bluuebunny/crossref_metadata_2025 huggingface dataset:
Case study: Comparing performance of pier scour equations using field data for the Gediz bridge, Manisa, Turkey
Authors: Gülbahar Necati
Published: May 2009

All over the world, many studies have been carried out on river bridge scour, but most of the findings have been based on laboratory data. Here, field data were used to understand the performance of several pier scour equations. The most commonly predictive equations were used to predict the type of scour that would be expected to be found on the Gediz Bridge in Turkey. Then, theoretical pier scour was calculated using several equations and the results were compared with field data on real scour observed at the Gediz bridge. From the results of the study, the relative performances of various prediction algorithms were compared and recommendations for their applications were provided.
Seismic evaluation of concrete moment frames in existing government buildings
Authors: Akhras G. , Li W.
Published: May 2009

Many government departments have hundreds of buildings located in active seismic regions. Most of these buildings were built decades ago according to old design codes, and could be vulnerable to strong or even moderate earthquakes. To evaluate the seismic performance of concrete moment frames or moment frames with shear walls in these buildings, the static, vibration and modal response spectrum analyses are carried out according to the 2005 National building code of Canda NBCC. The analysis uses 2-D finite element models consisting of frame elements and inplane elements. The frame element has a built-in rigid linear segment at each end for modeling the portion within the beam–column joint, whereas the inplane element may have openings for modeling doors and windows in shear walls. The stiffness of both elements is adjusted to include effects of shear deformation in beams and bending deformation in wall piers. The results are further adjusted to incorporate effects of torsion and accidental torsion. Then, CSA-A23.3-04 is followed for detailed evaluation on safety in limit states, “strong column – weak beam” concept and shear strength requirements. Based on this approach, a new computer program is developed to perform this evaluation with minimum input data. Important issues in each step are discussed in detail. Examples are presented, and results are compared with available existing data.
Modelling aerosol concentration distributions from transient (puff) sourcesA paper submitted to the Journal of Environmental Engineering and Science.
Authors: DeVito Timothy J. , Cao Xiaoying , Roy Gilles , Costa Johnathan R. , Andrews William S.
Published: May 2009

A field trial involving 50 separate releases of inert aerosol (kaolin) was conducted to determine the concentration distribution within aerosol puffs resulting from near-instantaneous releases. Atmospheric conditions during the trial fell within Pasquill stability classes A and B (very and moderately unstable, respectively). Aerosol concentration measurements were made using a scanning lidar system operating at 1.06 μm. Artificial neural network (ANN) models were developed using the data to predict concentration distributions, given a number of meteorological parameters. The ANN predictions were compared to those from traditional Gaussian puff models, and provided better predictions than the Gaussian model parameterizations examined. The ANN models were also used to develop Gaussian fitting parameters to replace traditional Pasquill and Slade dispersion coefficients. The ANN-derived dispersion coefficients provided better predictions of measured puff concentration distributions than either the Pasquill or Slade parameterizations, though the full multi-input ANN models provided even better predictions than the Gaussian puff model using ANN-derived dispersion coefficients.
Stability of freeze-dried vaginalLactobacillusstrains in the presence of different lyoprotectors
Authors: Juárez Tomás María Silvina , Bru Elena , Martos Gladys , Nader-Macías María Elena
Published: May 2009

The industrial use of lactic acid bacteria as probiotic cultures depends on the preservation techniques employed, which are required to guarantee stable cultures in terms of viability and functional activity. The aim of this study was to evaluate the effects of 12% lactose and 12% sucrose suspended in water or reconstituted skim milk on the survival and expression of beneficial characteristics during freeze-drying and subsequent storage of 6 vaginal lactobacilli strains. A cubic polynomial model was also used for the first time to evaluate the effects of different protectors on survival behavior during storage. Different survival patterns were observed among the strains considered. The presence of both lactose and sucrose in water or in 6% skim milk as the suspension medium proved to be effective in maintaining a high degree of survival and expression of potentially probiotic characteristics (production of antimicrobial substances or auto-aggregation capabilities) of most strains after lyophilization and long-term storage. This study constitutes a valuable step to obtain concentrated cultures with the highest stability of microorganisms for pharmaceutical purposes.
LEFT-HANDNESS IN A FOUR-LEVEL ATOMIC SYSTEM
Authors: ZHAO SHUNCAI , LIU ZHENGDONG
Published: May 2009

A scheme is proposed for realizing simultaneous negative permittivity and negative permeability based on quantum coherence in a four-level dense atomic system here. Under some parametric conditions the system shows that simultaneous negative permittivity and negative permeability (i.e. Left-handness) can be achieved in a wider frequency band because of quantum coherence. And the novelty properties of gain and dispersion near the resonance frequency may have some potential applications.
MIXING AND DECOHERENCE TO NEAREST SEPARABLE STATES
Authors: LAHIRI AVIJIT , GHOSH GAUTAM , NAG SANKHASUBHRA
Published: May 2009

We consider a class of entangled states of a quantum system (S) and a second system (A) where pure states of the former are correlated with mixed states of the latter, and work out the entanglement measure with reference to the nearest separable state. Such "pure-mixed" entanglement is expected when the system S interacts with a macroscopic measuring apparatus in a quantum measurement, where the quantum correlation is destroyed in the process of environment-induced decoherence whereafter only the classical correlation between S and A remains, the latter being large compared to the former. We present numerical evidence that the entangled S–A state drifts towards the nearest separable state through decoherence, with an additional tendency of equimixing among relevant groups of apparatus states.
Adrenergic activation of electrogenic K+secretion in guinea pig distal colonic epithelium: desensitization via the Y2-neuropeptide receptor
Authors: Zhang Jin , Halm Susan T. , Halm Dan R.
Published: June 2009

