bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transfusionsmedizinische Versorgung von Patienten nach allogener Blutstammzelltransplantation
Authors: Hölig Kristina , Rosner Andrea 
Published: November 2019

ZusammenfassungIm Rahmen einer allogenen Blutstammzelltransplantation kommt es häufig zu immunhämatologischen Phänomenen, die im Rahmen der Diagnostik und der supportiven Hämotherapie berücksichtigt werden müssen. Durch Diskrepanzen der AB0-Merkmale von Spender und Empfänger können verschiedene Komplikationen auftreten. Die wesentlichsten sind ein verzögertes Engraftment der Erythropoese nach major-inkompatibler Transplantation (sogenannte Pure-red-Cell-Aplasie, PRCA) und die verzögerte Hämolyse durch Aktivierung von minor-inkompatiblen Lymphozyten im Transplantat, das sogenannte Passenger-Lymphocyte-Syndrom (PLS). Durch ein gezieltes immunhämatologisches Monitoring der Patienten können diese Phänomene zeitgerecht erkannt und adäquat therapiert werden. Ein Wechsel im Bereich des Rhesusantigens D ist ebenfalls bei der Hämotherapie allogen transplantierter Patienten zu berücksichtigen, verursacht allerdings nur selten Komplikationen. Hinsichtlich der Thrombozytenversorgung sollte rechtzeitig vor Konditionierungsbeginn eine gezielte Diagnostik von Immunisierungen gegen HLA- (humane Leukozyten-Antigene) und Plättchen-spezifische Antigene erfolgen, um die Thrombozytenversorgung mit ausgewählten Spendern in der Aplasiephase zuverlässig gewährleisten zu können. Bei sehr breit und hochtitrig immunisierten Patienten kann eine Immunsuppression mit Rituximab und Immunadsorption vor Transplantation die Inkremente nach Thrombozytensubstitution verbessern und im Falle von einem HLA-Mismatch des Transplantats auch das Engraftment unterstützen.
Die Rolle transfusionsmedizinischer Einrichtungen bei der Implementierung zugelassener CAR-T-Zell-Therapien
Authors: Humpe Andreas , Körper Sixten , Schäfer Richard , Klump Hannes , Worel Nina 
Published: November 2019

ZusammenfassungÜber viele Dekaden hinweg war für die Behandlung hämatologischer Erkrankungen die einzige akzeptierte zelluläre Therapie die Transplantation von hämatopoetischen Stamm- und Progenitorzellpräparationen, autolog oder allogen, nach vorheriger Konditionierung als individualisierte Therapieform etabliert. Dabei impliziert diese Art der Therapie aus rechtlicher Sicht nur minimale Manipulationen der Transplantate (Zentrifugation, Konzentrierung, Verdünnung, immunmagnetische Anreicherung oder Depletionen, Kryokonservierung), sodass die Gewinnung, Verarbeitung, Qualitätskontrolle und Abgabe der Stammzell-/Immuntherapeutika zumeist komplett in der Hand transfusionsmedizinischer Institutionen liegen. Nach der Zulassung durch die Europäische Arzneimittelbehörde (EMA) im August 2018 sind erstmals kommerziell erhältliche, autologe chimäre Antigen-Rezeptor-T-Zellen (chimeric antigen-receptor-T-cells, CAR-T-cells) in Deutschland sowie einer Vielzahl anderer europäischer Länder für die individualisierte Therapie von Patienten mit ausgewählten malignen Neoplasien der B-Zell-Reihe verfügbar. Im Rahmen einer gemeinsamen Sitzung der Sektion „Stammzelltransplantation und Zelltherapie“ und der Sektion „Präparative und therapeutische Apherese“ der Deutschen Gesellschaft für Transfusionsmedizin und Immunhämatologie (DGTI) am 19.10.2018 in Frankfurt wurden mehrere Impulsvorträge zum Thema „Zugelassene CAR-T-Zell-Therapie ante portas: Rolle der Transfusionsmedizin“ gehalten. Dabei wurden die Themen Finanzierung und Kostenerstattung, regulatorische und rechtliche Rahmenbedingungen sowie verschiedene Aspekte der notwendigen Verantwortungsabgrenzung zwischen dem Hersteller des Ausgangsmaterials, dem pharmazeutischen Unternehmen und dem klinischen Anwender ausführlich diskutiert.
Immunonkologie trifft Intensivmedizin: CAR-T-Zellen
Authors: Böll Boris , Borrega Jorge Garcia , Schellongowski Peter , Subklewe Marion , von Bergwelt-Baildon Michael 
Published: November 2019

