was observed in 48.7% of the study population. Other variations included trifurcations (22.6%); quadrifurcations (21.7%), pentafurcations (6.1%) and hexafurcations (0.6%). With regard to abnormalities, 16 arteries (13.9%) had atheromatous plaques, 21 (18.3%) were rigid, and 26 (22.6%) were tortuous. There was significant correlation between age and pathological abnormalities (p = 0.01)

Conclusion There are several variations at the terminal end of the basilar artery in the Ugandan population. Arterial pathological abnormalities are also not uncommon and tend to increase with age. Thus, the need for routine imaging investigations in patients with cerebrovascular disorders and individuals of 40 years and above.
Variable Parotid Papillue and its Implication in Sialadenitis
Authors: Araújo J. , Costa Neta H. , Oliveira J. , Pereira F. , Cavalcanti R. , Gomes F. , Assis T. , Oliveira A.
Published: July 2018

Introduction Papillae are small conical bumps found on the skin or mucous membranes surfaces. In the mouth, the parotid papillae are responsible for expelling saliva from the parotid gland to its cavity. Sialadenitis is an inflammation that affects the salivary gland and/or its duct.

Objectives To report a variable parotid papilla case and its implication in sialadenitis.

Materials and Methods The research was performed at the Morphofunctional Sciences Laboratory of the Faculdades Integradas de Patos - FIP. We used a cadaveric hemiface from the anatomy laboratory and a digital caliper rule for the morphometric evaluations.

Results The papilla found was located posterior to the 3rd molar. The distance from the variation to the most frequent location of the papilla (18.8 mm).

Conclusion The variable papilla was located in the lower retromolar region, which increases the chances of developing parotid sialadenitis, expanding the theoretical basis for its clinical diagnosis.
Macht Musizieren wirklich schlau?
Authors: Spitzer M. , Kammer T.
Published: July 2018

Seit Platon wird vermutet, dass aktives Musizieren positive Auswirkungen auf affektive, kognitive und soziale Fähigkeiten junger Menschen hat. Man unterscheidet heute nahe und ferne Transfereffekte. Während nahe Effekte auditive und davon abgeleitet sprachliche Fähigkeiten betreffen, spricht man von fernen Transfereffekten, wenn es um allgemeinere Fähigkeiten geht. In den letzten 20 Jahren wurden eine Reihe empirischer Untersuchungen zu nahen als auch zu fernen Transfereffekten publiziert. Wir stellen exemplarisch Ergebnissen dieser Studien vor und diskutieren den gesellschaftlichen Stellenwert der gefundenen positiven Auswirkungen aktiven Musizierens.
Musiktherapie als Psychotherapie
Authors: Tüpker R.
Published: July 2018

Musiktherapie gehört als eine der Künstlerischen Therapien zu den Formen der Psychotherapie im weiteren Sinne, die medizinische Behandlungen unterstützen und ergänzen können. Mit den Mitteln des aktiven Musizierens und des Hörens von Musik werden das erlebte psychische und körperliche Leiden in einer therapeutischen Beziehung behandelt, meist ergänzt durch das therapeutische Gespräch. Musik wird dabei als psychosoziales Mittel verstanden, als Möglichkeit des Ausdrucks, der Kommunikation, der Verarbeitung und der Teilhabe. Der Beitrag gibt einen Überblick über Historie, Formen und Anwendungsgebiete, ergänzt durch Fallbeispiele aus den Bereichen Onkologie, Psychosomatik, Psychiatrie, Neurologie und Palliativmedizin.
Klassifikation des Morbus Wilson
Authors: Tinta C. , Hermann W.
Published: July 2018

Der Morbus Wilson, eine autosomal-rezessive Störung des hepatischen Kupfertransporters ATP 7B, ist von einer hepatischen und extrapyramidalmotorischen Leitsymptomatik (EPS) mit variabler Manifestation vorrangig zwischen dem 5. und 45. Lebensjahr geprägt. Aufgrund dieser Symptomvielfalt ist eine frühzeitige Diagnosestellung erschwert.

