bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Effects Of Ibuprofen (Motrin) On Prostacyclin And Thromboxane Production
Authors: Parks W M , Hcak J C , Czervionke R L , Haycraft D L
Published: July 2018

Ibuprofen (Ibu) has potential as an anti-thrombotic agent with ability to inhibit platelet thromboxane A2 (TXA2) synthesis and to protect the ischemic myocardium. We have evaluated the effect of Ibu on prostacyclin (PGI2) production by primary cultures of human umbilical vein endothelium and TXA2 production by washed human platelets. Radioimmunoassays for 6-keto-PGF1α and TXB2, the stable end-products of PGI2 and TXA2 were employed. Bovine thrombin 0.33 U/ml was used as the stimulus for prostaglandin synthesis. Endothelial and platelet func ion was assessed using platelet adherence with 51cr-platelets to cell monolayers and platelet aggregometry. Both platelets and endothelium exhibited a similar sensitivity to Ibu. Complete inhibition of PGI2 and IXA2 production was seen after 30 min incubation with 100 #x03BC;M Ibu, 85% inhibition with 25 μM Ibu and 50% inhibition with 5 μM Ibu. In contrast to aspirin the effect of Ibu was rapidly reversible and PG synthesis in platelets returned within 5 min after removal of Ibu. In the presence of Ibu, the irreversible effect of aspirin upon TXA2 production was inhibited. When PGI2 and TXA2 production was completely inhibited by 100 μM Ibu, thrombin-induced platelet adherence increased from a baseline value of 3% to 27%. After a single oral dose of 400 mg, Ibu produces serum concentrations up to 135 #x03BC;M. If comparable mechanisms operate in vivo, Ibu has the potential to cause significant inhibition of both PGI2 and TXA2 production. Reversal of the effect appears to be prompt, but no significant differential effect upon TXA2 production, without a similar effect upon PGI2 production, was observed at any concentration of Ibu tested.
A Comparison of Methods for Platelet Lysis and the Isolation of Platelet Membranes
Authors: Barber A. J , Pepper D. S , Jamieson G. A
Published: July 2018

Four methods of platelet lysis, namely, sonication, nitrogen cavitation in a high pressure bomb, the use of a “no clearance” tissue homogenizer and simple osmotic lysis have been compared in terms of ease, effectiveness and reproducibility in comparison with a method involving the hypotonic lysis of glycerol-loaded platelets ; the most extensive studies have been carried out using sonication and the tissue homogenizer. In order to reduce the degree of fragmentation of the platelet membrane, the use of surface stabilizing agents such as zinc chloride and fluorescein mercuric acetate have also been investigated. Membranes obtained in these different ways have been isolated by centrifugation on continuous or discontinuous sucrose density gradients and the resulting fractions compared by electron microscopy, enzymatic activity, chemical analysis and hemagglutination inhibition. The glycerol-lysis technique was found to be most effective (85%) in untreated platelets and the degree of lysis was considerably reduced in platelets hardened by the zinc chloride method. Ultrastructural studies showed that the largest membrane fragments (175 nm) were obtained by glycerol lysis of untreated platelets and that smaller vesicles (50-100 nm) were obtained by the other techniques even following membrane stabilization. Double membrane structures were obtained in several of these methods.
The Role of Hageman Factor in Disseminated Intravascular Coagulation Induced by Septicemia, Neoplasia, or Liver Disease
Authors: Mason J. W , Colman R. W
Published: July 2018

The human plasma kallikrein system was assayed in patients with disseminated intravascular coagulation (DIC) induced by gram negative bacteremia, neoplasia and severe liver disease. Only the patients with gram negative septicemia showed activation of plasma kallikrein with concomitant depletion of kallikreinogen and kallikrein inhibition. Since the activation of kallikrein is a function of activated Hageman factor, it is suggested that in DIC associated with gram negative septicemia, Hageman factor activation may be involved in the DIC. In DIC associated with neoplasia or liver disease lack of Hageman factor activation should be considered.
Assessment of Damage to Human Platelets after Aggregation and Other Injuries by Microscopic Observation and Estimation of Serotonin Uptake
Authors: Zbinden G , Mehrishi J. N , Tomlin S
Published: July 2018

The severity of platelet damage induced by hyper- and hypotonic NaCl solutions and freezing and thawing was assessed by microscopic evaluation and measuring inhibition of 5-HT uptake. The same techniques were used to quantitate the effects of aggregating agents. The positively charged macromolecules PS, Poly-L und Poly-O reduced the net negative surface charge as determined by microelectrophoresis, caused platelet aggregation and inhibited 5-HT uptake. The damaging effects of Poly-L and Poly-O were more severe and more closely related to concentration than that of PS. The negatively charged macromolecules Poly-IC and NaPS increased the anodic electrophoretic mobility. Poly-IC and heparin caused a low degree of platelet clumping and no inhibition of 5-HT uptake. NaPS produced severe platelet damage with extensive clumping and complete inhibition of 5-HT uptake. Na laurate had the same effect, but did not alter electrophoretic mobility. ADP caused concentration-dependent platelet aggregation and inhibition of 5-HT uptake. The effects of ADP and NaPS were compared in agitated and non-agitated platelet samples containing identical concentrations of the 2 compounds. Agitation was found to increase the degree of platelet clumping and to reduce 5-HT uptake.
Intestinal Alkaline Phosphatase as a Thrombogenic and Platelet-Altering Factor in Rabbits
Authors: Iatridis S. G , Ferguson J. H , Iatridis P. G
Published: July 2018

Purified intestinal alkaline phosphatase (AlPh), 10 mg/kg, was injected intravenously into rabbits. In normal animals, 1 min post-injection, averaged samples showed platelet count decreases to 50% of control values in whole blood and to 20% in centrifuged “platelet-rich” plasma. Small or large platelet aggregates were noted in the counting chambers, and a glass-bead platelet-adhesiveness test gave values at least twice that in the controls. The platelet changes were paralleled by shortening of an ear-lobe bleeding-time test and by an equally temporary shortening of the r and h values in thrombelastograms (TEG) of fresh whole blood. A very significant correlation, in the 1 min data, was with 4 + thrombosis in 30 min occluded test segments of mesenteric veins. Screening tests of coagulation and fibrinolysis were not significantly altered, and the same was true of various clotting factor assays, except perhaps for small changes which might be attributable to limited local clot formation.