ZusammenfassungDie Behandlung mit CAR-T-Zellen kann zwar keine „Wunder“ vollbringen, aber sie führt bei einem Teil der Patienten zu spektakulärem Ansprechen und mitunter sogar zur Heilung von bisher palliativen Patienten. Dennoch: Regelhaft geht die Anwendung dieser zielgerichteten Therapie mit schweren Nebenwirkungen einher, die zumeist intensivmedizinischen Einsatz erfordern. Wie es dazu kommt und wie dem zu begegnen ist, zeigt dieser Beitrag.
Prognostic Value of Residual Syntax Score after Percutaneous Coronary Intervention in Multivessel Coronary Artery Disease
Authors: Aramalla Sunitha , Garre Indrani , Shaik Shabbir Ali , Hemanth Harish P. 
Published: December 2019

Abstract
Background Residual SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) Score (RSS) is an objective measure for the assessment of degree and complexity of residual stenosis after the percutaneous coronary intervention (PCI).
Aim The study aimed at evaluating the role of angiographic complete (CR) and incomplete (ICR) revascularization on clinical outcomes in patients undergoing PCI for multivessel coronary artery disease (MVCAD). The study sought to investigate the role of initial and residual severity of coronary atherosclerosis in prognostication of patients with MVCAD who underwent PCI.
Material and Methods We retrospectively recruited 135 patients having MVCAD who underwent PCI. Coronary angiogram was used to assess the severity of coronary atherosclerosis. From the angiographic data baseline (BSS) and RSS were calculated. Subjects having a RSS of 0 were defined as having CR, and those having RSS > 0 are defined as ICR group. The study population was subgrouped into two groups as follows: CR, 0 (n = 17, 23%); ICR, >0 to 4 (n = 89, 47.2%). Clinical outcomes were measured, which included major adverse cardiac and cerebrovascular events (MACE) at 1 year.
Results Among the study subjects mean age was 57.25 ± 17.55. About 76.3% were males, and 23.7% were females. About 89.4% had diabetes, 88.6% had hypertension as risk factors, and 95.8% were smokers.The mean values of BSS and RSS were 20.2 ± 9.2 and 4.1 ± 7.0, respectively. Based on RSS the individuals were divided into two groups as follows: CR, 0 (n = 17, 23%); ICR, > 0 to 4 (n = 89, 47.2%), > 4 to 8 (n = 16, 21.6%), > 8 (n = 13, 17.55%). After 1 year, three patients lost the follow-up. Among the remaining 132 patients, those with higher BSS had more mortality and morbidity, and the difference is statistically significant (MACE in ≥23 vs. <23, p = 0.000755); 10 patients in the ICR group had MACE compared with 1 patient in CR group(5.8% in CR group vs. 8.6% in ICR group, p-value of 0.38); however, the difference was not statistically significant. However, higher RSS acts as an indirect marker of increasing morbidity and mortality when compared within the tertiles, and the difference was statistically significant (RSS 1–4 group vs. > 4 MACE, p = 0.0009559, RSS < 8 vs. >8 MACE, p = 0.00000172).
Conclusions This study proved that both BSS and higher RSS help to foretell the risk of adverse clinical outcomes in individuals with MVCAD who underwent PCI. RSS, which is an indirect marker of residual atherosclerosis, that is, ICR, had a positive correlation MACE after PCI.
Portal Venous Interventions after Liver Transplant
Authors: Mahon Scott , Molvar Christopher 
Published: November 2019

AbstractLiver transplant (LT) recipients are a challenging patient population when presenting with graft dysfunction or sequelae of portal hypertension. When no medical causes for graft dysfunction are found, a hemodynamically significant vascular lesion is suspected. Although rare, a variety of diseases may arise involving the portal system, which inhibit flow and graft function. Herein, we present a review of portal venous interventions performed in the LT setting, with focus on imaging diagnosis, endovascular treatment techniques, and outcomes. Entities addressed include portal venous stenosis, portal venous thrombosis, and recurrent fibrosis/cirrhosis with sequelae of portal hypertension.
A Case of Severe Early-Onset Neuropathy Caused by a Compound Heterozygous Deletion of the PMP22 Gene: Clinical and Neurographic Aspects
Authors: D'Arrigo Stefano , Tessarollo Valeria , Taroni Franco , Baratta Silvia , Pantaleoni Chiara , Schiaffi Elena , Ciano Claudia 
Published: November 2019