Durch eine Klassifikation werden klinische Varianten beschrieben, die eine Einordnung der Befundlage ermöglicht. Berücksichtigt werden das Manifestationsalter, die pathogenetische Entwicklung und vorherrschende Symptomatik. Weitere Einteilungen charakterisieren spezielle Befundmuster der Bildgebung (cMRT, SPECT, PET), der Feinmotorik und Elektrophysiologie. Damit ergibt sich die Möglichkeit einer besseren Zuordnung der Befunde hinsichtlich der Verdachtsdiagnose eines Morbus Wilson. Rückschlüsse auf den Genotyp lässt keine dieser Klassifikationen zu.
Orale Antikoagulanzien: Management von elektiven und Notfalleingriffen
Authors: Nowak Hartmuth , Unterberg Matthias
Published: July 2018

Orale Antikoagulation bei chirurgischen Patienten erfolgt meistens mit Vitamin-K-Antagonisten (VKA) oder nicht-Vitamin-K-antagonistischen oralen Antikoagulanzien (NOAK). Während VKA wegen ihrer langen Halbwertszeit über die INR gesteuert werden, ist bei NOAK in der Regel keine Gerinnungskontrolle notwendig. Die Gabe erfolgt in festen Dosierungen. Spezifische Gerinnungswerte zur Bestimmung der Wirkung von NOAK können über die Anti-Faktor-Xa(FXa)-Aktivität (für FXa-Inhibitoren: Apixaban, Edoxaban, Rivaroxaban) und die verdünnte Thrombinzeit (für Dabigatran) erfolgen. Es gibt aktuell keine validierten Grenzwerte, die mit einem erhöhten Risiko für perioperative Blutungen einhergehen. Während VKA perioperativ auf eine parenterale Antikoagulation (z. B. niedermolekulares Heparin) umgestellt werden („Bridging“), werden NOAK pausiert. Ebenso ist nach ausreichendem Sicherheitsabstand die Durchführung von rückenmarksnahen Regionalanästhesieverfahren möglich. Falls erforderlich können NOAK auch auf ein parenterales Verfahren umgestellt werden („Switching“). Lebensbedrohliche Blutungskomplikationen können sowohl unter VKA als auch unter NOAK mit Prothrombinkomplex (PPSB) behandelt werden. Für Dabigatran steht ein Antidot zur Verfügung.
Störungen des Kaliumhaushalts
Authors: Koeppen Michael
Published: July 2018

Störungen des Kaliumhaushalts sind perioperativ und beim Intensivpatienten häufig anzutreffen – sie können sich schnell zu einer akuten Lebensbedrohung entwickeln. Dieser Beitrag geht auf die physiologischen Grundlagen des Kaliumhaushalts ein und zeigt auf, wie akute Störungen behandelt werden können.
Störungen des Kalziumhaushalts
Authors: Müller Markus
Published: July 2018

Störungen des Kalziumhaushalts sind weit verbreitet. Ihre pathophysiologischen Ursachen sind sehr heterogen und die klinischen Symptome häufig unspezifisch. Daher ist eine genaue Diagnostik unerlässlich und ein schneller Ausgleich der Kalziumhomöostase essenziell. Dieser Artikel erörtert die pathophysiologischen, diagnostischen und therapeutischen Pfeiler von Hypo- und Hyperkalzämie sowie ihre Auswirkungen auf Anästhesie und Intensivmedizin.
Störungen des Natriumhaushalts
Authors: Dresely Florian
Published: July 2018

Störungen des Natriumhaushalts sind häufig auftretende Elektrolytimbalancen. Sowohl sie selbst als auch ihre unsachgemäße Therapie können schwerwiegende Komplikationen nach sich ziehen. Der vorliegende Artikel informiert über die Ätiologie von Störungen des Natriumhaushalts und stellt wichtige therapeutische Prinzipien dar.
Flow modulation by a mushroom-like coating around the separation region of a wind-turbine airfoil section
Authors: Doosttalab Ali , Dharmarathne Suranga , Bocanegra Evans Humberto , Hamed Ali M. , Gorumlu Serdar , Aksak Burak , Chamorro Leonardo P. , Tutkun Murat , Castillo Luciano
Published: July 2018