15 min post-injection, platelet counts had risen again, no aggregates were noted, the TEG normalized, and the thrombosis test was negative.

In dicumarolized rabbits, the AlPh injections still elevated the serum alkaline phosphatase and caused the platelet alterations, but now without the thrombophilic changes.

Electrophoretic studies of AlPh isoenzyme distribution suggested that the significant post-injection elevations were not those in the total serum or beta-globvlin enzyme levels, but in a specific “gamma” isoenzyme, migrating cathodic to the ß-globulins.

The significance of the present experiments to the basic understanding and testings of thrombotic states is briefly discussed.
L’Activité Fibrinolytique dans les Endocardites Subaiguës
Authors: Scrobohaci Dr. Marie-Lorraine , Stancioiu Dr. N , Orha Dr. I
Published: July 2018

Les auteurs ont étudié l’activité fibrinolytique chez 50 malades valvulaires, dont 30 malades avec ERR et 20 avec EBS, dans le but de tirer au clair quelques aspects moins explorés de la thrombogénèse.

L’activité fibrinolytique a été étudiée par determination des activateurs et des antiactivateurs de l’urokinase et de la streptokinase.

Les résultats mettent en évidence une diminution de l’activité fibrinolytique tant pour ERR que pour EBS, l’inhibition prédominant dans cette dernière affection.

Le taux des antiactivateurs de la fibrinolyse est augmenté tant pour ERR que pour EBS, mais davantage pour ERR. Les mécanismes de diminution de l’activité fibrinolytique diffèrent dans les deux maladies : pour ERR elle est due probablement à l’excès des antiactivateurs de la fibrinolyse, mais pour EBS à la déficience des activateurs.

Les auteurs attirent l’attention sur le fait que ce comportement différent des activateurs de la fibrinolyse pourrait constituer un indice de la réactivité différente dans les deux maladies dans le sens de l’hyperergie pour ERR et de l’hypoanergie pour en EBS. La tendance thrombophilique variable pour chaque maladie pourrait être une conséquence de la modification immunobiologique spécifique.
Der Einfluß von Gift der Sandrasselotter (Echis carinata) auf die Hämostase
Authors: Zimmermann Heide , Habermann E , Lasch H.-G
Published: July 2018

Echis carinata-Gift und die daraus gewonnene gerinnungsfördernde Fraktion (»Coagulase«) führen zu einer Aktivierung des Prothrombinkomplexes. Die initiale Phase der Gerinnungsaktivierung geht in eine Phase der Hypokoagulabilität über. Sowohl der Abfall der Faktoren I, II, V, VIII, XIII, des Thrombozyten und des Antithrombin III als auch der Nachweis von Kryofibrinogen und Fibrinmonomer sind ein Beweis für intravaskulär entstandenes Thrombin. Diese im Sinne einer »Verbrauchs - koagulopathie« zu deutenden gerinnungsphysiologischen Veränderungen werden in ihrer Wirkung auf den Organismus (Steigerung der Letalität) durch gleichzeitige Norepinephringabe oder RES-Blockade verstärkt und können durch Vorbehandlung der Tiere mit Marcumar verhindert werden.
Purification of Streptokinase and Human Plasmin and Their Interaction
Authors: Blatt W. F , Segal H , Gray J. L
Published: July 2018

Procedures have been described for the purification of streptokinase and human plasmin, and molecular weights of 42,600 and 88,800 respectively have been determined. Equilibration of streptokinase with plasmin solutions produced an inhibition of caseinolytic activity and indicated a mole-mole interaction. This inhibitory activity was lost following acid treatment. When these data are considered with the previously reported findings using plasminstreptokinase mixtures as plasminogen activators, it would appear that plasmin and streptokinase react to form a complex which has the ability to convert both human and bovine plasminogen to plasmin.
Studies on Tissue Thromboplastin II. Species Specificity*)
Authors: Irsigler K , Lechner K , Deutsch E ,   with the technical assistence of H. Lomoschitz
Published: July 2018

1. Purified brain tissue thromboplastins of human, bovine and chicken origin have been tested on homologous and heterologous plasmas.

2. Purified brain tissue thromboplastin is species specific.

3. Lipid extracts from purified brain tissue thromboplastin prepared with pyridin show a negligable residual species specificity, probably caused by a slight contamination with brain tissue thromboplastin.

4. The activity curves of our lipid extracts differ from typical curves expected for lipid activators by a less distinct inhibition in high concentrations probably caused by a different composition of petrol-ether and pyridin extracts.

5. The protein part of tissue thromboplastin does not activate prothrombin in any system.

6. The protein part of tissue thromboplastin of one species could be combined with the lipid part of another species to form an active tissue thromboplastin.