AbstractHeterozygous deletions of the gene PMP22 are associated to hereditary neuropathy with liability to pressure palsies (HNPP), a demyelinating neuromuscular disease causing variable transitory focal muscles weakness. Deletions involving both copies of PMP22 cause more severe phenotypes, with early-onset neuropathy and impairment in motor development. We report a patient with a severe early-onset demyelinating neuropathy, caused by two different inherited deletions of PMP22, whose parents had an HNPP. The patient showed neurological signs and delay in motor development but normal intellective abilities. A motor and sensitive conduction study showed severe signs of demyelination, suggestive for Dejerine Sottas Syndrome (DSS). The patient's father had a typical HNPP caused by a heterozygous 17p11.2 deletion, encompassing PMP22. The patient's mother reported no neuropathic symptoms, but in a nerve conduction studies, parents and several relatives showed signs of sensory–motor deficit with focal slowing of conduction at common sites of entrapment. Quantitative analysis of PMP22, performed in our patient by multiplex ligation-dependent probe amplification, revealed a compound heterozygous status with the same deletion of the father and a deletion of PMP22 exon 5, after proved to be inherited from the mother. Therefore, when we face an early-onset, severe form of neuropathy, we have to consider rare forms of hereditary neuropathy caused by homozygous or compound heterozygous mutations in PMP22, even if parents are asymptomatic; an exhaustive family history and an electrodiagnostic study are essential to guide genetic tests and to make a diagnosis.
Role of Advanced Imaging in Gasserian Neurolysis in Head and Neck Cancer with Skull Base Invasion
Authors: Mahawar Bablesh , Mahawar Vivek 
Published: November 2019

Introduction A 46-year-old female with a postoperated case of carcinoma left upper alveolus diagnosed in March 2018, with recurrence, was presented to the hospital. She had lancinating pain around left facial pain, which gradually increased over 10 months. On numerical rating scale, her pain was 9 on 10. Her chief complaint was continuous dull pain above and below the left eye, with sudden, brief, paroxysmal episodes of intolerable burning and stabbing type of pain. This episodic pain lasted for 30 to 40 seconds. On examination, she had left III, V, and VI nerve palsy with ptosis. Magnetic resonance imaging of face and brain revealed an enhancing infiltrative mass in left maxillary sinus extending to base of skull. Clinical diagnosis of left-sided painful trigeminal neuropathy in ophthalmic and maxillary (V1 and V2) division was made.
Aim This study was aimed to relieve patient’s pain and improve her quality of life.
Materials and Methods Gasserian neurolysis was successfully completed under computed tomography (CT) guidance because of the distortion of skull base anatomy using a 22-G, 10-cm long spinal needle directed towards foramen ovale (FO) from a lateral approach.
Conclusion CT-guided identification of foramen ovale can be labeled as a novel method of locating FO for precise percutaneous techniques to the trigeminal ganglion in advanced head and neck cancers.
Vascular variations in abdomen, face and neck in a single cadaver
Authors: Pal Dolan Champa , Baral Karabi , Sarkar Jayanta , Ray Koushik 
Published: November 2019

AbstractDuring Routine dissection at Bankura Sammilani Medical College, multiple vascular variations were detected in a cadaver of 60 years aged female. Variation in formation of hepatic portal vein was present as union of splenic vein with the common trunk formed by Superior mesenteric vein & Inferior mesenteric vein. Second variations were in unilateral facial vessels, where the right facial artery terminated as superior labial artery and the right common facial vein drained into the External jugular vein. Knowledge of variant anatomy of hepatic portal vein is essential for surgical and interventional procedures because large visceral territory drained by inferior mesenteric vein. Knowledge of Facial vessels is important for maxillofacial surgeries.
Accessory head of biceps brachii muscle in North Indian cadavers
Authors: Gindha Gurbachan Singh , Sharma Anand Kumar , Munjal Ratesh Kumar 
Published: November 2019