The flow over a mushroom-shaped microscale coating was experimentally inspected over a diverging channel that followed the pressure side of a wind turbine blade (S835). High-resolution particle image velocimetry was used to obtain in-plane velocity measurements in a refractive-index-matching flume at Reynolds number Reθ ≈ 1200 based on the momentum thickness. The results show that the evolution of the boundary layer thickness, displacement thickness, and shape factor change with the coating, contrary to the expected behavior of an adverse pressure gradient boundary layer over a canonical rough surface. Comparison of the flow with that over a smooth wall revealed that the turbulence production exhibited similar levels in both cases, suggesting that the coating does not behave like a typical rough wall, which increases the Reynolds stresses. Proper orthogonal decomposition was used to decompose the velocity field to investigate the possible structural changes introduced by the wall region. It suggests that large-scale motions in the wall region lead to high-momentum flow over the coated case compared to the smooth counterpart. This unique behavior of this surface coating can be useful in wind-turbine applications, with great potential to increase the power production.
Calibration of two compact permanent magnet spectrometers for high current electron linear induction accelerators
Authors: Burris-Mog T. J. , Chavez M. A. , Espy M. A. , Manard M. J. , Moir D. C. , Schillig J. B. , Trainham R. , Volegov P. L.
Published: July 2018

In this work, two compact, permanent magnet, electron spectrometers have been built to measure the electron beam energy at the Dual Axis Radiographic Hydrodynamic Test facility. Using H− and OH− anions, the spectrometers were calibrated at the Special Technologies Laboratory in Santa Barbara, California (USA). The spectrometers were mounted on a custom drift tube that allows the magnet assemblies to be translated, which increases the path length of the electrons traveling through the magnetic field and therefore increases the upper bound of the measurable electron kinetic energy. The measurable range of electron kinetic energies is between 2.8 MeV–4.1 MeV for the first spectrometer and 14.1 MeV–21.1 MeV for the second spectrometer, with an overall measurement uncertainty of 0.32%.
Dynamical analysis for nanofluid slip rheology with thermal radiation, heat generation/absorption and convective wall properties
Authors: Awan Saeed Ehsan , Awais Muhammad , Rehman Saeed Ur , Niazi Shahab Ahmad , Zahoor Raja Muhammad Asif
Published: July 2018

In this article, nanofluid rheology with slip effects over a convective wall is staggeringly examined. The simultaneous effects of non-linear thermal radiations and internal heat generation/absorption properties are taken into the account. The hydro-magnetic flow in the presence of a porous medium, thermophoresis and Brownian motion effects are analyzed. Mathematical modelling of the fluid dynamic system has been performed in order to obtain the governing relations of the problem. Numerical solutions for the velocity, temperature and mass fraction profiles have been determined using the finite-difference method (FDM) based numerical computing. Various graphical and numerical illustrations for several parameters have been presented in order to investigate physics behind the mathematical equations.
Surface discharge characteristics and initiation mechanism of PEEK in nitrogen under semi-square voltage
Authors: Fu Pengyu , Zhao Zhibin , Li Xuebao , Cui Xiang , Wen Teng , Mo Shenyang
Published: July 2018

The surface discharge behaviors of polyetheretherketone (PEEK) in nitrogen under both positive and negative semi-square voltage were investigated using the current pulse detection method by non-inductive resistor and optical signal detection method by photomultiplier and digital camera. A 50Hz positive or negative semi-square voltage was applied to a rod-plane electrode system, and two types of surface discharge in a voltage cycle were found: one forward discharge and one back discharge. The characteristics and initiation mechanism of the two types of surface discharge were explored. The experimental results showed that surface discharges between cycles were independent. Based on the independence, the time-lag characteristics of surface discharge were obtained. An improvement on Laue-Zuber time-lag theory was made to fit the time-lag characteristics of forward discharge and back discharge. The mean time-lag decreased with the increase of voltage for both forward discharge and back discharge, and the relation between mean time-lag and applied voltage could be modeled by inverse power law. Comparative analysis on the characteristics of back discharge and forward discharge under opposite voltage was performed, and the characteristics of back discharge and forward discharge under opposite voltage were homogenous. In addition, the initiation mechanism of the two types of discharge was discussed. The initiation of forward discharge is believed to be mainly determined by the time-lag and the electric field caused by the applied voltage, while the initiation of back discharge is believed to be mainly determined by the time-lag and the electric field induced by the residual surface charge left by the forward discharge in the same cycle. Verification tests under positive semi-square voltage with different fall time were conducted to validate the initiation mechanism.
Flexible fiber-shaped liquid/quasi-solid-state quantum dot-sensitized solar cells based on different metal sulfide counter electrodes
Authors: Gao Xiaoyue , You Xingyan , Zhao Xin , Li Weifeng , Liu Xiangyang , Ye Meidan
Published: July 2018

