bluuebunny/crossref_metadata_2025 huggingface dataset:
Sequential Treatment of Deep Leg Vein Thrombosis with Porcine Plasmin and Low Dose Streptokinase
Authors: Marbet G A , Eichlisberger R , Duckert F , de Silva M A , Biland L , Widmer L K , Ritz R , Schmitt H E
Published: July 2018

Sequential treatment of deep leg vein thrombosis with porcine plasmin and low dose streptokinase (10,000-20,000 U/h) produces strong systemic fibrinolysis as demonstrated by the sustained decrease of euglobulin lysis time, of thromboplastin time values in percent, fibrinogen and factor V levels. There is a statistically significant negative correlation between thrombolytic results and euglobulin lysis time. Treatment periods below 3 days are unlikely to give satisfactory results. Occluded vein segments with an apparent median age of 4 days including thrombi older than 10 days (20% of cases) are cleared with an average chance of 50%. Complete dissolution of all thrombi proximal to the crural veins has been demonstrated in 47/114 = 41.2%, some thrombolytic effect in 31/114 = 27.2% and treatment failure in 36/114 = 31.6%. The data favour laboratory monitoring of thrombolytic therapy.
A Unique Pathway for the Plasma Elimination of α2-Antiplasmin-Protease Complexes in Mice
Authors: Gonias S L , Fuchs H E , Pizzo S V
Published: July 2018

Radiolabeled α2-antiplasmin cleared slowly from the circulation of mice. Complex formation with either plasmin or trypsin resulted in a significant increase in the plasma elimination rate of the protease inhibitor. Approximately 20 min and 14 min were required for 50% of the injected α2-antiplasmin-plasmin and α2-antiplasmin-trypsin to clear from the circulation, respectively. Significant competition was observed when radiolabeled α2-antiplasmin-plasmin was cleared in the presence of a large molar excess of unlabeled α2-antiplasmin-plasmin. α1-Antitrypsin-trypsin failed to compete with radiolabeled α2-antiplasmin-plasmin even when present at 2000 fold molar excess. Organ distribution studies localized the major site of α2-antiplasmin-plasmin clearance in the liver. Microscopic autoradiography data suggested that the cell responsible for the clearance pathway was the hepatocyte.
Decreased Levels of Histidine-Rich Glycoprotein (HRG) and Increased Levels of Free Plasminogen in Women on Oral Contraceptives Low in Estrogen
Authors: Jespersen Jørgen , Kluft Cornelis
Published: July 2018

Determinations by immunologic methods of histidine-rich glycoprotein (HRG) and plasminogen, were made in plasma samples collected during one normal or hormone induced cycle in 15 young, normal women and in 11 women using oral contraceptives with 30 μg ethinyl estradiol and 150 μg levo-norgestrel. The hormone group showed an increase in plasminogen level to about 150% of normal, while the concentration of HRG was decreased to about 75% of normal. This resulted in a considerable relative increase in the concentration of free plasminogen in the hormone group (calculated from the equilibrium: HRG·plasminogen ⇌ HRG + plasminogen, using KD = 1.0 μM), representing a doubling of that in the normal group. Hence, more plasminogen is available for binding to fibrin and activation in the hormone group.
In Vivo Photoactivation of Caged-Thrombin
Authors: Arroyo Jorge G , Jones Paul B , Porter Ned A , Hatchell Diane L
Published: July 2018

Aberrant ocular neovascularization is a major cause of blindness in the world. Abnormal blood vessels in the eye may produce corneal opacification, corneal transplant rejection, neovascular glaucoma, vitreous hemorrhage, traction retinal detachment, and subretinal scars from choroidal neovascular membranes (1-5). Light-induced clotting of blood within these abnormal vessels could provide a novel method for the ablation of deleterious neovascularization. Thrombin is a serine proteinase that participates in the final stages of the coagulation cascade. An inhibitor of thrombin, p-Amidinophenyl-(E)-4-diethyl- amino-2-hydroxy-α-methylcinnamate hydrochloride, MeCINN (1), covalently attaches to the active site serine hydroxyl, inhibiting or caging, the enzyme. Photolysis of the caged-thrombin in vitro causes a trans-cis isomerization of MeCINN which leads to regeneration of active enzyme and cleaving of fibrinogen into fibrin (6). Using a rabbit model of corneal neovascularization, we found that light at 366 nm safely and effectively photoactivates intravenous caged-thrombin and produces localized thrombosis in vivo. These results suggest that intra- vascular photoactivation of caged-thrombin could be used to occlude abnormal blood vessels in the human eye.
Comparison of the Effects of Different Low Molecular Weight Heparins on the Hemostatic System Activation In Vivo in Man
Authors: Wolzt Michael , Eder Michaela , Weltermann Ansgar , Entlicher Jesusa , Eichler Hans-Georg , Kyrle Paul A
Published: July 2018

In a double-blind, randomized, cross-over study the effects of single subcutaneous doses of 120 anti-Xa units/kg body wt. of three different low molecular weight heparin (LMWH) preparations were investigated in 15 healthy subjects by determination of thrombin-antithrombin El complex (TAT), prothrombin fragment 1.2 (fl.2), and β-thromboglobin (β-TG) in shed blood and in venous blood.

Certoparin, dalteparin, and enoxaparin significantly inhibited coagulation activation marker formation in shed blood. The substantial inhibition of TAT and fl.2 formation was slightly more pronounced in response to certoparin. β-TG was decreased following certoparin and enoxaparin, but not following dalteparin. However, no difference between groups was detectable. A small but consistent decrease of fl.2 formation in venous blood was noted for all LMWHs and dalteparin and enoxaparin, but not certoparin, inhibited TAT formation. Only a minor impact of the three LMWH preparations was noted on β-TG plasma concentrations.