7. The species specificity of these combinations was determined by the source of protein used.
Neutralization of Antithrombin VI (Fibrinogen Breakdown Products) with Platelet Antiheparin Factor (Platelet Factor 4)*
Authors: Niewiarowski S , Farbiszewski R , Popławski A
Published: July 2018

It has been found that fibrinogen breakdown product – antithrombin VI – is neutralized by the purified preparation of platelet factor 4, obtained by means of zinc acetate precipitation and DEAE chromatography column. It has been suggested that antiheparin activity of platelet factor 4 and its ability to neutralize antithrombin VI may be related to the same protein.

The purified preparation of platelet factor 4 does not influence the fibrinogen – fibrin conversion by thrombin. This means that platelet factor 2 and platelet factor 4 are not the same substance.

Crude platelet extracts neutralize antithrombin III and V. However, the purified product did not interferes with the action of these antithrombins.
A One-stage Factor VIII (Antihaemophilic Globulin) Assay and its Use on Venous and Capillary Plasma
Authors: Hardisty R. M , Macpherson Janet C. ,   Note on the Calculation of Confidence Limits by G. I. C. Ingram
Published: July 2018

A one-stage factor-VIII assay is described, based on the method of Lang-dell, Wagner and Brinkhous (1953), in which contact activation is controlled by the addition of a suspension of kaolin to the system. Experiments to show the effect of this modification on the clotting times and reproducibility of the system are presented.

The error of the method is expressed in terms of the confidence limits of a random series of field assays, which lay between 64—156% and 76—131% of the observed result.

The normal range of factor-VIII concentrations, as determined by this method on venous plasma samples from 116 normal subjects, was 50—170%, with a roughly normal distribution. There was good correlation between the results of one-stage and two-stage factor-VIII assays carried out in parallel on 110 plasma samples and between the observed and expected factor-VIII concentrations of a series of mixtures of normal and haemophilic plasma.

The use of the assay on capillary plasma samples is described, and the results compared with those obtained on venous plasma. The practical value of capillary factor-VIII assays is discussed.
Der Mechanismus des sogenannten »Heparin-Rebound« nach extrakorporellem Kreislauf
Authors: Brögli H
Published: July 2018

Das sogenannte »Heparin-Rebound«-Phänomen nach extrakorporellem Kreislauf ist die Folge einer Inaktivierung des Protamins. Die Protaminstabili-tät ist präparatabhängig und variiert von Patient zu Patient. Protaminchlorid verhält sich im Plasma weitgehend stabil, während Protaminsulfat rasch inaktiviert wird. Es wird gezeigt, daß bei unstabilen Protaminpräparaten trotz initial vollständiger Heparinneutralisation sowohl in vivo als auch in vitro ein Heparineffekt wieder in Erscheinung tritt. Die Protamininstabilität im Plasma ist temperaturabhängig und wird durch einen hitzelabilen Plasmafaktor verursacht. Im Plasma bei 4° 0, in hitzedenaturiertem Plasma oder in Puffer bei 37° C inkubiert bleibt der Heparin-Protamin-Komplex stabil.
Coagulation Dynamics in Factor V Deficiency: A Family Study, with a Note on the Occurrence of Thrombophlebitis, ,
Authors: Miller Sherwood P. ,   with the technical assistance of Joanna Siggerud and Tadeusz Stefanski, B. S.
Published: July 2018

1. A family with congenital proaccelerin (factor V) deficiency is here reported. The mode of inheritance appears to be by means of an autosomal recessive gene. The homozygous propositus (proaccelerin less than 2% of normal) had a life-long, moderately severe, bleeding tendency. The heterozygotes (proaccelerin 45 to 66%) were clinically normal.

2. Studies on the rate of consumption of coagulation factors during blood clotting revealed normal consumption of antihemophilic globulin (factor VIII), but defective consumption of prothrombin (II) in the propositus. This indicated the entry of proaccelerin into the clotting process between the stages at which antihemophilic globulin and prothrombin are involved. Five of the seven heterozygotes studied showed a similar pattern. These findings are consistent with current theories of the role of proaccelerin in the normal sequence of events in the coagulation scheme.

3. The propositus had an episode of thrombosis of the deep saphenous vein which is apparently a unique occurence in the literature of proaccelerin deficiency.
Anticoagulant Activity of β2-Glycoprotein I Is Potentiated by a Distinct Subgroup of Anticardiolipin Antibodies
Authors: Galli Monica , Comfurius Paul , Barbui Tiziano , Zwaal Robert F A , Bevers Edouard M
Published: July 2018

Plasmas of 16 patients positive for both IgG anticardiolipin (aCL) antibodies and lupus anticoagulant (LA) antibodies were subjected to adsorption with liposomes containing cardiolipin. In 5 of these plasmas both the anticardiolipin and the anticoagulant activities were co-sedimented with the liposomes in a dose-dependent manner, whereas in the remaining cases only the anticardiolipin activity could be removed by the liposomes, leaving the anticoagulant activity (LA) in the supernatant plasma. aCL antibodies purified from the first 5 plasmas were defined as aCL-type A, while the term aCL-type B was used for antibodies in the other 11 plasmas, from which 2 were selected for this study.

Prolongation of the dRVVT was produced by affinity-purified aCL-type A antibodies in plasma of human as well as animal (bovine, rat and goat) origin. aCL-type B antibodies were found to be devoid of anticoagulant activity, while the corresponding supernatants containing LA IgG produced prolongation of the dRVVT only in human plasma.