Abstract
Background and aims : The biceps brachii is the large muscle of flexor compartment of arm. Normally it arises by two heads (long head and short head) and gets insertion in two parts (tendinous part and aponeurotic parts). The biceps brachii muscle is well known for variation in its origin. These variations can cause compression of brachial artery and median nerve which may pass deep to the accessory head of biceps brachii muscle, and can create problems for surgeons. So the surgeons should keep in mind such variations of biceps brachii muscle. The present study is to find out the variations in the origin of biceps brachii muscle. Material and methods: The present study was conducted in the department of anatomy of Gian Sagar Medical College, Ramnagar, Rajpura district Patiala (Punjab). In this study 32 human cadaveric limbs which were embalmed and fixed in 10% formaldehyde solution were used and these limbs were dissected and variations in origin of the biceps brachii muscle were noted. Results : Out of 32 limbs, 3 limbs (9.38%) were having three heads of biceps brachii muscle in its origin. The variations were found in the right limbs only. Conclusions : The knowledge of accessory head of biceps brachii muscle is important for the surgeons and troumatologists because there can be iatrogenic injury to the third head of biceps brachii muscle.
Duplication in the formation of median nerve - a case report
Authors: Mehta Gyata , Mokhasi Varsha 
Published: November 2019

AbstractThe median nerve is formed in the axilla by fusion of the two roots from the lateral and medial cords. The present case report describes an anomalous presentation of double formation of median nerve and its relation with axillary and brachial arteries. The median nerve was formed in two stages at different levels, first in the axilla and then in the upper arm by receiving double contribution from the lateral root of the lateral cord, which fuse with the medial root of the medial cord to form the median nerve. The formation took place medial to the axillary artery in the axilla and antero-medial to the brachial artery in the arm. Such anatomical variations and their relation with the arteries are important for the surgeons and anesthesiologists and of great academic interest to the anatomists.
A study on histology of fetal liver
Authors: A. Jaiswal , DN Sinha , AK Singh 
Published: November 2019

Abstract
Background and aims : Background and aims : The liver during fetogenesis does not follow classical lobular pattern. Normal histology of the fetal liver at various stages of development was studied to get insight into the morphology of fetal liver and special function it performs in fetal life. Method: Dissection of 29 normal human fetuses was done and histological findings of liver were noted with respect to the age of fetus. The histology of fetal liver was studied using H & E stain and important features of fetal liver were studied. Result: Fetal liver histology is different from adult liver. Unlike adult liver, fetal liver shows hepatocytes arranged in sheets predominantly with cordlike pattern at places. The sinusoids are dilated and filled with hemopoietic cells, which could be appreciated at different stages of fetal development. The Kupffer cells were also noticed in fetal liver. Conclusion: The present study will be helpful in understanding the normal histology of fetal liver and add to the existing knowledge regarding development of fetal liver.
Axillary arch muscle- a case report
Authors: Sachdeva Kanika , Lalit Monika , Mahajan Anupama , Delmotra Poonam 
Published: November 2019

AbstractAnomalous muscles donot usually cause symptoms but are of academic interest. Axillary arch is a variable muscular slip encountered in axilla. Purpose of the present study was to report a rare case of axillary arch muscle. Knowledge of this muscle variation and the possibility of finding it during axillary procedures are crucial for lymph node staging, lymphaedenectomy and for differential diagnosis in compressive pathologies of axillary vessels and brachial plexus. During routine dissection of left axilla in a 60-year old male cadaver, an anomalous muscular slip was encountered. The slip was extending between latissimus dorsi muscle to coracoid process, deltoid muscle, fascia covering biceps and coracobrachialis and was confirmed as axillary arch muscle. The embryological basis, genetics and clinical implications have been discussed. This rare variation will be of interest not only to anatomists but also for clinicians and surgeons dealing with this area.
A histological study of uterus in reproductive and postmenopausal women
Authors: Dutta Malamoni , Talukdar K L 
Published: November 2019

Abstract
Background and aims: The "Uterus" or "Womb" is a part of the female reproductive tract that receives the fertilized ovum from the oviduct, provides the bed for implantation and establishes the vascular connections necessary for sustenance of the embryo throughout its development. Due to increasing rate of infertility, the reproductive organs are gaining importance. The aim of the study is to ascertain that the research work could be utilized for investigation and guidance for management of infertility cases. The knowledge of normal histological architecture of the uterus will be of help to isolate any pathological changes. Materials and methods: Ten samples each from reproductive and postmenopausal women were collected from fresh unembalmed human cadavers. The slides were prepared using the standard laboratory procedure. Stress was given on the structure of endometrium, cervical mucosa and squamocolumnar junction. Endometrial and cervical mucosal thickness were measured in both groups. Results: Significant differences of histological architecture were noted between the two groups. The average endometrial thickness as measured by micrometer scale was 4.29 mm and 1.64 mm in reproductive and post-menopausal women respectively. The average cervical mucosal thickness was 2.76 mm and 1.55 mm in reproductive and postmenopausal women respectively. Conclusion: Knowledge of the normal histological structure of the uterus is of prime importance to have the basic knowledge of various pathological entities.
Complete occipitalization of atlas vertebra with other congenital malformations
- a rare variation
Authors: Verma Poonam , Mahajan Anupama ,   Seema
Published: November 2019