Our data indicate that the studied LMWH preparations have a major impact on blood clotting in the activated state and inhibit in vivothe hemostatic system to a comparable extent.
Sympathoadrenal Activation and Muscarinic Receptor Stimulation Induce Acute Release of Tissue-Type Plasminogen Activator but not von Willebrand Factor across the Human Forearm
Authors: Jern Christina , Selin Lena , Tengborn Lilian , Jern Sverker
Published: July 2018

We have previously shown that both mental stress and administration of the muscarinic receptor agonist methacholine induce an acute release of tissue-type plasminogen activator (t-PA) across the human forearm. There are data indicating that the regulated acute release of t-PA from the endothelium is closely interrelated with release of von Willebrand factor (vWF). The aim of the present study was to simultaneously determine basal and stimulated in vivo release rates of t-PA and vWF in an intact human muscle vascular bed. Eighteen healthy young males were studied at rest and during 10 min of mental stress (forced arithmetic). A subsample of ten subjects also received a stepwise i.a. infusion of methacholine (0.1-0.8-4.0 |xg/min). Forearm blood flow was determined by venous occlusion plethysmography and interconverted to forearm plasma flow (FPF) using individual hematocrits. Net release/uptake rates of t-PA and vWF were calculated as the product of the arteriovenous concentration gradient and FPF. At rest there was a net release of both t-PA antigen and activity. In contrast, there was no significant local net release of vWF antigen across the forearm. Net release rates of t-PA roughly doubled in response to the stress test (0.4 to 0.8 and 0.2 to 0.5 ng X min-1X 100 ml-1for t-PA antigen and activity, respectively, p <0.05 for both). Local administration of methacholine induced a more than 10-fold increase in the net release rates of t-PA (0.6 to 9.6 and 0.3 to 6.6 ng X min-1X 100 ml-1at the highest dose step for antigen and activity respectively, p <0.01 for both). In contrast, neither mental stress nor local administration of methacholine induced a significant net release of vWF antigen across the forearm. The results demonstrate that the processes of acute release of t-PA and vWF are not necessarily linked in vivo in man.
Effect of a New Monoclonal Anti-Glycoprotein IX Antibody, KMP-9, on High Shear-Induced Platelet Aggregation
Authors: Miyake Tetsuya , Nomura Shosaku , Komiyama Yutaka , Miyazaki Yasuhiko , Kagawa Hideo , Masuda Midori , Takahashi Hakuo , Fujimura Yoshihiro , Ikeda Yasuo , Fukuhara Shirou
Published: July 2018

Human platelet glycoprotein Ib/IX complex acts as a receptor for von Willebrand factor. It is widely accepted that glycoprotein lb is the essential receptor component, but the role of glycoprotein IX is still unclear. We produced a new monoclonal anti-glycoprotein IX antibody (KMP-9) by the hybridoma technique using platelets from a patient with Glanzmann’s thrombasthenia. The epitope of KMP-9 was localized to the C-terminal 8 kD fragment of glycoprotein IX using ELISA analysis of polyethylene-pin-synthesized peptides, as well as Western blot analysis of platelets after digestion with N-glycosidase and Staphylococcus aureus V8 protease. KMP-9 partially inhibited high shear stress-induced platelet aggregation, but had no effect on aggregation induced by ristocetin or low shear stress. Its inhibitory effect on high shear stress-induced aggregation was weaker than that of antiglycoprotein lb or anti-glycoprotein Ilb/IIIa monoclonal antibodies. A 21-mer synthetic peptide (glycoprotein IX L110-G130) inhibited the binding of KMP-9 to platelets. It also competively inhibited the suppression of high shear stress-induced platelet aggregation by KMP-9, but had no direct effect on this aggregation. KMP-9 may be useful to clarify the physiological role of GPIX.
Observations on the Development of Mural Thrombi in Chronic Experimental Aneurysms in Sheep
Authors: Stehbens W E
Published: July 2018

Observations were made on mural thrombi in experimental venous pouch aneurysms in sheep. Thrombi associated with mural tears and dissection consisted predominantly of laminated fibrin masking the earlier platelet deposition and infiltrating the wall to some extent. Thrombus growth was associated with platelet masses of Zahn and secondary fibrin deposition. Intervening spaces contained a variable quantity of coagulated plasma, fibrin mesh, leucocytes, disintegrating red cells and platelets rather than red thrombus as often suggested. Periodic deposition of platelet masses with surface rippling, the whorling patterns of laminated fibrin and mechanical disruption of red cells indicated the importance of haemodynamics. Coarse macroscopic lamination of mural thrombi was attributed in part to recurrent dissections between the wall and the mural thrombus and of the thrombus itself. These accounted for growth of thrombus with expansion of the wall and interference with organization of the thrombus. The model has proved suitable for the study of thrombogenesis and thrombus behaviour in aneurysms.
Effect of Changes in Liver Blood Flow on the Pharmacokinetics of Saruplase in Patients with Acute Myocardial Infarction
Authors: van Griensven Jean M T , Koster Rudolph W , Hopkins Gwynn R , Beier Horst , Günzler Wolfgang A , Kroon Ria , Schoemaker Rik C , Cohen Adam F
Published: July 2018

Background: The recombinant unglycosylated single chain urokinase-type plasminogen activator saruplase is cleared for a large part by the liver. A large interindividual variation in saruplase concentration is found in acute myocardial infarction (AMI) patients. The variable cardiac performance after an infarct may induce differences in liver blood flow that could explain the concentration diversity. This study was performed to investigate the relation between hepatic blood flow and the pharmacokinetic and pharmacodynamic properties of saruplase.