These anticoagulant activities of aCL-type A and of LA IgG's were subsequently evaluated in human plasma depleted of β2-glycoprotein I (β2-GPI), a protein which was previously shown to be essential in the binding of aCL antibodies to anionic phospholipids. Prolongation of the dRVVT by aCL-type A antibodies was abolished using β2-GPI deficient plasma, but could be restored upon addition of β2-GPI. In contrast, LA IgG caused prolongation of the dRVVT irrespective of the presence or absence of β2-GPI.

Since β2-GPI binds to negatively-charged phospholipids and impedes the conversion of prothrombin by the factor Xa/Va enzyme complex (Nimpf et al., Biochim Biophys Acta 1986; 884: 142–9), comparison was made of the effect of aCL-type A and aCL-type B antibodies on the rate of thrombin formation in the presence and absence of β2-GPI. This was measured in a system containing highly purified coagulation factors Xa, Va and prothrombin and lipid vesicles composed of 20 mole% phosphatidylserine and 80 mole% phosphatidylcholine. No inhibition on the rate of thrombin formation was observed with both types of aCL antibodies when either β2-GPI or the lipid vesicles were omitted. Addition of β2-GPI to the prothrombinase assay in the presence of lipid vesicles causes a time-dependent inhibition which was not affected by the presence of aCL-type B or non-specific IgG. In contrast, the presence of aCL-type A antibodies dramatically increased the anticoagulant effect of β2-GPI. These data indicate that the anticoagulant activity of aCL-type A antibodies in plasma is mediated by β2-GPI.
Tumor renal benigno versus carcinoma renal: reporte de caso y revisión de la literatura
Authors: Salinas Perdomo Jorge , Luna Meza Ángela , Castañeda-Cardona Camilo , Rosselli Diego
Published: July 2018

Introducción El cáncer renal representa 2,4% de los casos diagnosticados de cáncer en la población general, es más común en hombres que en mujeres, y se presenta con más frecuencia entre la 6ta y la 8ta décadas de vida. Se estima que el 16% de los pacientes se diagnostican como enfermedad metastásica.

Objetivo Se presenta el caso de un paciente cuyo diagnóstico de carcinoma renal se confundió inicialmente con un tumor benigno.

Métodos A un hombre de 56 años de edad se le realizó hace 3 años ese diagnóstico en un estadio avanzado de la enfermedad, a pesar del hallazgo incidental de una masa, que se consideró benigna durante 5 años.

Resultados Al momento del diagnóstico de carcinoma de células claras, el tumor era Estadio IV, con metástasis a pulmón. Recibió primera línea de tratamiento con sunitinib, pero fue suspendido por toxicidad; segunda línea con pazopanib durante 1 año, después presentó progresión de la enfermedad, por lo cual se cambió a tratamiento con axitinib con respuesta parcial, sin embargo, se suspendió por toxicidad cardiaca, entre otras. Al momento el paciente ha recibido 5 ciclos de bevacizumab con adecuada tolerancia.

Conclusiones Es necesario resaltar la indicación de diagnóstico adecuado y manejo quirúrgico en masas renales sospechosas.
Relevancia del antecedente de absceso perirrenal en pacientes sometidos a nefrectomía simple retroperitoneal
Authors: Carrillo-Córdova Luis , Sarabia-Estrada Roberto , Jiménez-Villavicencio Jean , Vitar-Sandoval Jhonatan , Rivera-Astorga Hugo , Lemus-Mena Gerardo , Sánchez-Meza Eduardo , Carrillo-Córdova Jorge , Camilo-Martínez Eli , Hernandez-Farias Miguel , Rosas-Ramírez Alejandro , Virgen-Gutiérrez José , Jaspersen-Gastelum Jorge , Garduño-Arteaga Mateo
Published: July 2018

Antecedentes Las infecciones supurativas del riñón y del espacio peri nefrítico son poco comunes. La nefrectomía simple consiste en extraer el riñón contenido dentro de la fascia de Gerota, técnica usada principalmente para padecimientos no malignos del riñón. Ese término puede ser potencialmente engañoso ya que el término “simple” implica que la cirugía para enfermedad benigna, es técnicamente menos desafiante con menos complicaciones en relación a su contra parte: la nefrectomía radical.

Metodología Se analizaron 58 pacientes. Los parámetros demográficos de los pacientes con antecedente de absceso perirrenal, fueron comparados con los pacientes sin antecedente de absceso (Edad, género, peso, localización del lito) variables transoperatorias (tiempo quirúrgico, sangrado transoperatorio) y variables postquirúrgicas (necesidad de terapia intensiva, necesidad de transfusión, infección de herida quirúrgica y días de estancia hospitalaria).

Resultados Los pacientes se dividieron en dos grupos, los que contaban con antecedente de absceso (Grupo 1), y aquellos que no tenían antecedente de absceso (Grupo 2). Se encontraron veinte pacientes con antecedente de absceso (34,55%) y treinta y ocho sin antecedente de absceso (65,6%). Al realizar la comparación entre los dos grupos se encontraron con mayor frecuencia en el grupo diferencias estadísticamente significativas para las variables de tiempo quirúrgico (212 minuto (DE 46,6) vs 130.3 minuto (DE 49)p = 0.0001), días de estancia hospitalaria (8,6 días (DE 4,1) vs 5,6 días (DE 1.9) p = 0.0003), e infección de herida quirúrgica (70% vs 31% p = 0,0008), no existieron diferencias estadísticamente significativas para el sangrado transoperatorio, necesidad de transfusión o necesidad de atención en unidad de cuidados intensivos.