AbstractOccipitalization of the atlas vertebra or atlantooccipital fusion represents the most cephaled blocked vertebra found in the vertebral column. It is defined as the congenital bony fusion of the atlas vertebra to the base of the occipital bone of the skull. Out of the sixty skulls studied in the Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, we come across a dry adult human skull with the total synostosis of the whole atlas vertebra with the occipital bone of the skull. The awareness of this anatomical variation in the patients showing abnormalities of the neck region can help the neurosurgeons, radiologists anaesthetologists andorthopaedic surgeons to reach at a correct diagnosis.
Craniorachischisis - a case report
Authors: Rao N. Ratnakar 
Published: November 2019

AbstractCraniorachischisis is an extreme example of anencephaly and spina bifida. It is an example for defective neural groove closure. A female dead fetus delivered by caesarian section in Malla Reddy Medical College, Hyderabad found to have features of craniorachischisis. There was complete absence of calvaria and brain; the entire vertebral column was open on the posterior side with spinal nerves seen outside. On dissection, all thoracic and abdominal organs were found to be normal. Since infant organs are in high demand for pediatric transplantation, laws must be framed to use the normal organs from these cases of neural tube defects.
Morphological study of the sensory nerve which induces jaw opening reflex
Authors: Shimotakahara Rie , Mine Kazuharu , Ogata Shigemitsu 
Published: November 2019

Abstract
Background and objectives: An anatomical site in the oral cavity can be used to trigger the jaw opening reflex in patients with pseudobulbar palsy who have difficulty opening the mouth. The site is located at the midpoint between the palatoglossal arch and pterygomandibular fold and medial to the retromolar pad. However, previous findings on the nerves innervating this particular area are inconsistent. Therefore, in this study, we carefully investigated the sensory nerves that innervate the area near the trigger point of the jaw opening reflex. Materials and methods: For the morphological investigation of sensory innervation in this area, in this study we exposed the cranial nerves in 26 halves of cadaver head and observed their distribution in soft tissue. Results: In all cases, several nerve fibers diverged anteroinferiorly from the lingual nerve located between its junction with the chorda tympani nerve and the junction with the communicating branch of the submandibular ganglion. These nerve fibers, thought to be the facial branches of the lingual nerve, innervated the mucosa in the vicinity of the palatoglossal arch, retromolar pad, and the lingual gingiva of the last molar which were near to the trigger point of the jaw opening reflex. Conclusion: The results suggest that the sensory nerve that induces the jaw opening reflex appears to be the branches to isthmus of fauces diverged from the lingual nerve.
Gross anatomical study of recurrent artery of Huebner
Authors: Narayanan Sunitha 
Published: November 2019

Abstract
Background: Cerebral aneurysms frequently occur in the arterial complex composed of Anterior Cerebral Artery, Anterior Communicating Artery and Recurrent Artery of Huebner. Due to the anatomical variations in the origin and course of the Recurrent Artery of Huebner, surgical interventions in the anterior portion of circle of Willis can be complicated by obstruction or vascular damage to Recurrent Artery of Huebner, caused by improper clip placement. Objectives: To study the variations in the origin, number, course &amp; termination of Recurrent artery of Huebner. Also the distance of origin of the Recurrent artery from the junction of Pre and Postcommunicating segment of Anterior Cerebral Artery was noted. Materials and methods: The study was conducted in 60 randomly selected brain specimens fixed in 10% formalin for 10 days in the Department of Anatomy. The Recurrent Artery was then carefully dissected and observations were made. Photographs were taken to document the observations. Results: The Recurrent artery of Huebner arose most frequently from the junction of Pre and Postcommunicating segment of Anterior Cerebral Artery (59.2%) and next frequently from the Postcommunicating segment of Anterior Cerebral Artery within 1mm from the junction of Pre and Postcommunicating segment of Anterior Cerebral Artery. It coursed more commonly anterior to the Precommunicating segment of Anterior Cerebral Artery in 80% cases. The artery terminated in the lateral part of anterior perforated substance in 96.7% of the specimens. Conclusions: The Recurrent artery should be routinely identified during clipping of the aneurysm of the Anterior Communicating Artery to prevent postoperative neurological deficit.