Methods and Results: Thirteen AMI patients were enroled in this open label study. Patients received a bolus injection of 20 mg saruplase followed by a one-hour infusion of 60 mg saruplase. Concurrently 36 mg intravenous indocyanine green (ICG) was given over 1 h to measure hepatic blood flow. Blood samples were taken at regular time intervals to measure plasma levels of urokinase-type plasminogen activator (u-PA) antigen and activity, the two-chain form (tcu-PA) activity, indocyanine green, fibrinogen, fibrin and fibrin degradation products, α2-antiplasmin and thrombin antithrombin III complex. A correlation was seen between the clearance of ICG and both those of u-PA antigen (r = 0.62; p <0.05) and u-PA activity (r = 0.57; p <0.05). A negative correlation was seen between the area under the curve of tcu-PA activity and the areas under the effect curves of both fibrinogen and α2-antiplas-min (r = -0.84; p <0.01 and r = -0.65; p <0.05).

Conclusions: Liver blood flow is an important determinant of the clearance of u-PA antigen and activity and reduction of flow in patients with heart failure will lead to an increase in plasma concentrations. High plasma concentrations of tcu-PA activity lead to increased systemic fibrinogenolysis. These results may be used to optimize saruplase treatment in patients with impaired cardiac function or after co-medication with drugs that affect liver blood flow.
Release of the Thrombin Receptor (PAR-1) N-terminus from the Surface of Human Platelets Activated by Thrombin
Authors: Ramachandran Ram , Klufas Alexandra S , Molino Marina , Ahuja Menaka , Hoxie James A , Brass Lowrence F
Published: July 2018

Platelet activation by thrombin is at least partially mediated by a G-protein-coupled receptor whose extended N-terminus is cleaved by thrombin. Theoretically, this should release a small fragment containing the original receptor N-terminus. However, the fate of this fragment is unknown, as is its biological role, if any. To begin to examine these issues, we have prepared monoclonal anti-receptor antibodies whose epitopes lie entirely N-terminal to the thrombin cleavage site. By flow cytometry and fluorescence microscopy of human platelets and mega- karyoblastic CHRF-288 cells, these antibodies were found to recognize intact receptors and receptors activated by the agonist peptide, SFLLRN, but not receptors whose N-terminus had been cleaved by thrombin or cathepsin G. Incubating CHRF-288 cells with thrombin released pre-bound antibody from the cell surface. An assay based upon the antibodies was able to detect a fragment containing the original receptor N-terminus in the supemate of thrombin-treated human plate lets. The concentration of the fragment obtained with platelets from 15 normal donors was 4.8 ± 0.9 pmol per 109 platelets (mean ± sem), which is similar to the value expected if all of the thrombin receptors present on human platelets have been cleaved. Taken together, these results demonstrate that 1) following receptor cleavage a fragment containing the original N-terminus of the receptor is released from the platelet surface, 2) based upon epitope mapping, this fragment is at least 15-20 residues long, 3) it is possible to quantitate the receptor fragment in the supemates of cells exposed to thrombin, and 4) the results of the quantitation suggest that on platelets all of the receptors have been cleaved and 100% of the fragment is present in the cell supemate. Depending on it survival time, measurements of the receptor fragment in blood or urine samples may eventually prove to be a useful marker for thrombin receptor activation in vivo.
Absence of Synergism Between Tissue-Type Plasminogen Activator (t-PA), Single-Chain UrokinaseType Plasminogen Activator (scu-PA) and Urokinase on Clot Lysis in a Plasma Milieu In Vitro
Authors: Collen D , De Cock F , Demarsin E , Lijnen H R , Stump D C
Published: July 2018

A potential synergic effect of tissue-type plasminogen activator (t-PA), single-chain urokinase-type plasminogen activator (scuPA) or urokinase on clot lysis was investigated in a whole human plasma system in vitro. The system consisted of a human plasma clot labeled with 125I-fibrinogen, immersed in titrated whole human plasma, to which the thrombolytic agents were added. Clot lysis was quantitated by measurement of released 125I, and activation of the fibrinolytic system in the surrounding plasma by measurements of fibrinogen and α2-antiplasmin.

t-PA, scu-PA and urokinase induced a dose-dependent and time-dependent clot lysis; 50 percent lysis after 2 h was obtained with 5 nM t-PA, 20 nM scu-PA and 12 nM urokinase. At these concentrations no significant activation of the fibrinolytic system in the plasma was observed with t-PA and scu-PA, whereas urokinase caused significant α2-antiplasmin consumption and concomitant fibrinogen degradation. The shape of the dose-response curves was different; t-PA and urokinase showed a log linear dose-response whereas that of scu-PA was sigmoidal.
Proposal for Objective Evaluation of the Performance of Various Functional APC-resistance Tests in Genotyped Patients
Authors: Freyburger G , Javorschi S , Labrouche S , Bernard P
Published: July 2018