Conclusiones La realización de una nefrectomía retroperitoneal simple abierta secundaria a litiasis en pacientes con antecedente de absceso perirrenal, conlleva a un mayor tiempo quirúrgico, secundario a una mayor dificultad técnica del procedimiento, por la gran cantidad de fibrosis y destrucción de la anatomía producida por el absceso. Los pacientes, también presentan un riesgo aumentado de infección de la herida quirúrgica, lo que conlleva a una mayor estancia hospitalaria y a una mayor inversión de recursos materiales y humanos.
Thermographic Patterns for Real-time Intraoperative Monitoring of Testicular Reperfusion Following Surgical Testicular Detorsion
Authors: Fernandez Nicolas , Lorenzo Armando , Blais Anne-Sophie , Matava Clyde
Published: July 2018

A 5-year-old patient presents to the emergency department with testicular torsion. Intraoperative sequential infrared thermographic images were registered in real-time using a FLIR One (FLIR Systems, Inc., Wilsonville, OR, US) infrared camera. The temperatures of the scrotum and the testis prior to scrotal exploration were 43.6°C on the affected side, and 41.7°C on the contralateral side. The core temperature of the patient was 36.8°C. Immediately after the tunica vaginalis had been opened and the testis had been brought out through the incision, the temperature of the testicle was 31.5°C. After 30 seconds of being detorted, the temperature increased to 34.3°C. The use of intraoperative infrared thermographic imaging helps to detect discrete changes in testicular temperature, which suggests it may be useful to objectively assess reperfusion. Future studies will require more patients to correlate postoperative blood flow to the injured testis as well as volume changes after surgery to see if the intraoperative thermography findings can be used as a predictive tool for postoperative outcomes.
Indikationen zur Thrombolyse im Kindesalter
Authors: Mentzer D. , Becker Sabine , Kreuz W.
Published: July 2018

Die steigende Anzahl von thrombotischen Ereignissen im Kindesalter, auch bedingt durch die zunehmenden Katheterisierungen in Neonatologie, Kardiologie und Onkologie, zeigen die Bedeutung und Notwendigkeit thrombolytischer Therapien im Kindesalter. Die Indikationsstellung zu einer thrombolytischen Therapie hängt ab von der Lokalisation des Verschlusses sowie den Zielen und möglichen Folgen einer Thrombolyse. Für die Anwendung der Thrombolytika Streptokinase und Urokinase bei Erwachsenen liegen Richtlinien vor, aus denen die Indikationen eindeutig hervorgehen. Im Kindesalter existieren inzwischen zahlreiche Erfahrungen mit der Lysetherapie, jedoch gibt es keine offiziell erstellten Indikationen für diese Therapie. Daher muß bei Kindern auf bisher publizierte Erfahrungen bei der Indikationsstellung zurückgegriffen werden und der zu erwartende Nutzen einer thrombolytischen Therapie gegenüber möglichen Folgeschäden abgewogen werden.

Durch die Entwicklung des Thrombolytikums rt-PA haben sich neue Aspekte für die Lysetherapie bei Kindern ergeben. Eine fibrinolytische Behandlung mit rt-PA bietet den großen Vorteil einer weitgehend fibrinspezifischen Wirkung im Gegensatz zu Streptokinase und Urokinase. Ein weiterer Vorteil liegt in der guten Steuerbarkeit der fibrinolytischen Therapie mit rt-PA aufgrund der kurzen Halbwertszeit.

Generell sollte die Indikation zur Thrombolyse im Kindesalter gestellt werden, wenn von dem thrombotischen Verschluß unmittelbar eine Lebensbedrohung ausgeht oder wenn eine lebensbedrohliche Krankheitsprogredienz durch eine erfolgreiche Lyse abgewendet werden kann. Außerdem ist die Indikation zur Lyse dann gegeben, wenn ein sicherer oder möglicher Dauerschaden aus dem Thromboseereignis erwächst. Eine Lyse kann auch indiziert sein, wenn dadurch Beschwerden des Patienten bekämpft werden oder ein thromboembolisches Ereignis beziehungsweise ein Thromboserezidiv verhindert werden kann. Vor jeder Indikationsstellung müssen eventuelle Kontraindikationen beachtet werden. Eine Relativierung der Kontraindikationen ist bei vitaler Indikation beziehungsweise bei zu erwartenden schweren Folgeschäden zu erwägen.
Espectro de hallazgos por TC multidetector en el trauma esplénico y hepático
Authors: Ghezzo Andrés C. , Adri Daniel O. , Gentile Ernestina , Yetati Ezequiel Levy
Published: July 2018

El trauma abdominal cerrado puede ser causa de lesiones en varios órganos sólidos, siendo el bazo y el hígado más frecuentemente afectados en ese tipo de situaciones. La tomografía computada multicorte (TCMC), es el método de imágenes de elección en la evaluación de pacientes que sufrieron un trauma cerrado abdominal gracias a que aporta un rápido y preciso diagnóstico y permite un eficaz tratamiento. El objetivo de este trabajo, es describir el espectro de las lesiones esplénicas y hepáticas encontradas en el trauma abdominal cerrado.
Rhinoplasty—Do Patients and Surgeons See the Same? A Double-Blind Study with 100 Randomized Patients
Authors: Santos Mariline , Carmo Diogo , Neves José , Sousa Cecília , Datema Frank , Ferreira Miguel
Published: July 2018