Adrenergic activation of electrogenic K+secretion in isolated mucosa from guinea pig distal colon was desensitized by peptide-YY (PYY). Addition of PYY or neuropeptide-Y (NPY) to the bathing solution of mucosae in Ussing chambers suppressed the short-circuit current ( Isc) corresponding to electrogenic Cl−secretion, whether stimulated by epinephrine (epi), prostaglandin-E2(PGE2), or carbachol (CCh). Neither peptide markedly inhibited the large transient component of synergistic secretion (PGE2+ CCh). Sustained Cl−secretory Iscwas inhibited ∼65% by PYY or NPY, with IC50s of 4.1 ± 0.9 nM and 9.4 ± 3.8 nM, respectively. This inhibition was eliminated by BIIE0246, an antagonist of the Y2-neuropeptide receptor (Y2-NpR), but not by Y1-NpR antagonist BVD10. Adrenergic sensitivity for activation of K+secretion in the presence of Y2-NpR blockade by BIIE0246 was (EC50s) 2.9 ± 1.2 nM for epi and 13.3 ± 1.0 nM for norepinephrine, approximately fourfold greater than in the presence of PYY. Expression of mRNA for both Y1-NpR and Y2-NpR was indicated by RT-PCR of RNA from colonic mucosa, and protein expression was indicated by immunoblot. Immunoreactivity (ir) for Y1-NpR and Y2-NpR was distinct in basolateral membranes of columnar epithelial cells in the crypts of Lieberkühn as well as intercrypt surface epithelium. Adrenergic nerves in proximity with crypts were detected by ir for dopamine-β-hydroxylase, and a portion of these nerves also contained NPYir. BIIE0246 addition increased secretagog-activated Isc, consistent with in vitro release of either PYY or NPY. Thus PYY and NPY were able to suppress Cl−secretory capacity and desensitize the adrenergic K+secretory response, providing a direct inhibitory counterbalance against secretory activation.
The Walking Capacity Assessment in the Respiratory Patient
Authors: Chetta Alfredo , Pisi Giovanna , Aiello Marina , Tzani Panagiota , Olivieri Dario
Published: May 2009

Exercise testing is commonly used in respiratory patients to assess their degree of disability, prognosis for survival, presence of exercise-induced hypoxemia and response to treatment. Recently, simple exercise tests, which are based on walking, have been developed and are increasingly being used both for clinical and research purposes. The 6-min walk test (6-MWT) is the most widely used and simply consists in the measurement of the distance walked in 6 min. The 6-MWT is self-paced and differs from the shuttle walking test, which is externally paced via a recorded metronome and entails incrementally faster speeds. Although the field walking tests do not require complex equipment, they can provide reliable and useful clinical information. This review deals with the validity, reliability and interpretation of these walking tests in the assessment of patients with chronic respiratory disease.
Autosomal Recessive von Willebrand Disease Type 1 or 2 due to Homozygous or Compound Heterozygous Mutations in the von Willebrand Factor Gene
Authors: Castaman G. , Giacomelli S. , Rodeghiero F.
Published: June 2009

For a long time, autosomal recessive inheritance has been considered a unique feature of type 3 von Willebrand disease (VWD), which is characterized by the virtual absence of von Willebrand factor (VWF) in plasma and storage compartments. In recent years, it has been demonstrated that this type of inheritance is also present in some type 1 and 2 families, previously considered the epitome of true dominant transmission. In many patients of these families with recessive VWD, molecular basis studies have provided insights into the molecular mechanisms responsible for the heterogeneity of phenotypes. We report our experience with 12 families with clearly recessive inheritance, but definitely measurable factor VIII and VWF, which is not typical for severe type 3 VWD.
TGF-Beta Auto-Induction and Connective Tissue Growth Factor Expression in Human Renal Tubule Epithelial Cells Requires N-Ras
Authors: Dockrell Mark E.C. , Phanish Mysore K. , Hendry Bruce M.
Published: May 2009

Background/Aims: Transforming growth factor (TGF) β is strongly implicated in the progression of renal fibrosis. TGFβ1 is reported to cause epithelial-mesenchymal transition, inhibition of epithelial cell proliferation, increased apoptosis, auto-induction of TGFβ production and induction of secondary mediators of tissue fibrosis such as connective tissue growth factor (CTGF, CCN2). The aims of this study were to investigate the role of the Ras/MAP kinase pathway in TGFβ1 inhibition of proliferation, TGFβ auto-induction and TGFβ1-induced CTGF expression in HKC human renal tubule epithelial cells. Methods and Results: TGFβ1 (0–25 ng/ml) inhibited proliferation of HKC cells and at 25 ng/ml also induced apoptosis. After 5–10 min of incubation, TGFβ1 increased cellular levels of phospho-ERK1/2 and phospho-AKT with a bell-shaped dose-response curve with a maximally effective concentration of 2.5 ng/ml. TGFβ3 caused an increase in extracellular TGFβ1, which was significantly reduced in the presence of PD 98059. TGFβ1 increased cellular and secreted CTGF protein in HKC cells in a MEK-dependent manner. To identify the Ras isoform involved, specific antisense oligonucleotides targeted to Ha-Ras, Ki-Ras and N-Ras were employed. Only inhibition of N-Ras resulted in a significant reduction of auto-induced TGFβ1 secretion and TGFβ1-induced cellular and secreted CTGF. Conclusion: These results establish that the Ras/MAP kinase pathway, specifically through N-Ras, mediates TGFβ1 auto-induction and TGFβ1-induced CTGF expression in human renal tubule epithelial cells.
Incidence and Prevalence of Amyotrophic Lateral Sclerosis in Canada: A Systematic Review of the Literature
Authors: Wolfson C. , Kilborn S. , Oskoui M. , Genge A.
Published: May 2009