The aim of the present study was to evaluate the relative performance of five screening methods for APC resistance caused by the factor V:Q506 mutation: the original method Coatest® APC™ Resistance Chromogenix, a modified method using the same reagents but a predilution 1+4 of the plasma in a factor V deficient plasma from Stago (Stago deficient V) or from Chromogenix (V-DEF Plasma), the Coatest® APC™ Resistance V (Chromogenix), and Accelerimat™ from bioMérieux. Normalization was done against a pool of normal plasmas for the methods from Chromogenix. The study included 350 subjects, 219 were genotyped (174 FV:R506R, 42 FV:Q506R, 3 FV:Q506Q) and most of them were assessed by more than one method. Uncertainty in predicting the FV genotype was evaluated by statistical analysis, which provided a way to quantitate the performance of the different diagnostic approaches. Performance of each test was evaluated by its sensitivity, specificity, R.O.C. curves, positive and negative likelihood ratios (LR), and the overall performance was determined by two parameters derived from the LR curves : the maximum LR value obtained at the crossover of the two curves, and the distance between the two curves for LR = 10. Coatest® APC™ Resistance V and Accelerimat™ were proven to be the methods most able to discriminate for factor V:Q506, while normalization was not shown to improve the screening performance. The original method from Chromogenix was confirmed to undergo many influences (factor XII, PAI-1, thrombin- antithrombin complexes, antithrombin III, hematocrit). Although a very good improvement was provided by the newest methods, they were shown to be influenced by protein S and/or factor V levels in the sample plasma.
Thrombin and Its Precursor in Human Cerebrospinal Fluid
Authors: Smirnova Irina V , Salazar Andres , Arnold Paul M , Glatt Sander , Handler Michael , Festoff Barry W
Published: July 2018

The blood coagulation cascade proteolytic enzyme, thrombin, affects many cell types, including neurons and astrocytes, in which it prevents process outgrowth and induces significant morphological degeneration and even cell death. Since thrombin may contribute significantly to pathological conditions in the central nervous system (CNS), where it is synthesized locally, we measured the levels of thrombin and its precursor, prothrombin, in the cerebrospinal fluid (CSF) of 67 individuals from 6 groups: non-neurologic controls (NNC); spinal degenerative disease (SDD); peripheral nerve disease (PND); cerebrovascular, neuroimmune and seizure disorders and tumor (CNSD); traumatic brain injury (TBI) and neurodegenerative disorders (NDD). We employed a sensitive chromogenic assay utilizing the thrombin specific tripeptide substrate, S-2238, to evaluate CSF levels of thrombin and prothrombin. The latter estimated after its conversion to active enzyme by the snake venom prothrombinase, ecarin. No measurable active thrombin was detected in these CSF samples. However, activatable prothrombin was measured in all groups. The mean activatable prothrombin concentrations (in nM) were 7.26 ± 3.39 (NNC); 8.85 ± 3.09 (SDD); 6.78 ± 2.58 (PND); 6.33 ± 3.87 (CNSD); 5.10 ± 1.86 (TBI), and 7.80 ± 3.27 (NDD). Duncan’s multiple comparison test showed significant reduction (p <0.05) in prothrombin levels of the TBI group. Our data suggests that the prothrombin zymogen gains access to the CSF, likely-across either an intact or compromised blood-brain barrier (BBB), in increased amounts with age. Reduced levels in TBI patients may have diagnostic and/or prognostic value.
Hawking radiation from acoustic black holes in two space dimensions
Authors: Eskin G.
Published: July 2018

We study the Hawking radiation for the acoustic black hole. In the beginning, we follow the outline of Jacobson but then we use a different 2 + 1 vacuum state similar to the vacuum state constructed by Unruh. We also use a special form of the wave packets. The focus of the paper is to treat the 2-dimensional case, in particular, the case when the radial and angular velocity are variable.
A novel deep learning approach for short-term wind power forecasting based on infinite feature selection and recurrent neural network
Authors: Shao Haijian , Deng Xing , Jiang Yingtao
Published: July 2018

There are many features that have been taken into consideration for wind power forecasting. Since properly ranking these relevant features, often redundant, can be quite difficult, highly accurate short term wind power forcasting remains a big challenge. Another noted problem that adversely impacts the accuracy of wind forcasting stems from the weakness of the prevailing prediction models based on the feedforward neural network (FNN) in handling wind power time series. This paper thus attempts to address the aforementioned problems in short-term wind power forecasting with a novel approach that combines the infinite feature selection (Inf-FS) with the recurrent neural networks (RNN). In particular, all the possible features related to wind forecast are first clustered into multiple feature sets, after which the identified feature sets are mapped onto the paths of a graph built for Inf-FS. Traversing such a graph helps effectively determine/rank the significance of the features according to their stability and classification accuracy measured in the feature space. The proposed wind prediction model then feeds the ranked features into a deep learning prediction system enabled by RNN, whose neurons have self-feedback loops to help gather the past decisions, and thus be more effective than FNN for wind power prediction. The proposed wind power prediction approach is demonstrated through the experimental evaluations using a dataset from the National Renewable Energy Laboratory (NREL). The result shows that the accuracy of short-term wind power forecast is increased by 11%, 29%, 33%, and 19% in spring, summer, autumn and winter, respectively, over that achieved using the traditional approaches.
Fabrication and evaluation of controllable deposition distance for aligned pattern by multi-nozzle near-field electrospinning
Authors: Wang Zhifeng , Chen Xindu , Zhang Jiarong , Lin Ya-Ju , Li Kuan , Zeng Jun , Wu Peixuan , He Yunbo , Li Yang , Wang Han
Published: July 2018