One of the key points of a successful rhinoplasty is communication between the patient and surgeon. The surgeon needs to get a clear understanding of the patient's motivation for surgery and expectations of the procedure. This information is mandatory in formulating an optimal surgical plan and managing realistic expectations of the procedures. Ideally, surgeons and patients see, discuss, and quantify the same nasal defects. In reality, the subjective nature of perceiving aesthetics can cause variability of inter-rating nasal appearance. Therefore, one might question how well surgeons understand their patients. Do they see what patients see? The aim of this study is to assess the level of agreement on the evaluation of nasal appearance between patients, surgeons, and nonphysicians observers, and try to find predictive factors that cause high interobserver variability. This prospective, observational, and cross-sectional study was performed on a total of 100 randomized patients undergoing rhinoplasty. All patients were photographed before surgery and asked to rate the appearance of their nose on a 10 cm visual analogue scale (VAS) with 0 indicating very ugly and 10 indicating very nice. Subsequently, the photographs of each patient were, independently, rated by two panels: one constituted by two rhinoplasty surgeons and the other by four nonmedical raters. Both panels included European raters from the north (The Netherlands) and south (Portugal). Data regarding age, gender, skin type, and major nasal deformity were also collected. The authors found that there is no statistical agreement between the aesthetical evaluation of the nose between patients and surgeons or patients and nonmedical raters. Based exclusively on the VAS for subjective evaluation of nasal appearance, the authors' findings show that surgeons and patients do not “see the same” and generally, the score attributed by the surgeon is more favorable (almost 1 point higher) than the auto-assessment's score. This is important to realize when communicating about nasal appearance before rhinoplasty.
Facial Asymmetry Index: Validation and Applications in Various Smile Restoration Techniques
Authors: Albathi Monirah , Byrne Patrick , Ishii Masaru , Ishii Lisa , Boahene Kofi , Malm Ian-James
Published: July 2018

Consistent and objective evaluation of the paralyzed face is imperative for documenting preoperative findings and assessing postoperative outcomes of reanimation techniques. Static and dynamic facial asymmetry are the key features of the paralyzed face. To date, there is no consensus among surgeons on how best to document facial asymmetry. The authors propose a Facial Asymmetry Index (FAI) as an objective measure of facial asymmetry and validate its use and reliability across numerous reanimation techniques. Frontal photographs of patients with unilateral facial nerve paralysis were analyzed. The length from the medial canthus to the ipsilateral oral commissure was compared between affected and nonaffected sides. The FAI is the difference between the two values, with a higher value reflecting poorer facial symmetry. Validation and reliability testing was then performed. There was a consistent decrease in the FAI with procedural intervention (FAI pre = 10.1, FAI post = 3.17; p < 0.0001). Furthermore, there was excellent inter- and intrarater reliability among independent judges. The FAI is a powerful and accessible tool to quantify operative outcomes for many lower facial nerve reanimation techniques.
Biopsia transrectal ecodirigida de la próstata: estado del arte y guía práctica de consejos y trucos
Authors: Chavarriaga Soto Julián , Ocampo María Antonia , Gutiérrez Andrés Felipe
Published: July 2018

Introducción y Objetivos La biopsia transrectal de la próstata (BTRP), fue propuesta por primera vez en 1937 y hasta 1981 se realizó la primera biopsia ecodirigida, actualmente es la vía de acceso a la próstata más utilizada por su fácil curva de aprendizaje como por el alto rendimiento diagnóstico, sin embargo, en el Reino Unido, el 68% de los urólogos no realizan BTRP porque consideran que no han recibido suficiente entrenamiento. El objetivo de este estudio es describir las diferentes técnicas utilizadas en la actualidad, las complicaciones del procedimiento y aportar una guía de consejos y trucos implementada en varios centros de referencia a la hora de realizar una BTRP para prevenir complicaciones, mejorar el desempeño de la prueba y del urólogo y estandarizar el método de toma de la BTRP.

Materiales y Métodos Realizamos una búsqueda en las bases de datos de PubMed, MEDLINE, SciELO utilizando las palabras claves “Transrectal ultrasound biopsy of the prostate” “tips and tricks” “Transperineal biopsy of the prostate” “Magnetic resonance imaging targeted biopsy” “MRI/US fusion biopsy”, basados en la literatura y en la experiencia de los autores de más de 1100 biopsias anuales entre los diferentes centros de referencia. Brindamos una guía práctica de consejos y trucos para facilitar el desempeño del urólogo en la BTRP.

Resultados La biopsia transrectal de próstata ecodirigida continúa siendo la primera opción para el abordaje diagnóstico del paciente con sospecha clínica de cáncer de próstata, es de gran importancia estandarizar el esquema de toma de la biopsia, y en nuestro caso recomendamos utilizar un esquema de 12 cores, definir la profilaxis antibióticas y la duración del tratamiento, y el uso de analgesia o anestesia local. Presentamos los consejos y trucos que hemos utilizado en nuestra práctica clínica en varios centros de referencia.
Renal Function in Cirrhosis: A Critical Review of Available Tools
Authors: Piano Salvatore , Brocca Alessandra , Angeli Paolo
Published: July 2018

Patients with cirrhosis have a high prevalence of renal dysfunction. The susceptibility to renal dysfunction is due to both the severe splanchnic arterial vasodilation and the systemic inflammation observed in these patients. An accurate assessment of renal function is recommended in all patients with cirrhosis. Indeed, the renal function assessment guides the management of patients, helps to refine prognosis and to define transplant strategies. Despite its limitations, serum creatinine is still the most used biomarker for the estimation of glomerular filtration rate (GFR) and the assessment of acute kidney injury (AKI) in patients with cirrhosis. New biomarkers of GFR such as cystatin C may improve the assessment of GFR and the prognostic stratification in these patients. AKI is a life-threatening complication and needs a timely management. The differential diagnosis between hepatorenal syndrome (HRS) and acute tubular necrosis (ATN) is tricky in clinical practice. New biomarkers of kidney injury, such as neutrophil gelatinase-associated lipocalin and interleukin-18, represent useful tools in refining the discrimination between HRS and ATN. Patients with HRS need a prompt treatment with vasoconstrictors and albumin and a rapid evaluation for liver transplant eligibility. In this article, the authors reviewed the available tools in the diagnosis and management of renal dysfunction in cirrhosis.
Management Strategies for Diastasis Recti
Authors: Nahabedian Maurice
Published: July 2018

