bluuebunny/crossref_metadata_2025_split huggingface dataset:
Einbindung von Rehabilitationseinrichtungen in die Traumanetzwerke – Praktische Umsetzung des Phasenmodells der Traumarehabilitation
Authors: Müller Wolf-Dieter , Simmel Stefan , Köhler Stephanie , Hoffmann Reinhard , Reimertz Christoph 
Published: July 2018

ZusammenfassungDie aktuelle Versorgungskette von Traumapatienten in Deutschland weist noch erhebliche Defizite, sogenannte „Reha-Löcher“, in den Bereichen Früh- und Postakutreha, aber auch in der langfristigen Nachsorge ehemals Schwerverletzter, auf. Die Einführung eines 6-stufigen Phasenmodells der Traumarehabilitation, in Anlehnung an das über Jahre gut etablierte und erfolgreiche Phasenmodell Neurorehabilitation der BAR, könnte, aus Sicht der Autoren, die Schwerverletztenversorgung komplettieren. Die erfolgreiche Umsetzung des neuen Phasenmodells ist abhängig von der Einbindung eines Trauma-Rehanetzwerkes mit geeigneten und entsprechend ausgestatten Reha-Einrichtungen in das Traumanetzwerk DGU®. Die enge Kooperation zwischen Akutbehandlung und Rehabilitation soll zu einer lückenlosen Behandlung Schwerverletzter und dadurch zu einem verbesserten langfristigen Outcome führen. Die Zu- und Einordnung der Trauma-Rehabilitationszentren sollte analog des 3-stufigen Modells des Traumanetzwerkes durch Reha-Einrichtungen unterschiedlicher Versorgungsstufen realisiert werden. Wesentliche Charakteristika zur Einordnung dieser Reha-Einrichtungen in die bestehenden Traumanetzwerke von DGU und DGUV, einschließlich der in den jeweiligen Versorgungsstufen zugeordneten Heilverfahren, werden vom Autorenteam vorgeschlagen und zur Diskussion gestellt.
Klinische Auswertung einer neuartigen Intraokularlinse mit erweiterter Tiefenschärfe (EDOF) zur Verbesserung der Sehkraft im Intermediärbereich
Authors: Kretz Florian , Tarib Imane , Teisch Swetlana , Kaiser Insa , Lucchesi Rafaela , Herbers Claudia , Hinkens Annalena , Hagen Philipp , Breyer Detlev 
Published: July 2018

Zusammenfassung
Hintergrund Die moderne Intraokularlinsen-Chirurgie hat in den letzten Jahren einen deutlichen Fortschritt im Bezug auf die Brillenunabhängigkeit im Alltag gemacht. Vor allem das Sehen in der Ferne und im Nahbereich konnte hierdurch deutlich optimiert werden. Jedoch zeigt sich durch den Einsatz neuer Medien sowie Anforderungen im Berufsleben eine gesteigerte Notwendigkeit für die Optimierung unterschiedlicher Intermediärabstände. Im Rahmen einer prospektiven, nicht randomisierten Studie wurden daher die funktionellen und refraktiven Ergebnisse nach Implantation einer neuartigen Intraokularlinse mit verbessertem Tiefenschärfenbereich ausgewertet.
Patienten/Material und Methoden Bisher konnten 11 Patienten nach binokularer Implantation der AT LARA 829MP (Carl Zeiss Meditec AG, Deutschland) 3 Monate postoperativ ausgewertet werden. Untersucht wurden die Refraktion, der korrigierte und unkorrigierte monokulare und binokulare Fernvisus (CVDA, UDVA) sowie die fernkorrigierten monokularen und binokularen Visusergebnisse in unterschiedlichen Intermediärdistanzen (DCIVA in 90, 80 und 60 cm) und in 40 cm (DCNVA). Des Weiteren erfolgte eine Analyse der Defokuskurve.
Ergebnisse Es zeigte sich ein mittlerer Anstieg des korrigierten Fernvisus von 0,35 auf − 0,01 logMAR. Der binokulare, fernkorrigierte Intermediärvisus in 90, 80 und 60 cm zeigte stabile Werte von − 0,07, 0,04 und 0,07 logMAR. Trotz des Fokus auf die Intermediärdistanz konnte ein akzeptabler fernkorrigierter, binokularer Nahvisus von 0,33 logMAR festgestellt werden. Im Rahmen der Defokuskurvenanalyse konnte ein Visus von 0,3 logMAR über einen Bereich von − 2,5 bis + 1,0 dpt festgestellt werden.
Schlussfolgerung Die binokulare Implantation der AT LARA 829MP mit Zielrefraktion im emmetropen Bereich ermöglicht ein stabiles Sehschärfenergebnis von der Ferne bis in den nahen Zwischenbereich bei immer noch funktionellen Sehschärfewerten im Nahbereich um 40 cm.
Kieferorthopädische Behandlungsplanung mit der computerunterstützten Behandlungsanalyse – CUBA
Authors: Bönning Ralph 
Published: July 2018