To mass-volume fabricate micro- and nano-scales aligned pattern, multi-nozzle near-field electrospinning (NFES) direct-writing technology is well proposed as a high-efficiency method in electrohydrodynamic (EHD) printing process. However, the interference effect among adjacent nozzles and coupling effect of various parameters have restricted to investigate deposition characteristic of multi-nozzle NFES and control EHD multi-jet deposition accuracy. In order to improve the accuracy of EHD multi-jet deposition with high-efficiency printing process, the experimental result compared with theoretical method were discussed. In this work, the influence of multi-nozzle geometry distribution and electrospinning parameters on deposition characteristic was studied with multi-nozzle NFES setup, and nozzles were in linear array. The deposition distance and homogeneity of aligned nanofibers were measured and explained with coefficient of dispersion on electric field among nozzles by simulation. Moreover, deposition distance of multi-nozzle NFES process was evaluated by modified theoretical derivation based on our previous studies. The modified theoretical derivation showed a good agreement with experiment results, and indicated that multi-nozzle NFES could accurately and efficiently direct-write aligned array pattern in future.
Wafer-scale epitaxial germanium (100), (111), (110) films on silicon using liquid phase crystallization
Authors: Chaurasia Saloni , Mohan Nagaboopathy , Raghavan Srinivasan , Avasthi Sushobhan
Published: July 2018

A wafer-scale method to obtain epitaxial germanium (Ge) on crystalline silicon (Si) using liquid-phase-crystallization (LPC) is presented. The technique provides a simple yet versatile method to grow epitaxial germanium on silicon with any crystallographic orientation: (100), (110) or (111). The process starts with amorphous Ge, which is melted and cooled in a controlled manner to form epitaxial germanium. LPC Ge films are continuous with an average grain-size of 2-5 μm. Rocking scan confirms that the LPC Ge is oriented with a threading dislocation density of ∼109 cm-2. The phi-scan confirms that LPC germanium is epitaxial with Ge (100), Ge (110) and Ge (111) showing four-fold, two-fold, and three-fold symmetry, respectively. The epitaxial quality of the Ge is influenced by the cleanliness of the Ge/Si interface; rate of cooling and ambient gas during LPC; and Ge layer thickness. Best films are obtained for 1 μm thick LPC Ge(100), cooled at ∼3-4 C/min in hydrogen ambient. Electron Hall mobility in these LPC Ge films is 736cm2/Vs, a high value that confirms the electronic quality of LPC Ge film.
First synthesis of (±)-myristicyclin A
Authors: Kubo Shinichiro , Mori Naoki , Watanabe Hidenori , Takikawa Hirosato
Published: July 2018

The first synthesis of myristicyclin A, which was isolated from the Papua New Guinean plant Horsfieldia spicata, is described. The synthesis features acid-mediated hydroarylation reaction to form a dihydrocoumarin moiety, construction of the 2,8-dioxabicyclo[3.3.1]nonane skeleton under acidic conditions, and regioselective Friedel-Crafts acylation at a later stage.
Holism, or the Erosion of Modularity: A Methodological Challenge for Validation
Authors: Lenhard Johannes
Published: July 2018

Modularity is a key concept in building and evaluating complex simulation models. My main claim is that in simulation modeling modularity tends to degenerate for reasons inherent to simulation methodology. The argument will proceed by analyzing the techniques of parameterization, tuning, and kludging. They are—to a certain extent—inevitable when building complex simulation models but erode modularity. As a result, the common account of validating simulations faces a major problem, namely, a problem of holism. In the conclusion, I will ask to what extent holism sets limits to validation.
Utilization of Arduino Uno on DikaTron TV Trainer Kit
Authors: Syaputra A , Pantjawati A B
Published: July 2018

This study aims to design Android-based TV trainer with DikaTron app on smartphone is an innovation from previous TV trainer. TV trainer is designed by connecting TV circuit path through the relay to the system that will be controlled, such as a sound circuit, image, color, power supply, tunner, and more. This TV trainer combines Arduino UNO, relay, Bluetooth modules, and TV circuit, with DikaTron application software that installed in smartphone. The Arduino Uno, relay and Bluetooth modules are located in a box separate from the TV set, so it can be developed to control other devices. Through the trial obtained results in accordance with the desired, this means that the function on the television set can work properly and can be controlled from the smartphone via Bluetooth network. From the research conducted can be concluded that Android-based TV trainer with DikaTron app on smartphone can work in accordance with the desired specifications and can be used to support the lab activities.
Implementation of Instructional Media Trainer Fiber Optic Sensor System on Sensor and Actuator Learning in SMKN 1 Katapang Bandung
Authors: Faozan Y M R , Mulyanti B , Wahyudin D
Published: July 2018

Instructional media trainer of fiber optic sensor system is media that utilize optical fiber as props in the lessons sensors and actuators. The purpose of this research is the study of students learning outcomes on subjects sensor and actuator by use trainer fiber optic sensor system and student’s responds about media has used. The method used in this research is experimental design, with the pre-experimental design. This research was conducted in class XI technique electronics industry (TEI) 1 in SMKN 1 Katapang Bandung with 38 students. The research results show that there has been increasing study results students who demonstrated by the strengthening ( the gain ) study results students on the cognitive domain an average of 0,64 in the medium category. In the domain affective and in the domain psychomotor the average value on the good predicate. All of students gives a very positive responds about implementation of this media. From the results of this research can be stated that using fiber optic sensor system could improve student learning outcomes and students’s response is very positive to the media used. Thus we can conclude that fiber optic sensor system on the subjects of sensor and actuator can improve learning outcomes students and very use full to be used in vocational school.
Development of Fiber Optic Chemical Sensor for Monitoring Acid Rain Level
Authors: Mulyanti B , Faozan Y M R , Putro W S , Pawinanto R E , Budi A H S , Sugandi G , Pantjawati A B
Published: July 2018