Background: Amyotrophic lateral sclerosis (ALS) is a fatal progressive neurodegenerative disease of unknown etiology. Although known to be rare, precise information on the frequency of ALS is essential to anticipate future demands on health resources and as baseline information for epidemiological studies. As part of a new ALS epidemiological initiative in Canada, we conducted a systematic review of published incidence and prevalence research in Canada. Methods: Electronic searches and bibliographic reviews of pertinent publications were conducted. Results: We identified 6 published studies from 4 Canadian provinces conducted between 1974 and 2004; 2 were available only as abstracts. Reported annual incidence rates were similar and study quality was generally good, but there was insufficient detail to adequately assess the methodological quality of 3 of the studies. The most recent studies reported an annual ALS age-adjusted incidence of 2.13 per 100,000 in Nova Scotia (2003–2004) and a crude mean annual incidence of 2.4 per 100,000 in Newfoundland and Labrador (2000–2004). Conclusions: There are limited data on the frequency of ALS in Canada. We found no studies from 6 of the Canadian provinces or from the territories. Future research is needed to estimate the frequency of occurrence of ALS in Canada.
Soy Consumption Reduces Risk of Ischemic Stroke: A Case-Control Study in Southern China
Authors: Liang Wenbin , Lee Andy H. , Binns Colin W. , Huang Rongsheng , Hu Delong , Shao Hong
Published: May 2009

Background: Experimental studies have suggested that soybean products may protect against ischemic stroke, but only limited epidemiological evidence is available. Objective: Our aim was to investigate the relationship between soy food consumption and the risk of ischemic stroke among the Chinese population. Methods: A case-control study was conducted in southern China during 2007–2008. Soy food consumption, dietary intake and lifestyle information were obtained from 374 incident ischemic stroke patients and 464 hospital-based controls. Logistic regression analyses were performed to assess the association between soy food intake and the ischemic stroke risk. Results: The mean weekly soy food intake was significantly lower (p = 0.001) among cases (89.9, SD = 239.3 g) than control subjects (267.7, SD = 426.1 g). Increased consumptions of dried soybean, tofu, soymilk and total soy foods were associated with reduced risks of ischemic stroke after adjusting for confounding factors. The corresponding adjusted odds ratios for the highest versus lowest level (<50 g) of intake were 0.20 (95% confidence interval = 0.09–0.48), 0.56 (0.36–0.89), 0.18 (0.06–0.51) and 0.23 (0.14–0.39), with significant dose-response relationships observed. Conclusion: The results provided evidence of inverse association between habitual soy food consumption and the risk of ischemic stroke for Chinese adults.
Cardioprotective Actions of Ascorbic Acid during Isoproterenol-Induced Acute Myocardial Infarction in Rats
Authors: Buttros Juliana B. , Bergamaschi Cassia T. , Ribeiro Daniel A. , Fracalossi Ana C.C. , Campos Ruy R.
Published: May 2009

Background/Aims: In the present study, we tested whether or not acute antioxidant treatment with vitamin C is able to protect the heart during myocardial infarction. The effects of vitamin C on the autonomic balancing of the heart and on the histopathological and immunohistochemical changes in response to isoproterenol administration (ISO) were evaluated. Methods: Four groups of male Wistar rats (n = 32) were studied: control; ISO treated; vitamin C treated; ISO + vitamin C treated. ISO 150 mg/kg was administered for 2 consecutive days. Vitamin C (250 mg/kg, oral) was administered 30 min before each ISO treatment. Phenylephrine and sodium nitroprusside were administrated to increase or decrease blood pressure in conscious rats. Results: The baroreceptor reflex index for bradycardia was significantly reduced in the ISO group (control, –3.4 ± 0.3 beats/mm Hg; ISO –2 ± 0.4 beats/mm Hg) and vitamin C treatment significantly improved the reflex index (–2.9 ± 0.7 beats/mm Hg). Treatment with vitamin C showed mild degenerative changes in the myocardial tissue of the ISO group. The antioxidant was able to decrease the inducible nitric oxide (iNOS) expression in rats treated with vitamin C. Conclusion: Vitamin C administration proved to be effective in reducing the extent of myocardial damage during ISO-induced myocardial infarction in rats associated with an iNOS downregulation and improving the autonomic balancing of the heart.
Assessment of the in vitro Efficacy of the Novel Antimicrobial Peptide CECT7121 against Human Gram-Positive Bacteria from Serious Infections Refractory to Treatment
Authors: Sparo M.D. , Jones D.G. , Sánchez Bruni S.F.
Published: May 2009

Background: Resistant Gram-positive bacteria are causing increasing concern in clinical practice. This work investigated theefficacy of AP-CECT7121 (an antimicrobial peptide isolated from an environmental strain of Enterococcus faecalis CECT7121) against various pathogenic Gram-positive bacteria. Methods: Strains were isolated from intensive care unit patients unresponsive to standard antibiotic treatments. Inhibitory activity of AP-CECT7121 was assessed using the agar-well diffusion method. The most resistant isolates from each species screened (Enterococcus faecium, Enterococcus faecalis,Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Clostridium perfringens and Clostridium difficile) were further examined in time-killing curve studies. Results: These bactericidal kinetic experiments demonstrated a rapid killing effect with no viable bacteria being detected within 30 and 90 min for enterococcal and streptococcal strains and 180 min for community-acquired methicillin-resistant S. aureus and C. perfringens: viable counts for C. difficile were threefold decreased after 90 min. Conclusions: AP-CECT7121 may provide a novel strategy for treating potentially fatal clinical infections in hospitalized patients.
Plateletpheresis-lnduced Increase in Platelet Reactivity Using Different Cell Separators
Authors: Jung F. , Bläsi U. , Radtke H. , Mrowietz C. , Pindur G. , Kiesewetter H. , Wenzel E.
Published: May 2009