ZusammenfassungDie computerunterstützte Behandlungsanalyse (CUBA) erlaubt durch die Einbeziehung von DVT-Daten die Erstellung eines 3D-Modells aus Zähnen, Zahnwurzeln und Alveolarfortsätzen von Oberkiefer und Unterkiefer. Damit kann eine exakte anatomische Beurteilung stattfinden und eine kieferorthopädische Behandlungsplanung unter Berücksichtigung der idealen Wurzelpositionen und der biologischen Grenzen durchgeführt werden. Dieses Konzept wird anhand von 3 Patientenfällen näher beschrieben.
3-D Optics for Thoracoscopic Vertebral Body Replacement – Essential Technical Progress or Just Nice to Have?
Authors: Jacobs Cornelius , Ploeger Milena , Scheidt Sebastian , Rößler Philip , Bornemann Rahel , Jacobs Collin , Burger Christof , Wirtz Dieter , Trommer Fridjof , Schildberg Frank 
Published: July 2018

Zusammenfassung
Hintergrund Dreidimensionale (3-D) endoskopische Optiken können durch 2 Kameras die unterschiedliche Perspektive des rechten und linken Auges simulieren und somit die Illusion einer räumlichen Tiefe erzeugen. Im laparoskopischen Einsatz konnte eine optimierte Orientierung und ein exakteres Handling gegenüber 2-D-Optiken nachgewiesen werden. Ob sich diese Ergebnisse auch auf den thorakoskopischen Wirbelkörperersatz im thorakolumbalen Übergang übertragen lassen, wird anhand der retrospektiven Studie untersucht. Hypothesen: 1. Der ventrale Wirbelkörperersatz unter Einsatz der 3-D-Thorakoskopie führt zu einer kürzeren OP-Zeit. 2. Der perioperative Blutverlust sinkt durch die bessere Raumorientierung (zügigere Blutstillung) und verminderte Gewebeschädigung.
Material und Methoden In der retrospektiven Studie wurden 29 Patienten mit ventralem thorakoskopischem Wirbelkörpersatz eingeschlossen. Bei n = 14 Patienten wurde die konventionelle 2-D-Optik angewendet, bei n = 15 Patienten die 3-D-Optik. Es wurden perioperative Daten wie Blutverlust, OP-Dauer und Aufenthaltsdauer analysiert. Statistische Signifikanz wurde mittels Studentʼs t-Test berechnet.
Ergebnisse Die häufigste Diagnose war eine LWK-1-Fraktur (n = 18, 62%). Die mittlere OP-Zeit war in der 3-D-Gruppe (149 ± 29, 107 – 198 min) um 24 min kürzer als in der 2-D-Gruppe (173 ± 39, 125 – 260 min), jedoch nicht signifikant. Der gesamte perioperative Blutverlust der 3-D-Gruppe war signifikant niedriger als in der 2-D-Gruppe (**p = 0,043). Der anteilige intraoperative Blutverlust der 3-D-Gruppe war ebenfalls niedriger (im Mittel um 115 ml), jedoch nicht signifikant. Signifikant geringer war die Fördermenge der Thoraxdrainage bei der 3-D-Gruppe (248 vs. 560 ml, *p = 0,0195). Der stationäre Aufenthalt bei der 3-D-Gruppe war im Mittel 1,5 Tage (d) kürzer, jedoch nicht signifikant.
Schlussfolgerung Sowohl mit der konventionellen 2-D-Optik als auch mit der 3-D-Optik ist der thorakoskopisch assistierte Wirbelkörperersatz im thorakolumbalen Übergang ein sicheres und zuverlässiges Operationsverfahren. Beide Verfahren ermöglichen vergleichbare OP-Zeiten, aber in unserer Studie bei der 3-D-Optik mit signifikant reduziertem Blutverlust postoperativ. Die vorliegende Studie ist hinsichtlich der geringen Fallzahl und aufgrund des retrospektiven Charakters lediglich als orientierende Pilotstudie zu werten.
Kombiniert kieferorthopädische-kieferchirurgische Therapie einer Klasse-II-Dysgnathie mit Invisalign
Authors: Triessnig Fanny , Reistenhofer Bärbel , Besser-Kizilyamac Katharina , Wutzl Arno , Seemann Rudolf 
Published: July 2018