Acid rain event is very dangerous for human activity especially in five cities of Indonesia. Here, acid rain has consistently attacked over five cities in Indonesia such as Jakarta, Manado, Pontianak, Bogor, and Surabaya with average pH level 4.22 to 6.34 in July 2010. Thus, in this study aim to develop Fiber Optic Chemical Sensor (FOCS) for monitoring acid rain level over five cities in Indonesia. The development of FOCS is used evanescent wave type and photodiode FDS10X10 to monitor acid rain quality. In this study, the Optical Power Meter (OPM) is used as a validator equipment to capture FOCS capability. The result shows absorption loss was successfully detected using OPM and photodiode FDS10X10 in FOCS evanescent wave type. Here, the maximum value ammonia mass over acid rain level has successfully detected with value range 7.12 dBm to 8.34 dBm and 7.51 dBm to 7.71 dBm using photodiode FDS10X10 and OPM, respectively. The good result over validation process shows FOCS has successful working with strong correlation 0.78 to monitor acid rain level.
Accuracy of Administrative Health Data for Surveillance of Traumatic Brain Injury
Authors: Lasry Oliver , Dendukuri Nandini , Marcoux Judith , Buckeridge David L.
Published: July 2018

Background:

Traumatic brain injury surveillance provides information for allocating resources to prevention efforts. Administrative data are widely available and inexpensive but may underestimate traumatic brain injury burden by misclassifying cases. Moreover, previous studies evaluating the accuracy of administrative data surveillance case definitions were at risk of bias by using imperfect diagnostic definitions as reference standards. We assessed the accuracy (sensitivity/specificity) of traumatic brain injury surveillance case definitions in administrative data, without using a reference standard, to estimate incidence accurately.

Methods:

We used administrative data from a 25% random sample of Montreal residents from 2000 to 2014. We used hierarchical Bayesian latent class models to estimate the accuracy of widely used traumatic brain injury case definitions based on the International Classification of Diseases, or on head radiologic examinations, covering the full injury spectrum in children, adults, and the elderly. We estimated measurement error-adjusted age- and severity-specific incidence.

Results:

The adjusted traumatic brain injury incidence was 76 (95% CrI = 68, 85) per 10,000 person-years (underestimated as 54 [95% CrI = 54, 55] per 10,000 without adjustment). The most sensitive case definitions were radiologic examination claims in adults/elderly (0.48; 95% CrI = 0.43, 0.55 and 0.66; 95% CrI = 0.54, 0.79) and emergency department claims in children (0.45; 95% CrI = 0.39, 0.52). The most specific case definitions were inpatient claims and discharge abstracts (0.99; 95% CrI = 0.99, 1.00). We noted strong secular trends in case definition accuracy.

Conclusions:

Administrative data remain a useful tool for conducting traumatic brain injury surveillance and epidemiologic research when measurement error is adjusted for.
BILATERAL ENDOGENOUS ENDOPHTHALMITIS FROM STREPTOCOCCUS PNEUMONIAE
Authors: Brill Daniel A. , Farley Nathan D. , Albert Desiree C. , Sassalos Therese M. , Sangave Amit A. , Desai Uday R.
Published: July 2018

Purpose:

To report a case of bilateral endogenous endophthalmitis from Streptococcus pneumoniae with devastating sequelae.

Methods:

Interventional case report.

Results:

A 56-year-old man presented with acute bilateral blurred vision and floaters with fever and hemodynamic instability. Previously, he was diagnosed with acute otitis externa and reported manually extracting several of his own teeth. He underwent a vitreous tap and intravitreal antibiotic injections. Blood and vitreous cultures were positive for S. pneumoniae. The patient later developed life-threatening medical sequelae. His final visual acuity was no light perception in the right eye and 20/25 in the left eye.

Conclusion:

Diagnosing endogenous endophthalmitis early is essential to initiating a systemic evaluation for potentially life-threatening medical conditions, including sepsis, endocarditis, and osteomyelitis. A high degree of suspicion, expeditious treatment, and interdisciplinary collaboration are essential to maximizing patient outcomes.
Adenomatous Neuroendocrine Tumors of the Middle Ear: A Multi-institutional Investigation of 32 Cases and Development of a Staging System
Authors: Marinelli John P. , Cass Stephen P. , Mann Scott E. , Haynes David S. , Hunter Jacob B. , Isaacson Brandon , Sweeney Alex D. , Pelosi Stanley , Willcox Thomas O. , O’Connell Brendan P. , Rivera Michael , Lane John I. , Carlson Matthew L.
Published: July 2018

Objective:

To date, less than 150 cases of middle ear adenomatous neuroendocrine tumors (MEANTs) have been reported in the English literature. The objective of this study was to provide a contemporary analysis of these rare lesions and develop a consensus-driven staging system.

Study Design:

Multi-institutional retrospective histopathologic, radiologic, and clinical review.

Setting:

Six tertiary referral centers.

Patients:

Thirty-two patients with pathologically confirmed MEANT.

Intervention:

Surgical resection, adjuvant therapy.

Main Outcome Measures:

Clinical manifestations, outcomes, staging system.

