bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rehabilitation after Clipping of Cerebral Aneurysms without Acute Subarachnoid Hemorrhage: Outcome Analysis of 100 Consecutive Cases
Authors: Bauer Karsten , Hajdukova Andrea , Jödicke Andreas 
Published: July 2018

Background Discharge to rehabilitation is reported in large studies as one important outcome parameter based on hospital codes. Because neurologic outcome scores (e.g., the modified Rankin Scale [mRS]) are missing in International Classification of Diseases (ICD) databases, rehabilitation indirectly serves as a kind of surrogate parameter for overall outcome. Reported fractions of patients with rehabilitation, however, largely differ between studies and seem high for patients with aneurysm clipping. Variances in rehabilitation fractions seem to largely differ between treatments (clipping versus coiling) for unruptured intracranial aneurysms, so we analyzed our patients for percentage of and potential factors predicting rehabilitation.
Patients From July 2007 to September 2013, 100 consecutive patients with at least one cerebral aneurysm underwent aneurysm clipping. Aneurysms were classified as incidental, associated, pretreated (coil compaction after subarachnoid hemorrhage), and symptomatic (oculomotor nerve compression, microemboli), and they were assigned to their anatomical location. Complications (infection, hemorrhage, cerebrospinal fluid fistula, transient and permanent neurologic deficit, reoperation) and outcome (mRS at 6 months; clip occlusion rate by postoperative digital subtraction angiography) as well as frequency and type of rehabilitation were analyzed and correlated retrospectively. Multiple aneurysms clipped in one procedure were not counted separately regarding complications or outcome (i.e., one patient, one outcome).
Results The overall complication rate was 17% including 10% early and 3% permanent neurologic deficits and 7% reoperations. There were no deaths. Overall, 98% of patients had a good outcome (mRS 0–2). Clip occlusion rate was 97.9%. Multivariate logistic regression analysis identified aneurysm location as the only significant independent factor for risk of complication (p < 0.001) and complication as the only significant independent risk factor for rehabilitation (p = 0.003). Rehabilitation was indicated or requested by the patient as early neurologic rehabilitation (5%), inpatient follow-up (15%), and outpatient follow-up (15%). The long-term care rate was 2%.
Conclusion Microsurgery of unruptured and not acutely ruptured aneurysms (including post-coil and associated aneurysms) has a low rate of rehabilitation with a low risk of a permanent neurologic deficit, long-term care, or early neurologic rehabilitation. The rate of rehabilitation is well below reported risks from studies based on ICD-based health care analysis. Rehabilitation per se is not a good indicator for outcome.
Optimal Parameters for Intervertebral Disk Resection Using Aqua-Plasma Beams
Authors: Yoon Sung-Young , Kim Gon-ho , Kim Yushin , Kim Nack , Lee Sangheon , Kawai Christina , Hong Youngki 
Published: July 2018

Objective A minimally invasive procedure for intervertebral disk resection using plasma beams has been developed. Conventional parameters for the plasma procedure such as voltage and tip speed mainly rely on the surgeon's personal experience, without adequate evidence from experiments. Our objective was to determine the optimal parameters for plasma disk resection.
Methods Rate of ablation was measured at different procedural tip speeds and voltages using porcine nucleus pulposi. The amount of heat formation during experimental conditions was also measured to evaluate the thermal safety of the plasma procedure.
Results The ablation rate increased at slower procedural speeds and higher voltages. However, for thermal safety, the optimal parameters for plasma procedures with minimal tissue damage were an electrical output of 280 volts root-mean-square (Vrms) and a procedural tip speed of 2.5 mm/s.
Conclusion Our findings provide useful information for an effective and safe plasma procedure for disk resection in a clinical setting.
Klinische Applikationsmöglichkeiten der Fibrinklebung im Bereich der Haut
Authors: Rupp G. 
Published: July 2018

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

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

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

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

Preoperative embolization for intracranial meningioma has remained controversial for several decades. In this study, we retrospectively reviewed our experience of embolization using particulate embolic material and coil to clarify the therapeutic efficacy, safety, and risk of complication.
Methods We reviewed 69 patients who underwent embolization with particulate embolic material followed by surgical resection. An additional 6 procedures were included for patients in whom recurrence was treated, for a total of 75 procedures of preoperative embolization. We analyzed the following clinical data: age, sex, tumor size pathology, complications related to embolization, and surgeon's opinion on the intraoperative ease of debulking and blood transfusion. Embolization was performed mainly from the branches of the external carotid artery.
Results No allogenic blood transfusions were needed for any patients. The surgeon had the opinion that whitening and softening of the tumor allowed for easy debulking during decompression of the tumor in most of the patients. Hemorrhagic complications were seen in two patients after embolization. Emergency tumor removal was performed in both of those patients, and they were recovered well after surgery. Transient cranial nerve palsy was seen in one patient. One ischemic complication and one allergic complication occurred.
Conclusion Preoperative embolization could give us an advantage in surgery for meningioma. The procedure reduces intraoperative blood loss and operating time by softening the tumor consistency. However, we must pay attention to the possibility of embolic complications and keep the preparation of emergency craniotomy, particularly in patients with large meningiomas.
Terminal end Variations and Common Pathological Abnormalities of the Basilar Artery among the Ugandan Population: a Human Autopsy Study
Authors: Nagawa E. , Okello M. , Kiryowa H. , Mwaka E. 
Published: July 2018