ZusammenfassungIn dem vorliegenden Fallbericht wird die kombiniert kieferorthopädisch-kieferchirurgische Behandlung einer 24-jährigen Patientin mit Klasse-II-Dysgnathie präsentiert, wobei die kieferorthopädische Behandlung ausschließlich mit Invisalign-Schienen durchgeführt wurde. Während der gesamten Behandlung wurden sowohl auf Brackets als auch auf einen OP-Splint verzichtet und so kam es während der gesamten Behandlungszeit von 1 Jahr und 5 Monaten zu keinerlei ästhetischer Beeinträchtigung durch kieferorthopädische Maßnahmen.
Optimized Screw Trajectory for Lumbar Cortical Bone Trajectory Pedicle Screws Based on Clinical Outcome: Evidence Favoring the Buttress Effect Theory
Authors: Asamoto Shunji , Winking Michael , Jödicke Andreas , Ishikawa Masayuki , Ishihara Shinichi , Deinsberger Wolfgang , Muto Jun , Nishiyama Makoto , Kojima Kota 
Published: July 2018

Background Cortical bone trajectory (CBT) is a relatively new technique for pedicle screw insertion in the field of spine surgery. Previous studies have demonstrated the significantly better pullout and toggle characteristics the new method offers, and it appears to have certain advantages over the widely used traditional trajectory. The mechanism of the pullout and toggle characteristics still remains unknown.
Purpose To report the medium- to long-term follow-up findings of patients who underwent posterior lumbar interbody fusion or posterior lumbar fusion (PLIF/PLF) at our institution and to discuss the ideal screw trajectory when using this technique.
Study Design Retrospective radiologic study.
Methods Fifty-five patients who underwent PLIF/PLF for lumbar spondylosis using the new technique between January 2011 and January 2016 were included. Clinical outcome was assessed using the Japanese Orthopaedic Association scores for low back pain and visual analog scale scores. Screw loosening was evaluated via the presence of a translucent zone surrounding the pedicle screw using plain X-radiography (Xp). The screw trajectory was evaluated by measuring the rostral range (RR) and the lateral range score (LRS). The RR is the angle between the line drawn along the distal end plate of the vertebra and the line drawn along the screw on the lateral view. The LRS is the score given depending on the position of the tip of the screw seen on the Xp taken in the anteroposterior (AP) view. The pedicle ring is equally divided into the medial third (zone A), central third (zone B), and the lateral third (zone C) by four vertical lines. A score of 0 to 3 points is given depending on the position of the tip of the screw: 0, outside the pedicle ring; 1, zone A; 2, zone B; and 3, zone C.
Results Bone fusion was recorded in 49 patients (49/55 patients). The total number of screws with a visible translucent zone on Xp was 26 (26/242 screws). When the screws are inserted at a more acute angle in the lateral view (low RR) or when the screws are directed more medially (low LRS), the risk of developing a translucent zone around the pedicle screw increased.
Conclusion With CBT, the pedicle screws are inserted from the pars interarticularis that is rich in cortical bone, strong enough to withstand the substantial forces usually encountered in the region. Our clinical data suggest that the optimal screw trajectory is one where the screw is inserted at an angle > 22.55 degrees (high RR) on the lateral view Xp and where the tip of the screw is directed toward the lateral third of the pedicle on the AP Xp. We believe the naturally occurring buttress effect that exists in the vertebra may give CBT a mechanical and anatomical advantage over the traditional screw trajectory.
Variant von Willebrand’s Disease
Authors: Green David , Philip K J 
Published: July 2018