Objective: Since plateletpheresis is being used increasingly, it is important to regard quality control to check health risks for donors and to exclude these. Design: Controlled randomised prospective open comparative study. Setting: Department of Transfusion Medicine of a University Clinic. Participants: 112 platelet donors were examined. Interventions: Prior to and after plateletpheresis platelet reactivity was determined. The platelet concentrates in the two groups of 56 donors each were produced using either the cell separator ‘CS-3000’ and the collecting chamber PLT 30TM with the OmnixTM system (group I) or the cell separator ‘AS-104’ (group II). Results: In group I five donors showed a pathologically increased platelet reactivity (p = 0.1297) after plateletpheresis. In group II there were 10 donors with a pathologically increased platelet reactivity (p = 0.0046) after plateletpheresis. The mean concentration of platelets was reduced by separation using the CS-3000 Omnix from 238 ± 49 · 103/µl to 172 ± 32 · 103/µl (68 ± 27 · 103/µl) and from 243 ± 53 · 103/µl to 180+31 · 103/µl (63 ± 33 · 103/µl) using the AS-104. In the first case the platelet yield was 3.9 1011 platelets/concentrate, in the latter case it was 2.9 · 1011 platelets/concentrate. The ‘CS-3000 Omnix’ is significantly more effective in separating (58.4 ± 15.5%) than the ‘AS-104’ with 44.2 ± 7.2% (p < 0.0001). Conclusions: Since both donor groups were comparable regarding all factors recorded – especially the cardiovascular risk factors – the separation process could be responsible for the different traumatisation of platelets.
Changes in the Initial Distribution Volume of Glucose and Plasma Volume Following Volume Challenge in Dogs
Authors: Miyahara A. , Ohkawa H. , Ishihara H. , Matsuki A.
Published: May 2009

Objective: This study aimed to test the hypothesis that the initial distribution volume of glucose (IDVG) is correlated with plasma volume determined by indocyanine green (ICG) following colloidal fluid challenges. The IDVG was also compared with cardiac output (CO) as measured by the conventional thermodilution method. Design and Setting: The study was prospective and was conducted in the animal laboratory, University of Hirosaki School of Medicine, after approval of the institutional animal experiment committee. Participants: Thirteen mongrel dogs of either sex, weighing 9.0–14.5 kg, were the subjects of the study. Interventions: They were anesthetized with pentobarbital and paralyzed with pancuronium. 30 ml · kg-1 of 3 % dextran in lactated Ringer’s solution was given twice to induce a hypervolemic state. Measurements and Results: In each stage of the fluid loading, the IDVG, plasma volume and CO were measured simultaneously. The IDVG was measured following an injection of glucose (100 mg · kg-1) by repeated determinations of plasma glucose (3–7 min) with a one-compartment model, and plasma volume was assessed similarly following ICG (0.5 mg · kg-1) injection. A closer correlation was observed between the IDVG and plasma volume (r = 0.79, p < 0.001) than between the IDVG and CO (r = 0.48, p < 0.01). Conclusion: The IDVG correlates with plasma volume following volume challenge in dogs. CO did not show a consistent change following volume challenge. The IDVG may have the potential as an indicator to presume the fluid volume in the body, even though the IDVG cannot be used directly to estimate plasma volume.
Der Einfluß kolloidaler Plasmaersatzmittel auf die Freisetzung von Tumor-Nekrose-Faktor-alpha (TNF-α) in menschlichem Vollblut in vitro
Authors: Sirtl C. , Salewsky G. , Baier J. , Lange S. , Laubenthal H. , Neumann H.A.
Published: May 2009

Ziel: In-vitro-Untersuchung des Einflusses von Plasmaersatzmitteln auf das mensch-liche Zytokinnetzwerk, speziell auf die Freisetzung von Tumor-Nekrose-Faktor-al-pha (TNF-α). Design: Heparinisiertes Vollblut von 8 gesunden Freiwilligen wurde fraktioniert und mit unterschiedlichen Konzentrationen kolloidaler Plasmaersatzmittel eingestellt (nativ = 0 mg/ml; 5 mg/ml; 15 mg/ml). Untersucht wurden jeweils Hydroxyethylstärke 200/0,5 (HES), Dextran 60 (DX), harnstoffvernetzte Gelatine (GEL) und Human-albuminlösung (HA). Die Freisetzung von TNF-α in den Chargen wurde jeweils ohne bzw. mit Stimulation durch Phytohämagglutinin (PHA) nach Inkubation (24 h; 5% CO2 37°C) gemessen. Die Analytik wurde analog der Methode von Gallati mit-tels ELISA durchgeführt. Als statistisches Modell wurde eine Varianzanalyse mit Meßwiederholung verwendet. Ergebnisse: Der Basalspiegel von TNF-α lag zwischen 226 und 273 pg/ml (0 mg Kolloid/ml), nach ausschließlicher PHA-Stimulation erfolgte ein Anstieg auf das etwa Vierfache (1066-1260 pg/ml; 0 mg Kolloid/ml). Bereits ohne Stimulation beobachtet man nach Zugabe aller 3 künstlichen Kolloide in 2 unterschiedlichen Konzentrationen (5 und 15 mg/ml) eine bis zu 50% erhöhte TNF-α-Freisetzung gegenüber den Basalspiegeln. Auch unter Stimulationsbedingungen übersteigt die TNF-α-Liberation den mit PHA stimulierten Basalwert bei den gewählten Konzentrationen aller Kolloide. Die unterschiedlichen TNF-α-Freisetzungen durch Konzentrationsände-rungen der künstlichen Kolloide DX und GEL waren statistisch signifikant (p < 0,001 bzw. p=0,005). Nach HES und HA in unterschiedlichen Konzentrationen wurde ebenfalls ein TNF-α-Anstieg beobachtet, dieser konnte jedoch statistisch nicht gesichert werden. Schlußfolgerungen: Plasmaersatzmittel verhalten sich in bezug auf TNF-α immunmodulatorisch in klinisch relevanten Konzentrationen nicht inert. Ob der beobachtete Effekt auch in vivo auftritt, welche Bedeutung ihm zukommt, ob und wie andere Zytokine mitreagieren, ist Gegenstand laufender Untersuchungen.
Photochemical Reactions during Virus Inactivation of Human Plasma by Methylene Blue and Light
Authors: Müller-Breitkreutz K. , Mohr H.
Published: May 2009