Flexible fiber-shaped quantum dot-sensitized solar cells (QDSSCs) were fabricated by assembling the CdS/CdSe quantum dot deposited TiO2 nanotube photoanodes and different metal sulfide (i.e., NiCo2S4, Ni9S8, and Co3S4) counter electrodes (CEs) all grown on Ti wires with a liquid or gel polysulfide electrolyte. Using the NiCo2S4 CEs, the best power conversion efficiencies of 3.41% and 2.76% were obtained for the resultant fiber-shaped QDSSCs with the liquid and gel polysulfide electrolytes, respectively. Impressively, all the metal sulfide electrodes showed considerable stability under electrochemical cycling tests.
Health literacy education for rural health professionals: shifting perspectives
Authors: Finlay Sarah , Meggetto Elizabeth , Robinson Anske , Davis Claire
Published: July 2018

Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants’ change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy perspectives. Healthcare professionals’ knowledge of health literacy has improved as a result of the health literacy education. Health service organisations are also taking greater responsibility for health literacy responsiveness in their services. Systematic changes to policy and procedures that support health literacy are required. Although health literacy education provides more accessible health care for consumers, where projects had executive-level support the changes implemented were more likely to be successful and sustainable.

What is known about this topic?
Low health literacy is a strong predictor of health status and it is important for health organisations to ensure they provide health care and information in a way that can be understood, interpreted and acted on by all clients, regardless of their health literacy levels.

What does this paper add?
This paper presents findings on staff training and resources that can effectively support staff to improve health literacy practices.

What are the implications for practitioners?
Addressing health literacy issues appears to result in more accessible health care for consumers. Executive support and health literacy champions are key requirements to successfully address health literacy issues.
Using transboundary wildfire exposure assessments to improve fire management programs: a case study in Greece
Authors: Palaiologou Palaiologos , Ager Alan A. , Nielsen-Pincus Max , Evers Cody R. , Kalabokidis Kostas
Published: July 2018

Numerous catastrophic wildfires in Greece have demonstrated that relying on fire suppression as the primary risk-management strategy is inadequate and that existing wildfire-risk governance needs to be re-examined. In this research, we used simulation modelling to assess the spatial scale of wildfire exposure to communities and cultural monuments in Chalkidiki, Greece. The study area typifies many areas in Greece in terms of fire regimes, ownership patterns and fire-risk mitigation. Fire-transmission networks were built to quantify connectivity among land tenures and populated places. We found that agricultural and unmanaged wildlands are key land categories that transmit fire exposure to other land tenures. In addition, fires ignited within protected lands and community boundaries are major sources of structure exposure. Important cultural monuments in the study area had fairly low exposure but higher potential for fires with moderate to high intensity. The results show how the spatial diversity of vegetation and fuels, in combination with vegetation management practices on private and public tracts of land, contribute to transboundary risk. We use the results to motivate a discussion of integrating transboundary risk assessments to improve the current wildfire-risk rating system and begin the process of reforming risk governance in Greece.
Parametric transitions between bare and vegetated states in water-driven patterns
Authors: Bertagni Matteo Bernard , Perona Paolo , Camporeale Carlo
Published: July 2018