Summary30 members of an Illinois kindred were studied with a battery of haemostatic tests including the template bleeding time, platelet retention by glass beads (PRGB), measurement of activities related to factor VIII, and crossed-immunoelectrophoresis (CIEP). 9 family members had a history of excessive bleeding, and all 9 had prolonged bleeding times and increased migration of their factor VIII-related antigen (VIIIR:Ag) on CIEP. Of the other tests performed, the VIII: Ristocetin Cofactor and the PRGB showed the best correlation with the bleeding time. 3 subjects who were not bleeders, but who came from a branch of the family where there were several affected members, also had an abnormal VIIIR: Ag. The pattern of inheritance of the altered VIIIR: Ag in this family was one of autosomal dominance with full penetrance. The CIEP is a valuable screening test for the detection of variant von Willebrand’s disease and the recognition of silent heterozygotes.
Molecular Subunits and Transamidase Activity of Factor XIII During Disseminated Intravascular Coagulation in Acute Leukaemia
Authors: Rodeghiero F , Barbui T , Battista R , Chisesi T , Rigoni G , Dini E 
Published: July 2018

SummaryThe "in vivo" thrombin generation which occurs during disseminated intravascular coagulation (DIC) leads to complex coagulation abnormalities. The subunit A of fibrin stabilizing factor (Factor XIII) is a sensitive target for thrombin whilst the subunit S, is not. The two subunits seem to be insensitive to plasmin.A typical DIC picture has been found in 15 out of 200 cases of acute leukaemia; the subunits and the transamidase activity (TA) of the enzyme were severely reduced. The biologically active component, subunit A, and its TA were found to be much more reduced (P < 0.001) in patients with DIC than in those with AML without typical laboratory DIC pattern ("controls"). The levels of subunit A were correlated only with fibrinogenaemia. No difference in subunit S levels was found between normal healthy subjects and "controls". On the other hand this subunit was significantly reduced in DIC patients.It is assumed that thrombin affects the zymogen Factor XIII leading to the activation product A2S which could be cleared from the circulation. An alternative explanation of the decrease of subunit S, insensitive to thrombin, could be sought in a defect of its synthesis which seems to be related to that of subunit A, as it has been shown in congenital Factor XIII deficiency.Haemorrhagic complications are common and often fatal in patients with acute leukaemia. Platelet transfusion therapy has reduced the risk of haemorrhage but there are cases, not responsive to platelets, in whom the haemostatic mechanism is altered, generally by disseminated intravascular coagulation (DIC) (1). This syndrome results from an exaggerated response to cell damage with release of thromboplastic substances which activate "in vivo" the coagulation system. Thus, the "in vivo" thrombin generation leads to a consumption pattern including reduced levels of platelets, fibrinogen, factor V, VIII and XIII; positive paracoagulation tests; prolonged thrombin time and increased fibrin degradation products (FDP). However, patients with haemorrhages, presumably due to DIC, do not always show all of the above laboratory features (2, 3). Moreover, conclusive and extensive clinical studies of the biological expression of the syndrome are missing especially in acute leukaemia. Consequently, the diagnostic criteria for DIC are not yet well established and the diagnostic or prognostic role of a single coagulation factor is not definitively known. Concerning Factor XIII in acute
An International Collaborative Study Establishing a Reference Preparation for Antithrombin III
Authors: Kirkwood T B L , Barroweliffe T W , Thomas D P 
Published: July 2018