Die viruzide Wirkung von Methylenblau in Kombination mit sichtbarem Licht wird zur Dekontamination von Humanplasma genutzt. Ziel unserer Untersuchungen war es, Aufschluβ über die an der Virusinaktivierung beteiligten photochemischen Reaktionen zu bekommen. Es wurde festgestellt, daβ Humanplasma einen negati-ven Einfluβ auf die Effektivität der Virusinaktivierung hat. Die Virusinaktivierung wurde durch hohe pH-Werte (pH 6-8) verstärkt, durch hohe Salzkonzentrationen (10-200 mM NaCl) gehemmt und war unabhängig von der Temperatur (4-37 °C). Für die photochemische Reaktion war die Anwesenheit von molekularem Sauerstoff erforderlich. Quencher, die reaktive Sauerstoffderivate aus Typ-I-Photoreaktionen abfangen können, hatten keinen Einfluβ auf die Virusinaktivierung. Durch Singulettsauerstoffquencher hingegen wurde die Inaktivierung der Viren gehemmt. Die Daten zeigen, daβ Singulettsauerstoff (Typ-II-Photoreaktion) für die photody-namische Inaktivierung der Viren bedeutsam ist, während Typ-I-Sauerstoffderivate keine nachweisbare Bedeutung haben.
Effective Leucocyte Depletion of Platelet Concentrates by Filtration without Flow Reduction
Authors: Richter E. , Lindner M. , Ullrich R. , Kerowgan M. , Goldmann S.F.
Published: May 2009

Bei Langzeitsubstitutionen mitThrombozytenkonzentraten ist eine effektive Redu-zierung der Leukozytenkonzentration unerläβlich. Bisher war die Reduktion der Fluβrate während der Filtration notwendig, was mit einem erheblichen Zeitaufwand verbunden ist. Wir untersuchten die Effektivität der Leukozytendepletion durch Filtration von Thrombozytenkonzentraten ohne Fluβreduktion mittels Sepacell PL 5 II BT1. Verwendet wurden Random-Thrombozytenkonzentrate (5 Einzelpräparate gepoolt) bzw.Thrombozytapheresekonzentrate (Fresenius AS 104). Die Filtrations-zeit betrug in Abhängigkeit vom Volumen (Apheresekonzentrat 220 ml, Random-Poolpräparat 400 ml) 3–4 min. Obwohl die Volumen-Recovery für beide Präparate gleich hoch war (92 bzw. 94%), lag die Thrombozytenausbeute im Apheresekonzentrat mit 82% unter der des Poolpräparates (87%). Die Entfernung der Tropf-kammer im Filtersystem führte zu einer signifikant höheren Thrombozytenausbeute (92%). Der Restleukozytengehalt (Nageotte-Zählkammer) lag für alle Präparate unter der CILL-Dosis (critical immunogenic leucocyte load) von 1 × 106 (0,6 × 105,0,2 × 106 bzw. 0,3 ×106). Die Untersuchungen haben gezeigt, daβ eine Fluβreduktion bei der Filtration von Thrombozyten nicht notwendig ist. Auf die im Filtersystem integrierte Tropfkammer kann verzichtet werden, wodurch der Thrombozytenverlust deutlich reduziert wird.
Rheologische und kapillarmikroskopische Größen zur Diagnostik des von-Willebrand-Jürgens-Syndroms
Authors: Koscielny J. , Jung F. , Mrowietz C. , Kiesewetter H. , Pindur G. , Wenzel E.
Published: May 2009

In future, the capillary microscopy may add to the spectrum of differential diagnosis finding in haemostaseological and angiogical centres as a screening test. Especially the fast and simple observation of the capillary morphology with changes such as capillary dilatations, capillary bleeding (the easiest case, extravasal cells, but also fresh bleeding at the summit of the capillary) and simultaneous findings of torqua-tion of the capillaries seem to be very sensitive for the diagnosis of the von Willebrand-Jürgens syndrome – according to the data collected until now.
Qualität von Erythrozytenkonzentraten aus rheologischer Sicht
Authors: Jung F. , Schüler S. , Mrowietz C. , Kiesewetter H. , Wenzel E.
Published: May 2009

The present study deals with the question if rheological properties of erythrocyte concentrates (EC) are altered during the storage duration. As a parameter of erythrocyte function cell deformability was measured by the passage time of single red blood cells through an artificial capillary. EC viscosity (ECV), red blood cell volume and red blood cell rigitidy of n=21 EC were measured on the 1st, 7th, 14th, 21th and 28th days of storage. An increase in ECV could be observed: 5.18 ± 0.64 on the 1st day, and 7.25 ± 1.53 on the 28th day; p=0.0001. This observation was mainly due to a marked deterioration of erythrocyte rigidity (1.03 ± 0.11 on the 1st day, 1.61+0.14 on the 28th day; p=0.0001). A rise in packed cell volume due to erythrocyte swelling (85.3 ± 4.33 on the 1st day;89.8 ± 4.11 on the 28th day;p=0.0001) might as well have caused an increase in ECV. During duration of storage a significant and relevant deterioration in rheological properties of erythrocyte concentrates could be observed.
Erworbene Faktor Vlll·C-Hemmkörper bei Nichthämophilen
Authors: Söhngen D. , Kuntz B.M.E. , Heins M. , Specker Ch. , Bach D. , Burk M. , Aul C. , Schneider W.
Published: May 2009