Results:

Patients commonly presented with progressive conductive or mixed hearing loss (90%), aural fullness (50%), and tonal tinnitus (46%). Pulsatile tinnitus (16%), carcinoid syndrome (4%), and facial nerve paresis (4%) were less commonly observed. MEANTs frequently mimicked temporal bone paraganglioma (31%) and cholesteatoma (15%) at presentation. According to a novel T/N/M/S staging system (S = secretory tumor) proposed herein, there were 6 (19%) T1, 19 (59%) T2, and 7 (22%) T3 MEANTs. T3 tumors were significantly more likely to undergo subtotal or near total resection compared with lower staged tumors secondary to adherence to critical neurovascular structures such as the petrous internal carotid artery and facial nerve (p = 0.027). Patients with T3 MEANTs were more likely to experience multiple recurrences, require adjuvant therapy with a somatostatin analogue, or develop permanent facial nerve paresis compared with lower staged tumors. At last follow up, no patients with T1 MEANTs had developed recurrence, whereas 37% (7/19) of patients with T2 MEANT and 57% (4/7) of patients with T3 MEANT experienced either disease recurrence after gross total resection (GTR) or regrowth of known residual tumor requiring additional surgery at a median duration of 72 months (95% CI, 24–84).

Conclusions:

Patients with MEANTs can present with nonspecific symptomatology that overlaps with more commonly encountered middle ear lesions. MEANT exhibits a proclivity for recurrence according to T-stage and long-term clinical follow up is necessary, particularly for advanced stage tumors.
A Randomized Controlled Trial Comparing Colonoscopic Enema With Additional Oral Preparation as a Salvage for Inadequate Bowel Cleansing Before Colonoscopy
Authors: Yang Hyo-Joon , Park Dong Il , Park Soo-Kyung , Kim Sunyong , Lee Taeheon , Jung Yunho , Eun Chang Soo , Han Dong Soo
Published: July 2018

Goals:

The goal of this study was to evaluate the noninferiority of colonoscopic enema to additional oral preparation in salvage bowel cleansing for inadequate preparation for a morning colonoscopy.

Background:

Colonoscopic enema, administering additional cathartics into the right colon through the colonoscope accessory channel, is suggested to rescue poor bowel preparation for a colonoscopy but lacking comparative study.

Study:

In this prospective, randomized, actively-controlled, parallel group, noninferiority trial, consecutive outpatients and health checkup recipients aged from 19 to 70 years with inappropriate bowel preparation during an elective colonoscopy were enrolled to receive either a colonoscopic enema of 1 L polyethylene glycol (PEG) (enema group) or additional oral intake of 2 L PEG (oral group). The primary endpoint was the proportion of adequate bowel preparation evaluated using the Boston Bowel Preparation Scale.

Results:

Overall, 131 participants were randomized. Adequate bowel preparation was achieved in 53% (35/66) of the enema group, which was significantly inferior to the oral group (81.5%; 53/67) with a difference of −28.5% (95% confidence interval, −44.1, −12.9; P=0.001). The largest difference in the proportion of adequate bowel preparation was observed in the right colon (57.8% in the enema group vs. 86.9% in the oral group; P<0.001), followed by the transverse colon (85.9% vs. 98.4%; P=0.017) and the left colon (90.6% vs. 96.7%; P=0.274).

Conclusions:

The colonoscopic enema of 1 L PEG was inferior to the additional oral ingestion of 2 L PEG regarding efficacy as a salvage bowel preparation in adults with inadequate bowel cleansing for colonoscopy.
Loss of SATB2 Expression in Colorectal Carcinoma Is Associated With DNA Mismatch Repair Protein Deficiency and BRAF Mutation
Authors: Ma Changqing , Olevian Dane C. , Lowenthal Brett M. , Jayachandran Priya , Kozak Margaret M. , Chang Daniel T. , Pai Reetesh K.
Published: July 2018

The special AT-rich sequence binding protein (SATB2) has been reported to be a specific immunohistochemical marker for colorectal carcinoma; however, correlation of SATB2 expression with molecular alterations commonly assessed in colorectal carcinoma has not been performed. We examined the immunohistochemical expression of SATB2 in 586 adenocarcinomas of the gastrointestinal (GI) tract and pancreas to assess its utility in diagnosis and analyze the clinicopathologic and molecular characteristics of colorectal carcinoma stratified by SATB2 expression. SATB2 and CDX2 expression were evaluated in 266 adenocarcinomas of lower GI tract origin (246 colorectal and 20 appendiceal mucinous), 208 adenocarcinomas of upper GI tract and small intestinal origin (74 esophagus/esophagogastric junction, 103 stomach, 20 duodenal, and 11 jejunoileal), and 112 pancreatic ductal adenocarcinomas. SATB2 expression was more frequently identified in adenocarcinomas of lower GI tract origin (222/266, 83%) compared with upper GI tract, small intestinal, or pancreatic origin (26/320, 8%) (P<0.001). Compared with CDX2 alone, dual positive expression for SATB2 and CDX2 (SATB2+/CDX2+) has a significantly higher specificity for adenocarcinoma of lower GI tract origin (94% vs. 57%, P<0.001). In colorectal carcinoma, loss of SATB2 expression was more frequently observed in DNA mismatch repair (MMR) protein deficient tumors (31%) compared with MMR protein proficient tumors (13%) (P<0.01). A BRAF V600E mutation was more frequently identified in colorectal carcinomas with loss of SATB2 expression compared with those with positive SATB2 expression (29% vs. 3%) (P<0.001). In summary, SATB2 expression is a relatively specific marker of lower GI tract origin; however, loss of SATB2 expression is more commonly seen in colorectal carcinoma with MMR protein deficiency and BRAF mutation.
Reestablishment of Lymphatic Drainage after Vascularized Lymph Node Transfer in a Rat Model
Authors: Najjar Marc , Lopez Marcos M. , Ballestin Alberto , Munabi Naikhoba , Naides Alexandra I. , Noland Roberto Daniel , Blackburn Collin , Akelina Yelena , Ascherman Jeffrey A.
Published: July 2018

Background:

Vascularized lymph node transfer has recently received attention as a potential surgical treatment for lymphedema. Despite good results in some series, the mechanism and benefits of vascularized lymph node transfer have yet to be fully understood. This study aimed to investigate the reestablishment of drainage into transferred lymph nodes following vascularized lymph node transfer in a rat model.