Introduction Morphological variations at the basilar artery terminal end are documented risk factors for cerebral vascular complications like atherosclerosis, thromboembolisms, and aneurysms that further predispose to fatal arterial occlusions. Pathological abnormalities of the basilar artery are usually ignored on diagnosis in third world countries despite their role in brain ischemia. There is a paucity of literature on the gross anatomy of cerebral vasculature in the Ugandan population. Therefore, this study set out to determine the terminal end variations and common pathological abnormalities of the basilar artery among the Ugandan population.
Materials and Methods This was a cross sectional study that accessed intact basilar arteries from 115 human autopsy brains (77 males and 33 females) at the Kampala City Council Authority mortuary. Arachnoid matter was removed and arteries perfused with clear water for visibility. The arteries were checked for variations including bifurcations, trifurcations, quadrifurcation, hexafuraction and pathological abnormalities. Representative photographs were taken and results presented as proportions and percentages.
Results The average age of the human cadavers was 38 years (Range 18–85 years). Normal bifurcation of the basilar artery was observed in 48.7% of the study population. Other variations included trifurcations (22.6%); quadrifurcations (21.7%), pentafurcations (6.1%) and hexafurcations (0.6%). With regard to abnormalities, 16 arteries (13.9%) had atheromatous plaques, 21 (18.3%) were rigid, and 26 (22.6%) were tortuous. There was significant correlation between age and pathological abnormalities (p = 0.01)
Conclusion There are several variations at the terminal end of the basilar artery in the Ugandan population. Arterial pathological abnormalities are also not uncommon and tend to increase with age. Thus, the need for routine imaging investigations in patients with cerebrovascular disorders and individuals of 40 years and above.
Variable Parotid Papillue and its Implication in Sialadenitis
Authors: Araújo J. , Costa Neta H. , Oliveira J. , Pereira F. , Cavalcanti R. , Gomes F. , Assis T. , Oliveira A. 
Published: July 2018

Introduction Papillae are small conical bumps found on the skin or mucous membranes surfaces. In the mouth, the parotid papillae are responsible for expelling saliva from the parotid gland to its cavity. Sialadenitis is an inflammation that affects the salivary gland and/or its duct.
Objectives To report a variable parotid papilla case and its implication in sialadenitis.
Materials and Methods The research was performed at the Morphofunctional Sciences Laboratory of the Faculdades Integradas de Patos - FIP. We used a cadaveric hemiface from the anatomy laboratory and a digital caliper rule for the morphometric evaluations.
Results The papilla found was located posterior to the 3rd molar. The distance from the variation to the most frequent location of the papilla (18.8 mm).
Conclusion The variable papilla was located in the lower retromolar region, which increases the chances of developing parotid sialadenitis, expanding the theoretical basis for its clinical diagnosis.
Macht Musizieren wirklich schlau?
Authors: Spitzer M. , Kammer T. 
Published: July 2018

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

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

ZusammenfassungDer Morbus Wilson, eine autosomal-rezessive Störung des hepatischen Kupfertransporters ATP 7B, ist von einer hepatischen und extrapyramidalmotorischen Leitsymptomatik (EPS) mit variabler Manifestation vorrangig zwischen dem 5. und 45. Lebensjahr geprägt. Aufgrund dieser Symptomvielfalt ist eine frühzeitige Diagnosestellung erschwert.Durch eine Klassifikation werden klinische Varianten beschrieben, die eine Einordnung der Befundlage ermöglicht. Berücksichtigt werden das Manifestationsalter, die pathogenetische Entwicklung und vorherrschende Symptomatik. Weitere Einteilungen charakterisieren spezielle Befundmuster der Bildgebung (cMRT, SPECT, PET), der Feinmotorik und Elektrophysiologie. Damit ergibt sich die Möglichkeit einer besseren Zuordnung der Befunde hinsichtlich der Verdachtsdiagnose eines Morbus Wilson. Rückschlüsse auf den Genotyp lässt keine dieser Klassifikationen zu.
Orale Antikoagulanzien: Management von elektiven und Notfalleingriffen
Authors: Nowak Hartmuth , Unterberg Matthias 
Published: July 2018

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

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

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

ZusammenfassungStörungen des Natriumhaushalts sind häufig auftretende Elektrolytimbalancen. Sowohl sie selbst als auch ihre unsachgemäße Therapie können schwerwiegende Komplikationen nach sich ziehen. Der vorliegende Artikel informiert über die Ätiologie von Störungen des Natriumhaushalts und stellt wichtige therapeutische Prinzipien dar.
Parametric transitions between bare and vegetated states in water-driven patterns
Authors: Bertagni Matteo Bernard , Perona Paolo , Camporeale Carlo 
Published: July 2018

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

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

SignificanceDeciphering the mechanisms of how cells restrict viral pathogens is imperative for understanding disease and seeding new therapies. Millions of people suffer with liver disease as a result of chronic infection with hepatitis C virus (HCV). MicroRNA-122, a target of phase II clinical trials, is a microRNA that is beneficial to HCV, in part by binding to viral transcripts and protecting them from XRN exonucleases. As XRNs are specific to 5′ monophosphate transcripts, how XRNs restrict the 5′ triphosphate products of the viral polymerase is unknown. Here, we reveal that the 5′ RNA triphosphatase DUSP11 colludes with XRNs to restrict HCV. These findings implicate DUSP11 as a component of HCV restriction relevant for understanding an emerging class of therapeutics.
Constraints on Paleoproterozoic atmospheric oxygen levels
Authors: Bellefroid Eric J. , Hood Ashleigh v. S. , Hoffman Paul F. , Thomas Matthew D. , Reinhard Christopher T. , Planavsky Noah J. 
Published: July 2018

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