Antibodies against factor VIII:C occur in about 5-15 % of hemophilia A patients and induce refractoriness to factor VIII:C infusions. These antibodies are mostly of IgG class. In very rare cases factor VIII:C inhibitors also develop in nonhemophilic patients. Although there are anecdotal reports that these antibodies may disappear spontaneously, in the majority of patients the clinical course is characterized by severe hemorrhages. During the last ten years we treated 9 nonhemophilic patients with acquired factor VIII:C inhibitors at our clinic. In most cases, a sudden bleeding tendency was observed shortly after an injury or surgery. Coagulation tests showed a prolonged aPTT and a decreased F VIIL:C level. Therapy with F VIII·C concentrates did not produce the expected increase. Measurement of F VIII:C inhibitor levels (Bethesda Units = BU) revealed values in the range between 2 and 108 BU. Immunosuppressive therapy in patients with > 5 BU using azathioprine or cyclo-phosphamide in combination with prednisone lead to complete disappearance of the inhibitor, normalization of the coagulation tests, and complete remission of the bleeding tendency in 7 patients within 6 weeks. During pregnancy only prednisone should be given. On the other hand in women with post-partum factor VIII inhibitors, steroid treatment appears to be not superior to no treatment, but immunosup-pression with cyclophosphamide or azathioprine seems to be more effective. In emergency situations, therapy with high doses of human F VIII:C concentrate is recommended. When bleeding does not cease, the additional use of activated pro-thrombin concentrates or porcine factor VIII concentrate is indicated. Side effects may include hepatitis and short-lived intravascular thrombin production.
Therapieergebnisse der chronischen Autoimmunthrombozytopenie des Erwachsenen
Authors: Anders O. , Barz D. , Krammer B. , Staack D.
Published: May 2009

118 patients suffering from thrombocytopenic purpura (87 women and 31 men, mean age 29 and 32 years, respectively) were retrospectively investigated with respect to therapeutic response (TR), remission rate (RR), and the long-term success rate (LR) of different treatment modalities. Splenectomy gave the most favourable outcome: TR in 92% of the patients and LR in 73%. Using treatment with prednisolo-neTR was achieved in 69% and LR in 16%. Azathioprine led to TR in 52% and LR in 27% of the patients. 104 patients (86%) achieved remission after therapy consisting of steroids, splenectomy, and immunosuppression. However, 17patients (14%) did not respond to these therapeutic modalities. The therapy of these patients with refractory thrombocytopenic purpura is still an unresolved problem.
Thrombomatch EIA: Evaluation of a New Test System for the Detection of Platelet-Reactive Antibodies
Authors: Bialleck H. , Zumpe P. , Lenhard V. , Seifried E.
Published: May 2009

Die Detektion thrombozytenreaktiver Antikörper bei polytransfundierten oder durch Schwangerschaften alloimmunisierten Patienten ist schwierig und erfordert geeignete serologische Testverfahren. In dieser Studie wurde der Thrombomatch EIA im Vergleich mit den drei etablierten Bestimmungsmethoden PAIFT, MCP® und MAIPA auf seine Praktikabilität sowie auf seine Sensitivität und Spezifität geprüft. Bei der Untersuchung von 137Patientenseren zeigte sich bei problemloser und schneller Durchführbarkeit eine gute Übereinstimmung des Thrombomatch mit den Vergleichsmethoden. Der Thrombomatch erscheint geeignet als Screening-Test bei der Frage nach throm-bozytenspezifischen und/oder HLA-Antikörpern bei refraktären Patienten. Die prädiktive klinische Wertigkeit muβ in einer prospektiven Studie überprüft werden.
Drastische Verkürzung von Inkubationszeiten bei immunhämatologischen Untersuchungen durch Einsatz von Mikrowellengeräten
Authors: Budde U. , Grimm C. , Schmidt L. , Scherlitzky L. , Poschmann A.
Published: May 2009

Many methods for the detection of red cell antibodies of the IgG type need incubation times between 15 and 20min at 37 °C. Microwaves induce a rapid movement of molecules resulting in heat delivery into the solution. A group from China shortened the incubation time of ELISA procedures from 1 -1.5 h to 15-20 s. To the best of our knowledge no attempts to use microwave irradiation in immunohematology have been published. We now report preliminary results for the gel technique (ID system), blood group typing on microtiter plates (Erytype), the SolidScreen test and the cross-match in plastic vials. Both the ICT and enzyme-dependent methods could significantly be shortened to incubation times of 60-75 s without a relevant loss of specificity and sensitivity for most of the antibodies tested. The commercially available microwave instruments that we used proved to be not ideal for our purposes. The choice of instruments capable of measuring the temperature within a defined solution should improve the results further, allowing microwave techniques to become routine methods of the immunohematological laboratory.
Eisenstatus und Eisenbedarf bei Blutspendern
Authors: Nielsen P. , Dietzfelbinger H. , Kaltwasser J.P.
Published: May 2009

Regular blood donors in Germany still have a high risk to become iron-deficient. Without consequent iron substitution the development of depleted iron stores is almost unavoidable. A practicable way out of this dilemma is to combine each blood donation with the supply of an adequate iron medication (20 tablets of lOOmg ferro iron). In addition, a more detailed and individual information on the respective iron status would be helpful to increase the compliance of the donors.
Regeneration of Central Nervous Tissue Using a Collagen Scaffold and Adipose-Derived Stromal Cells
Authors: Nakada Akira , Fukuda Seijun , Ichihara Satoshi , Sato Toshihiko , Itoi Shin-ichi , Inada Yuji , Endo Katsuaki , Nakamura Tatsuo
Published: May 2009

Adipose-derived stromal cells (ASCs) include stem cells, which have the potential to differentiate into a variety of cell lineages. The regeneration of central nerves was examined using ASCs and a collagen scaffold. A cerebral cortex defect (3 × 4 × 3 mm3) was created in the left frontal lobe of 16 male rats. In one group (n = 8), collagen (3 × 4 × 3 mm3) seeded with DiI-labeled ASCs was implanted in the defect. In order to seed the ASCs, a combination of the rotary cell culture system and pressing the collagen scaffold gently several times with a glass rod was applied. In the control group (n = 8), collagen was implanted without ASCs. The rats were sacrificed at 1 month after the scaffold implantation. Histologically, 0.2% of the implanted ASCs were positive for anti-human/rat microtubule-associated protein 2 (MAP2) antibody and microvessels were present at a density of 4.6 ± 1.2/mm2 within the collagen scaffold-implanted area in each coronal section. In the control group, no MAP2-positive cells were detected and the microvessel density was 0.6 ± 0.4/mm2. These data suggest that ASCs seeded into a collagen scaffold may have the potential to promote regeneration of nervous tissue after cerebral cortex injury.
Der Eisenhaushalt bei der präoperativen Eigenblutspende
Authors: Weisbach V. , Eckstein R.
Published: May 2009