Methods:

Seven rats underwent vascularized lymph node transfer. The operation performed on each rat consisted of two parts. First, the left groin lymph node basin with superficial epigastric vessels was harvested as a free flap. Second, the flap was reattached in the left groin of the rat by means of end-to-end microvascular anastomoses. Anastomosis patency was assessed immediately postoperatively and at the time of animal sacrifice. The rats were evaluated for reestablishment of lymphatic flow into the transplanted nodes at 1-month intervals for at least 6 months postoperatively. This was accomplished noninvasively by injecting the rats in their flanks with fluorescent indocyanine green, which was detected using a Photodynamic Eye infrared camera.

Results:

Anastomoses were patent in all seven rats immediately postoperatively. No indocyanine green uptake was seen in the transplanted lymph node basins in the first 2 months postoperatively in any of the rats. In five of seven rats, however, indocyanine green uptake was demonstrated in the transplanted lymph node basin by 6 months (average, 13 weeks).

Conclusion:

The authors report uptake of indocyanine green in five of seven rats at an average of 13 weeks after lymph node transplantation, consistent with the reestablishment of lymphatic drainage into the transplanted nodes.
Ten-Year Survival After Peptide Receptor Radionuclide Therapy of a Metastatic Well-differentiated G3 Pancreatic Neuroendocrine Neoplasm
Authors: Zhang Jingjing , Kulkarni Harshad R. , Singh Aviral , Baum Richard P.
Published: July 2018

Substantial molecular and clinical heterogeneity of high-grade neuroendocrine neoplasms (NENs) G3, all of which were previously referred to as neuroendocrine carcinomas, has been observed. Although data are still limited, somatostatin receptor expression in well-differentiated G3 NENs of the pancreas (according to the new WHO 2017 classification) may enable peptide receptor radionuclide therapy for these patients. We report our treatment experience of a G3 NEN patient with discordant Ki-67 proliferation indices (between primary tumor and the metastases), who had a long survival over a span of 10 years with excellent quality of life and no adverse effects after repeated cycles of PRRT.
Lambert-Eaton Myasthenic Syndrome Associated With Extrapulmonary Small Cell Cancer Detected by 18F-FDG PET/CT
Authors: Chen Guoqian , Fu Zhanli , Chen Xueqi , Li Qian
Published: July 2018

A 46-year-old woman suffering from lower extremity weakness, dysarthria, dysphagia, dyspnea, and dry mouth was suspected of having Lambert-Eaton myasthenic syndrome based on the characteristic electromyographic abnormalities of right ulnar nerve, which demonstrated reduced resting compound muscle action potential amplitude and greater than 100% incremental change in high-frequency repetitive nerve stimulation. An 18F-FDG PET/CT was performed to detect the underlying neoplasm and revealed a retroperitoneal soft tissue mass with high 18F-FDG avidity in the left iliac fossa. The patient's symptoms were prominently relieved after the tumor resection, and the histopathology indicated a small cell carcinoma.
Evolutionary Distance Predicts Recurrence After Liver Transplantation in Multifocal Hepatocellular Carcinoma
Authors: Heits Nils , Brosch Mario , Herrmann Alexander , Behrens Robin , Röcken Christoph , Schrem Harald , Kaltenborn Alexander , Klempnauer Jürgen , Kreipe Hans-Heinrich , Reichert Benedikt , Lenschow Christina , Wilms Christian , Vogel Thomas , Wolters Heiner , Wardelmann Eva , Seehofer Daniel , Buch Stephan , Zeissig Sebastian , Pannach Sven , Raschzok Nathanael , Dietel Manfred , von Schoenfels Witigo , Hinz Sebastian , Teufel Andreas , Evert Matthias , Franke Andre , Becker Thomas , Braun Felix , Hampe Jochen , Schafmayer Clemens
Published: July 2018

Background

Liver transplantation (LTx) is a potentially curative treatment option for hepatocellular carcinoma (HCC) in cirrhosis. However, patients, where HCC is already a systemic disease, LTx may be individually harmful and has a negative impact on donor organ usage. Thus, there is a need for improved selection criteria beyond nodule morphology to select patients with a favorable outcome for LTx in multifocal HCC. Evolutionary distance measured from genome-wide single-nucleotide polymorphism data between tumor nodules and the cirrhotic liver may be a prognostic marker of survival after LTx for multifocal HCC.

Methods

In a retrospective multicenter study, clinical data and formalin-fixed paraffin-embedded specimens of the liver and 2 tumor nodules were obtained from explants of 30 patients in the discovery and 180 patients in the replication cohort. DNA was extracted from formalin-fixed paraffin-embedded specimens followed by genome wide single-nucleotide polymorphism genotyping.

Results

Genotype quality criteria allowed for analysis of 8 patients in the discovery and 17 patients in the replication set. DNA concentrations of a total of 25 patients fulfilled the quality criteria and were included in the analysis. Both, in the discovery (P = 0.04) and in the replication data sets (P = 0.01), evolutionary distance was associated with the risk of recurrence of HCC after transplantation (combined P = 0.0002). In a univariate analysis, evolutionary distance (P = 7.4 × 10−6) and microvascular invasion (P = 1.31 × 10−5) were significantly associated with survival in a Cox regression analysis.

Conclusions

Evolutionary distance allows for the determination of a high-risk group of recurrence if preoperative liver biopsy is considered.