Diastasis recti is a relatively common condition in which there is a midline abdominal bulge that can affect a variety of individuals. The etiology and diagnosis is well understood and optimal management depends on the degree of severity. Patients at high risk for diastasis recti include multiparous women, obese patients, and those with multiple previous operations. Diagnosis includes clinical examination and assessment of symptoms. Physical characteristics include a midline abdominal bulge without a fascial defect. Classification systems are based on the degree of separation between the paired midline rectus and myofascial deformity. Optimal management varies and includes simple plication of the midline defect, extensive plication of the anterior abdominal wall, and sometimes the use of resorbable or nonresorbable mesh.
Introducing Hair Transplantation into a Facial Plastic Surgery Practice
Authors: Bared Anthony
Published: July 2018

Hair restoration can be an integral addition to the facial plastic surgery practice. As surgeons dedicated to reconstructive and aesthetic surgery of the head and neck, hair restoration is a natural complement to a facial plastic surgeon's practice. This article presents the keys to adding and starting hair restoration to one's facial plastic surgery practice.
A Comprehensive Review of Hepatic Sarcoid
Authors: Deutsch-Link Sasha , Fortuna Danielle , Weinberg Ethan
Published: July 2018

Sarcoidosis is a multisystem inflammatory disease, which is characterized by the development of noncaseating granulomas amid healthy tissue. While most commonly affecting the mediastinum and/or lungs, sarcoid can also affect the liver, resulting in “hepatic sarcoid.” The spectrum of disease in hepatic sarcoid is variable, ranging from asymptomatic or mild liver enzyme abnormalities to end-stage liver disease requiring liver transplantation. Because clinically-significant hepatic sarcoid is rare, research on epidemiology, clinical manifestations, and treatment is limited. The mainstays of hepatic sarcoid treatment have involved steroids and more recently, ursodeoxycholic acid; however, novel immunomodulatory agents provide new possibilities for management. Questions remain regarding screening, diagnostic modalities, and what to treat with and when. The purpose of this review is to summarize the available research on the epidemiology, clinical course, and management of hepatic sarcoid, and identify gaps in our knowledge to motivate future research.
Immunohistochemical Markers for Schwannomas, Neurofibromas and Malignant Peripheral Nerve Sheath Tumors—What Can the Recent Literature Tell Us?
Authors: Guedes-Corrêa José , Cardoso Rodrigo
Published: July 2018

Introduction Schwannomas and neurofibromas are the two most common benign neoplasms of the peripheral nerve sheath, and although they are generally easy to distinguish, in some cases, they can closely resemble one another. Furthermore, malignant peripheral nerve sheath tumors (MPNSTs), another example of peripheral nerve sheath neoplasm, may likewise constitute, due to their morphology and lack of specific immunohistochemical markers, a challenging diagnostic.

Objective To bring attention to new and promising biomarkers for schwannomas, neurofibromas and MPNSTs and to outline, based on the recent literature, a immunohistochemical profile for each neoplasm at hand, as well as to emphasize the need for further studies that could help us understand their diagnostic potential and disrupt our dependence of limited and nonspecific biomarkers.

Methods An overview of the recent literature published in English on both the classical promising immunohistochemical markers of schwannomas, neurofibromas and MPNSTs was performed. We discarded case reports.

Conclusions There is still a lack of specific biomarkers for peripheral nerve tumors. However, plenty of new immunohistochemical markers have been coming to light with presumed higher specificity and more diverse helpful uses than the classical ones. For example, Sox10 is a good biomarker for differentiating schwannomas and neurofibromas from sarcomas, calretinin schwannomas from neurofibromas, TLE1 and HMGA2 MPNSTs from sarcomas, and nestin, EGFR, p16 and Ki-67 MPNSTs from different types of schwannomas and neurofibromas. There is still need for further studies; however, the potential of some of these promising markers, among others, should not be disregarded.
Validity of amplitude equations for nonlocal nonlinearities
Authors: Kuehn Christian , Throm Sebastian
Published: July 2018

Amplitude equations are used to describe the onset of instability in wide classes of partial differential equations (PDEs). One goal of the field is to determine simple universal/generic PDEs, to which many other classes of equations can be reduced, at least on a sufficiently long approximating time scale. In this work, we study the case when the reaction terms are nonlocal. In particular, we consider quadratic and cubic convolution-type nonlinearities. As a benchmark problem, we use the Swift-Hohenberg equation. The resulting amplitude equation is a Ginzburg-Landau PDE, where the coefficients can be calculated from the kernels. Our proof relies on separating critical and noncritical modes in Fourier space in combination with suitable kernel bounds.
Rényi relative entropies of quantum Gaussian states
Authors: Seshadreesan Kaushik P. , Lami Ludovico , Wilde Mark M.
Published: July 2018