Ziel: Anhand der aktuellen Literatur wird die Bedeutung des Eisenstoffwechsels und die Wertigkeit sowohl der oralen als auch der intravenösen Eisensubstitution zur Unterstützung der Ery-thropoese bei der präoperativen Eigenblutspende diskutiert. Quellen und Auswahlkriterien: Grundlage der kritischen Ausein-andersetzung mit der deutsch- und englischsprachigen Literatur bildet eine die letzten 20 Jahre umfassende Medline-Recherche. Ergebnisse: Der Erfolg der präoperativen Eigenblutspende ist wesentlich vom Gesamtkörpereisenbestand und vom Füllungszu-stand der Eisenspeicher zu Beginn der Spendephase abhängig. Da die spendebedingten Eisenverluste aus der Nahrung nicht rasch genug ersetzt werden können, erscheint die medikamentöse Substitution von Eisen sinnvoll. Bisher konnte jedoch weder für die orale noch für intravenöse Eisensubstitution im Rahmen der präoperativen Eigenblutspende von nicht im Eisenmangel befindlichen Patienten der Nachweis der Wirksamkeit im Sinne einer verbes-serten erythropoietischen Regeneration geführt werden. Lediglich im begleitenden Einsatz zu humanem rekombinantem Erythro-peietin bei der Eigenblutspende ergeben sich deutliche Hinweise für die Effektivität von intravenös verabreichtem Eisen. Schluβfolgerungen: Der Einsatz von intravenösem Eisen bei der präoperativen Eigenblutspende sollte derzeit auβerhalb klinischer Studien auf gut begründete Ausnahmefälle beschränkt bleiben. In Kombination mit Erythropoietm erscheint der Einsatz zur Ver-meidung von ineffektiver Erythropoese und auch unter dem Ge-sichtspunkt einer Reduktion der erforderlichen Erythropoietin-dosis gerechtfertigt. Die orale Eisensubstitution kann bei zwar nicht erwiesener, aber auch nicht ausgeschlossener Wirksamkeit angesichts des günstigen Risikoprofils bei Patienten, die diese Medikation problemlos vertragen, durchgeführt werden. Dies sollte dann allerdings unter entsprechender Überwachung postoperativ fortgeführt werden. Ein manifester Eisenmangel muβ davon unberührt natürlich entsprechend behandelt werden. Eine endgültige Validierung der Eisensubstitution bei der präoperativen Eigenblutspende von nicht im Eisenmangel befindlichen Patienten muβ in zukünftigen klinischen Studien erfolgen.
Effect of Antibiotic Prophylaxis with Cefuroxime on Bacteriologic Quality of Intra- and Postoperatively Processed Wound Blood in Hip Joint Arthroplasty
Authors: Wollinsky K.H. , Büchele M. , Oethinger M. , Kluger P. , Mehrkens H.-H. , Marre R. , Puhl W.
Published: May 2009

Objective: Investigation of the bacteriological quality of processed wound blood in orthopedic hip surgery depending on antibiotic prophylaxis or not. Design: Prospective randomized study after approval of the Ethics Committee. Setting: Operation theatre/intensive care unit of an Orthopedic University Clinic. Patients: 40 patients underwent first hip arthroplasty under regional anesthesia. 20 received as antibiotic prophylaxis cefuroxime 1.5 g single shot, 20 not. Interventions: Preopera-tive collection of autologous plasma (2 × 900 ml), normovolemic hemodilution (15 ml/KG), intra- and postoperative mechanical autotransfusion (Cell Saver®/Autotrans®). A quantitative bacteriological study was performed from the collecting bag (Vacufix®), wound drainage blood and processed red blood cell concentrates (PRBCC), using a pour plate technique and broth culture enrichment (Bactec® bottles). Examination after 2 and 7 days. Results: Maximally 1 CFU/ml (colony-forming unit) of bacteria was isolated from 8 Vacufix® bags of the control group (8/20), in contrast to no growth in the antibiotic group (0/20; p < 0.005). Wound drainage blood was found sterile in all patients. In 8 PRBCC of the control group (8/20) bacteria were identified in a concentration of < l (5×), 1-2 (2×), and 130 (l×) CFU/ml. In the cefuroxime group only 3/20 showed bacterial growth < l CFU/ml. Conclusions: Bacterial contamination of processed wound blood never caused wound or systemic infections. Antibiotic prophylaxis (cefuroxime) led to sterility in the Vacufix® collecting bac and reduction of bacterial growth in the PRBCC.
Platelet Substitution in Hematologic-Oncologic Patients with Only One or Few HLA Antibodies
Authors: Wernet D. , Lang-Beck E. , Schnaidt M. , Northoff H.
Published: May 2009

Objective: To define retrospectively the number of hematologic-oncologic patients who undergo platelet substitution therapy and who develop only one or few HLA antibodies over a longer period of time, as well as to determine the corresponding antigens and to evaluate the substitution principle applied: preparations from whole blood lacking the corresponding antigens. Patients and Methods: Sera of 718 hematologic-oncologic patients were tested after platelet transfusions by means of platelet immunofluorescence and lymphocytotoxicity testing. Results: Long-term single HLA antibodies were detected in approximately 5% of the patients. Transfusion responses to preparations lacking the corresponding antigens were comparable to random substitution in patients without detectable HLA antibodies as well as to compatible substitution in patients with antibodies. Conclusions: Provided that regular antibody screening is carried out and a large pool of HLA-typed donors is available, patients with few HLA antibodies can effectively be substituted with platelets obtained by whole-blood donation from donors lacking the corresponding antigens.
Eigenschaften und Indikationen von PPSB-Konzentraten unter besonderer Berücksichtigung der Qualitätssicherung sowie flankierender therapeutischer Maßnahmen
Authors: Oldenburg J. , Hertfelder H.-J. , Brackmann H.-H. , Trobisch H. , Hanfland P.
Published: May 2009