SummaryAn international collaborative study involving 12 laboratories in 7 countries was carried out to establish a suitable reference preparation of antithrombin III (At III). The amount of At III present in two purified preparations, a freeze-dried normal plasma and local normal plasma pools was measured by clotting, immunological, and amidolytic assays. 120 assays were submitted of which 105 were accepted as valid for inclusion in subsequent analyses. Less laboratory to laboratory variation was found when At III was assayed in freeze-dried normal plasma, as compared to purified preparations of At III, and there was also less method to method variation when At III was measured in freeze-dried plasma. When measured as heparin co-factor activity, the two purified preparations contained only about half the level of At III found by immunoassay or progressive At III clotting assays. In contrast, the use of freeze-dried plasma provided results which showed excellent agreement between the various laboratories by all assays; accordingly, this material has been established by the World Health Organization as the International Reference Preparation for At III, with an assigned potency of 0.9 i. u. per ml.
Platelet Count on Acute Induction to High Altitude
Authors: Sharma Subhash C 
Published: July 2018

SummaryPlatelet counts in 50 normal healthy volunteers were performed at sea level and then serially on rapid induction to 3658 m by air. Subjects were divided into "symptomatic" and "asymptomatic" groups depending on their score on the symptoms score chart. All were brought back to sea level and study repeated. Platelet count in the symptomatic group showed a falling trend while in the asymptomatics a gradual rise was noted.
The Lysis of Artificial Thrombi
Authors: Metcalf Michael J 
Published: July 2018

SummaryThe susceptibility to lysis of artificial thrombi formed from native rabbit blood in the presence or absence of dextran was determined using the Chandler loop technique. Thrombi of identical weight were formed in the presence of saline or dextran and when spontaneous thrombolysis was allowed to take place, thrombi formed in the presence of dextran 70 were lysed to a greater extent than those formed under control conditions.The possible factors influencing this observation were studied. Increasing concentrations of streptokinase increased the extent of thrombolysis in both control and dextran treated thrombi. Maximal streptokinase induced thrombolysis occurred in the presence of a 2 per cent final concentration of dextran Mw 40,000 and 500,000 and dextran 70 at a final concentration of 1.2 per cent.Increased thrombolysis was not observed when albumin was substituted for dextran.Finally, similar observations were recorded for streptokinase induced thrombolysis using human blood.
Increased Ristocetin-Cofactor in Acute Myocardial Infarction: a Component of the Acute Phase Reaction
Authors: Cucuianu Mircea P , Missits Ileana , Olinic Nour , Roman Stefan 
Published: July 2018

SummaryWhen compared to the values obtained in healthy normal-weight, normolipemic controls, the plasma level of ristocetin-cofactor (VIII: R-cof.) was found to be much higher in patients with acute myocardial infarction and in postoperative conditions (4–5 days after a major surgical intervention). A lesser increase of VIII: R-cof. was noted in atherosclerotic patients without acute occlusive accidents and no significant changes of this plasma factor could be observed in hyperlipemic subjects without obvious clinical atherosclerosis. Serial studies emphasized a tendency towards normalization of plasma VIII: R-cof. as the acute phenomena of a myocardial infarction subsided. The above mentioned data suggest that the high levels of VIII: R-cof. recorded in myocardial infarction are mainly caused by a systemic acute phase reaction and to a lesser extent by endothelial damage. Delayed clearance of VIII: R-cof. subsequent to a hepatic dysfunction or to a modified pattern of protein metabolism during the above mentioned acute phase reaction might also contribute to the high level of this plasma factor.
Simplified Thromboplastin Calibration: Further Experience of the Dutch Reference Laboratory for Anticoagulant Control
Authors: Besselaar A M H P van den , Halem-Visser L P van , Hoekstra-Schuman M , Marel-van Nieuwkoop W van der , Loeliger E A 
Published: July 2018