The quantum Rényi relative entropies play a prominent role in quantum information theory, finding applications in characterizing error exponents and strong converse exponents for quantum hypothesis testing and quantum communication theory. On a different thread, quantum Gaussian states have been intensely investigated theoretically, motivated by the fact that they are more readily accessible in the laboratory than are other, more exotic quantum states. In this paper, we derive formulas for the quantum Rényi relative entropies of quantum Gaussian states. We consider both the traditional (Petz) Rényi relative entropy as well as the more recent sandwiched Rényi relative entropy, finding formulas that are expressed solely in terms of the mean vectors and covariance matrices of the underlying quantum Gaussian states. Our development handles the hitherto elusive case for the Petz–Rényi relative entropy when the Rényi parameter is larger than one. Finally, we also derive a formula for the max-relative entropy of two quantum Gaussian states, and we discuss some applications of the formulas derived here.
Causation and information flow with respect to relative entropy
Authors: Liang X. San
Published: July 2018

Recently, a rigorous formalism has been established for information flow and causality within dynamical systems with respect to Shannon entropy. In this study, we re-establish the formalism with respect to relative entropy, or Kullback-Leiber divergence, a well-accepted measure of predictability because of its appealing properties such as invariance upon nonlinear transformation and consistency with the second law of thermodynamics. Different from previous studies (which yield consistent results only for 2D systems), the resulting information flow, say T, is precisely the same as that with respect to Shannon entropy for systems of arbitrary dimensionality, except for a minus sign (reflecting the opposite notion of predictability vs. uncertainty). As before, T possesses a property called principle of nil causality, a fact that classical formalisms fail to verify in many situation. Besides, it proves to be invariant upon nonlinear transformation, indicating that the so-obtained information flow should be an intrinsic physical property. This formalism has been validated with the stochastic gradient system, a nonlinear system that admits an analytical equilibrium solution of the Boltzmann type.
Band gap tuning of layered III-Te materials
Authors: Olmos-Asar Jimena Anahí , Rocha Leão Cedric , Fazzio Adalberto
Published: July 2018

Gallium telluride is a layered material with high photoresponse and is very promising for applications in optoelectronic devices such as photovoltaic cells or radiation detectors. We analyze how the properties of thin films of this material scale with its thickness and also study two other proposed materials with the same crystalline structure whose room-temperature stability we verify. We show that electronic band gaps up to 2.16 eV can be obtained by stacking up and/or applying perpendicular electric field to these III-Te monolayers. This form of band gap engineering may be promising for several technological applications.
Formation and hot flow duration of micro shock flows
Authors: Kai Yun , Garen Walter , Zeitoun David E. , Teubner Ulrich
Published: July 2018

The key issue of the present work is the propagation of micro shock flows. In particular, this work focuses on the shock formation and hot flow duration (test time). The shock formation process involving trailing compression waves is experimentally well resolved. In contrast to experiments in macroscopic shock tubes (above 1 mm hydraulic diameter), the hot flow duration at a microscale cannot be described by the conventional “leaky piston” model or any other currently available models, especially, when the propagation length is more than one hundred times the diameter, namely, a length that has never been investigated before. Navier-Stokes computations show that the numerical and the experimental results have the same trend when the distance increases along the tube. Consequently the simulations indicate benefits when compared to the “leaky piston” model.
Causal network reconstruction from time series: From theoretical assumptions to practical estimation
Authors: Runge J.
Published: July 2018

Causal network reconstruction from time series is an emerging topic in many fields of science. Beyond inferring directionality between two time series, the goal of causal network reconstruction or causal discovery is to distinguish direct from indirect dependencies and common drivers among multiple time series. Here, the problem of inferring causal networks including time lags from multivariate time series is recapitulated from the underlying causal assumptions to practical estimation problems. Each aspect is illustrated with simple examples including unobserved variables, sampling issues, determinism, stationarity, nonlinearity, measurement error, and significance testing. The effects of dynamical noise, autocorrelation, and high dimensionality are highlighted in comparison studies of common causal reconstruction methods. Finally, method performance evaluation approaches and criteria are suggested. The article is intended to briefly review and accessibly illustrate the foundations and practical problems of time series-based causal discovery and stimulate further methodological developments.
Isomerization kinetics of flexible molecules in the gas phase: Atomistic versus coarse-grained sampling
Authors: Falvo Cyril , Gamboa-Suárez Antonio , Cazayus-Claverie Samuel , Parneix Pascal , Calvo Florent
Published: July 2018

Isomerization kinetics of molecules in the gas phase naturally falls on the microcanonical ensemble of statistical mechanics, which for small systems might significantly differ from the more traditional canonical ensemble. In this work, we explore the examples of cis-trans isomerization in butane and bibenzyl and to what extent the fully atomistic rate constants in isolated molecules can be reproduced by coarse-graining the system into a lower dimensional potential of mean force (PMF) along a reaction coordinate of interest, the orthogonal degrees of freedom acting as a canonical bath in a Langevin description. Time independent microcanonical rate constants can be properly defined from appropriate state residence time correlation functions; however, the resulting rate constants acquire some time dependence upon canonical averaging of initial conditions. Stationary rate constants are recovered once the molecule is placed into a real condensed environment pertaining to the canonical ensemble. The effective one-dimensional kinetics along the PMF, based on appropriately chosen inertia and damping parameters, quantitatively reproduces the atomistic rate constants at short times but deviates systematically over long times owing to the neglect of some couplings between the system and the bath that are all intrinsically present in the atomistic treatment. In bibenzyl, where stronger temperature effects are noted than in butane, the effective Langevin dynamics along the PMF still performs well at short times, indicating the potential interest of this extremely simplified approach for sampling high-dimensional energy surfaces and evaluating reaction rate constants.