Significance

Since the appearance of land plants in Devonian time, vegetation has played a key role in the coevolution of life and landscapes as a result of mutual orchestrated processes between vegetation characteristics, environmental disturbances, and soil allometry. We mathematically frame the interactions between these three processes into a single parameter that discriminates between vegetated and bare states. In agreement with theories linking ecosystem development to hydrosphere and lithosphere connectivity, this theory suggests that the vegetation biodiversity of river sediment deposits occurs as a selection process in and among the biomechanical characteristics of species. Verified against field observations, this theory allows for water management applications and has important implications to understand natural and man-induced changes in biogeomorphological styles.
Tractable near-optimal policies for crawling
Authors: Azar Yossi , Horvitz Eric , Lubetzky Eyal , Peres Yuval , Shahaf Dafna
Published: July 2018

Significance

We present a tractable algorithm that provides a near-optimal solution to the crawling problem, a fundamental challenge at the heart of web search: Given a large quantity of distributed and dynamic web content, what pages do we choose to update a local cache with the goal of serving up-to-date pages to client requests? Solving this optimization requires identifying the best set of pages to refresh given popularity rates and change rates—an intractable problem in the general case. To overcome this intractability, we show that the optimal randomized strategy can be efficiently determined (in near-linear time) and then use it to produce a deterministic policy that exhibits excellent performance in experiments.
RNA triphosphatase DUSP11 enables exonuclease XRN-mediated restriction of hepatitis C virus
Authors: Kincaid Rodney P. , Lam Victor L. , Chirayil Rachel P. , Randall Glenn , Sullivan Christopher S.
Published: July 2018

Significance

Deciphering the mechanisms of how cells restrict viral pathogens is imperative for understanding disease and seeding new therapies. Millions of people suffer with liver disease as a result of chronic infection with hepatitis C virus (HCV). MicroRNA-122, a target of phase II clinical trials, is a microRNA that is beneficial to HCV, in part by binding to viral transcripts and protecting them from XRN exonucleases. As XRNs are specific to 5′ monophosphate transcripts, how XRNs restrict the 5′ triphosphate products of the viral polymerase is unknown. Here, we reveal that the 5′ RNA triphosphatase DUSP11 colludes with XRNs to restrict HCV. These findings implicate DUSP11 as a component of HCV restriction relevant for understanding an emerging class of therapeutics.
Tumor promoter TPA activates Wnt/β-catenin signaling in a casein kinase 1-dependent manner
Authors: Su Zijie , Song Jiaxing , Wang Zhongyuan , Zhou Liang , Xia Yuqing , Yu Shubin , Sun Qi , Liu Shan-Shan , Zhao Liang , Li Shiyue , Wei Lei , Carson Dennis A. , Lu Desheng
Published: July 2018

Significance

The phorbol ester 12-
O
-tetra-decanoylphorbol-13-acetate (TPA) is a well-known tumor promoter in two-stage mouse skin carcinogenesis, but the exact mechanism by which TPA promotes tumorigenesis remains elusive. This study discovered that TPA could stabilize CK1ε, enhance its kinase activity, and induce phosphorylation of LRP6, resulting in the formation of CK1ε–LRP6–axin1 complex, which may bypass the requirement of Wnt–Fzd–Dvl complex. TPA also increased the interaction between β-catenin and TCF4E in a CK1ε/δ-dependent way, and finally led to activation of the Wnt/β-catenin pathway. Our findings reveal a pathway by which TPA activates the Wnt/β-catenin signaling cascade. This pathway may represent a common mechanism for the tumor-promoting activity of some carcinogenic agents.
Constraints on Paleoproterozoic atmospheric oxygen levels
Authors: Bellefroid Eric J. , Hood Ashleigh v. S. , Hoffman Paul F. , Thomas Matthew D. , Reinhard Christopher T. , Planavsky Noah J.
Published: July 2018

Significance

Earth’s protracted oxygenation significantly transformed global biological and geochemical cycles. In particular, the rise of atmospheric oxygen above trace levels was an essential prerequisite for the development of animals. However, quantifying atmospheric oxygen levels in Earth’s middle age remains a daunting challenge. Here we use a combination of sedimentology, geochemical constraints, and oceanographic modeling to provide a quantitative estimate of Precambrian atmospheric oxygen. We provide evidence that atmospheric oxygen levels decreased significantly after the “Great Oxygenation Event” in Earth’s early history, to levels that would have negatively impacted the ecology of the earliest complex organisms.