SummaryThe modified (and thereby simplified) thromboplastin calibration procedure using pooled lyophilized normal and patient plasmas is shown to equal, for batch-to-batch control of Thrombotest, the calibration procedure described by Biggs and Denson, which makes use of individual freshly prepared patient plasmas.
Reliability of Amidolytic Assays for Progressive Antithrombin and Heparin Cofactor Activities on Capillary Blood
Authors: Jensen A Hurlet-Birk , Maes E , Gillet C , Legrand-Monsieur A 
Published: July 2018

SummaryAmidolytic assay of antithrombin III on capillary blood can validly substitute for similar assays performed on venous blood, as an excellent correlation exists (r = 0.95).For the amidolytic assays of heparin cofactor activity, a much less satisfactory correlation is found (r = 0.81). Results are far more dispersed and a decrease is observed in late capillary samples.Using a low heparin concentration to assay heparin cofactor activity leads to surprisingly high activities for capillary blood. The same type of discrepancy is observed during the earliest stages of clotting of venous blood.
Abnormal Aggregation and Increased Size of Platelets in Myeloproliferative Disorders
Authors: Cortelazzo Sergio , Barbui Tiziano , Bassan Renato , Dim Enrico 
Published: July 2018

SummaryPlatelet aggregation is frequently impaired in myeloproliferative disorders (MPD). The presence of spontaneous platelet aggregation (SPA) or alterations of the aggregation pattern after ADP, epinephrine and collagen have been a frequent feature in the series of 52 patients here presented. The occurrence of SPA was not related to the findings obtained with the aggregating agents or to the number of circulating platelets. The aggregation results did not correlate with the number of megathrombocytes.The presence of platelet abnormalities, not completely corrected after busulfan therapy, and the increased size of platelets should aid in diagnosis of myeloproliferative disorders.
Gel Permeation Chromatography of Heparins
Authors: Mulloy Barbara , Johnson Edward A 
Published: July 2018

SummaryGel permeation chromatography of heparins using water as solvent has recently been used to obtain fractions for biological investigation. We find that heparin fractions obtained in this way are not, necessarily, differentiated simply on a molecular size basis as has been alleged. Correlations between biological activity and molecular size obtained using such fractions must therefore be treated with caution.
Increased Bleeding during Liver Resection in Ethanol-Intoxicated Rats
Authors: Bengmark Stig , Göransson Göran , Idvall Jan , Zoucas Evita 
Published: July 2018

SummaryThe effect of ethanol intoxication on hemostasis after liver resection was studied in the rat. Plasma levels of ethanol were within the range of those found in ethanol intoxication in man. Bleeding time and blood loss were significantly increased, whereas hemoglobin and hematocrit values were decreased after resection in intoxicated animals compared to controls. APT-times and platelet counts did not differ significantly between the two groups of rats. ADP- and collagen-induced platelet aggregation was slightly inhibited one hour after ethanol administration in non-operated animals. A decrease in pH, such as observed in intoxicated animals, did not affect hemostasis. Distribution of cardiac output was significantly altered after ethanol intoxication. Renal blood flow was increased by 54%, blood flow in the hepatic artery by 40% and in the portal vein by 47%.
Platelet Dense Bodies Loaded with Mepacrine Study in Chronic Idiopathic Thrombocytopenic Purpura (ITP)
Authors: Hourdille P , Bernard P , Reiffers J , Broustet A , Boisseau M R 
Published: July 2018

SummaryIn 22 cases of chronic ITP, the platelet 5-HT storage organelles were counted by examination of platelets loaded with mepacrine and correlated with the size and volume of the platelets. Statistical analysis showed that the mean volume and the number of granules increased in ITP without increase in the mean number of granules per unit volume. A strong correlation was found between platelet long diameter and number of dense bodies in controls (44 healthy subjects) (r = 0.94; y = 2.826 × – 0.699) and in ITP (r = 0.92; y = 2.587 × + 0.06). This study demonstrated in chronic ITP the presence both of platelets without granules and others rich in granules. These anomalies were present no matter what the count of platelets and did not change the mean values for granules and for ADP in most cases. Most platelets remain morphologically normal.