Ziel: Es werden wichtige Aspekte für die Anwendung von PPSB-Konzen-traten vorgestellt unter Berücksichtigung der Eigenschaften der heute ver-fügbaren PPSB-Präparate, der zugrundehegenden Hämostasestörungen und der zur Verfügung stehenden flankierenden therapeutischen Maßnahmen. Quellen: Die Grundlagen für diese Übersicht bilden Originalarbei-ten, Übersichtsartikel zu einzelnen Teilgebieten unter Berücksichtigung der «Leitlinien zur Therapie mit Blutkomponenten und Plasmaderivaten» der Bundesärztekammer sowie eigene Erfahrungen bei der Anwendung von PPSB-Konzentraten. Auswahlkriterien: Es werden die In-vitro- und In-vivo-Eigenschaften sowie die Virussicherheit von PPSB-Konzentraten sowie Aspekte der Qualitätssicherung dieser Präparate beschrieben. Auf der Grundlage dieser Daten werden die Indikationen zur PPSB-Substitu-tion bei angeborenen und erworbenen Mangelzuständen der Vitamin-K-abhängigen Faktoren diskutiert. Ergebnisse: In-vitro- und In-vivo-Unter-suchungen zeigen, daß PPSB-Konzentrate auch bei optimaler Herstel-lungstechnik zum gegenwärtigen Zeitpunkt noch gerinnungsaktivierejide Eigenschaften aufweisen. Diese können insbesondere bei komplexen Hämostasestörungen, wie z. B. bei Lebererkrankungen, zu vermehrten Komplikationen führen. Schlußfolgerungen: Erforderlich ist eine Qua-litätskontrolle für PPSB-Präparate, wie sie inzwischen vom Paul-Ehrlich-Institut begonnen wurde, unter Berücksichtigung der Kriterien «Spezifi-sche Aktivität der enthaltenen prokoagulatorischen und inhibitorischen Faktoren», «gerinnungsaktivierende und/oder Fibrinolyse-induzierende Eigenschaften» sowie «Virusinaktivierungsverfahren». Die Indikationen zur Substitution von PPSB-Konzentraten bei Blutungen infolge angebore-ner oder erworbener isolierter Mangelzustände der Vitamin-K-abhängi-gen Faktoren sind unumstritten. Dagegen sind die Indikationen zur PPSB-Gabe bei Blutungsbehandlung oder -prophylaxe von komplexen Hämostasestörungen, z.B. bei Lebererkrankungen, kritisch zu stellen. Sollte nach Charakterisierung der vorliegenden Hämostasestörung und Erw-ägung anderer therapeutischer Alternativen wie z.B. FFP (Fresh Frozen Plasma) die Gabe von PPSB erforderlich sein, können bei bestimmten gerinnungsphysiologischen Befunden flankierende therapeutische Maßnahmen (gezielte Heparinisierung, Substitution von Antithrombin III, gegebenenfalls antiproteolytische Therapie mit Aprotinin) zur Vermei-dung von Komplikationen beitragen.
Superantigene – Bedeutung als Sepsisinduktoren
Authors: Heeg K.
Published: May 2009

Superantigene sind bakterielle oder virale Proteine, die T-Lymphozyten oligoklonal aktivieren. Dabei reagieren je nach Superantigen bis zu 25% aller T-Zellen gleichzeitig. Diese massive T-Zell-Aktivierung führt zu einer fulminanten Zyto-kinfreisetzung aus T-Zellen (z.B. TNF, IFN-γ, IL-2), die einen tödlichen Schock auslösen kann. Wie beim endotoxininduzier-ten Schock spielt dabei TNF eine Schlüsselrolle. Nach der initialen Überreaktion beobachtet man später verschiedene Formen der Immunparalyse, die T-Zellen und antigenpräsentie-rende Zellen einschlieβt. Pathogene grampositive Bakterien (Staphylococcus aureus, Streptococcus pyogenes) produzieren häufíg Superantigene, die möglicherweise einen Induktor zur Auslösung einer grampositiven Sepsis darstellen.
Mechanismen immunologisch vermittelter kardialer Funktionsstörung bei Myokarditis und dilatativer Kardiomyopathie
Authors: Maisch B. , Herzum M. , Hufnagel G. , Schönian U. , Richter A. , Ritter M. , Ruppert V. , Bethge Ch. , Pankuweit S.
Published: May 2009

Humorale und zelluläre Effektormechanismen des Immunsy-stems können über multiple Interaktionen passagere oder per-manente Änderungen der systolischen und diastolischen Myo-kardfunktion hervorrufen. Dies kann über molekulare, metabo-lische, rezeptormediierte und ebenso auch strukturelle Verän-derungen am Myozyten (z.B. Hypertrophie), am Interstitium und an der extrazellulären Matrix (z.B. Fibrose) und der Zellularität (z.B. Myokarditis) erfolgen. In dieser Übersicht liegt der Schwerpunkt der Beschreibung solcher Veränderun-gen beim Krankheitsbild der entzündlichen Herzmuskelerkran-kungen und bei den Pathomechanismen, über die Viren, zyto-toxische T-Zellen, Zytokine und antikardiale Antiköφer in tierexperimentellen Untersuchungen und beim Menschen diese funktionellen und strukturellen Vorgänge beeinflussen.
Kawasaki-Syndrom – Pathophysiologie, Klinik und Therapie
Authors: Walm V.
Published: May 2009

In vieler Hinsicht repräsentiert das Kawasaki-Syndrom eine besondere Form der Vaskulitis, die sich in erster Linie im Säuglings- und Kleinkindesalter manifestiert. Falls die Diagnose nicht rechtzeitig gestellt und eine wirksame Behandlung eingeleitet wird, besteht ein Risiko zur Ausbildung von Aneu-rysmen, insbesondere im Bereich der Koronararterien. Diese Übersicht beschreibt wichtige Aspekte der Erkrankung mit dem Ziel, das Wissen über die Erkrankung zu verbreiten und damit die Voraussetzungen für eine verbesserte Prognose zu schaffen.