bluuebunny/crossref_metadata_2025_split huggingface dataset:
450 × 580 µm2 Pixel incorporating TX and coherent RX in CMOS for mm‐wave active imaging using a single reflector
Authors: Choi W. , Byreddy P.R. , Chen Z. , Chen A.J. , Newman A.J. , O K.K. 
Published: June 2018

A transceiver pixel for active imaging incorporating a transmitter (TX) and a coherent receiver (RX) is demonstrated in 65 nm CMOS at 260 GHz. The pixel occupies an area of 450 × 580µm2 and is the first demonstration of pixels incorporating a TX and a coherent RX which are smaller than λ/2 × λ/2. The pixel exhibits −21.3 dBm total radiated power and −79.5 dBm sensitivity at a 1 kHz noise bandwidth. This sensitivity is about 10 dB better than the state‐of‐the‐art pixel with only a coherent RX. The pixel consumes 18.7 mW of DC power.
Grundlagen der kontrastverstärkten Sonografie (CEUS)
Authors: Strunk Holger , Marinova Milka 
Published: June 2018

ZusammenfassungDie kontrastverstärkte Sonografie (CEUS) wird für viele Fragestellungen und in zahlreichen Fachdisziplinen eingesetzt, wenn auch mit unterschiedlichen Indikationen und Schwerpunkten. Dabei spielt die Erfahrung des Untersuchers sowohl für die Befunderhebung als auch für die Befundbeurteilung eine wesentliche Rolle. Im Folgenden werden die Grundlagen und die wichtigsten Einsatzgebiete der CEUS dargestellt.
Bauchaortenaneurysma – Diagnostik und interventionell-radiologische Therapie
Authors: Anton Susanne , Stahlberg Erik , Goltz Jan 
Published: June 2018

ZusammenfassungDas Bauchaortenaneurysma (BAA) als eine fokale Erweiterung aller Wandschichten der Aorta abdominalis ist ein komplexes und lebensbedrohliches Krankheitsbild – Albert Einstein und Charles de Gaulle sind an einer Ruptur verblutet. Eine endovaskuläre Aortenreparatur (EVAR) oder offen-chirurgische Therapie haben das Ziel, das Rupturrisiko niedrig zu halten bzw. zu eliminieren und die Lebenserwartung des Patienten zu verbessern.
„The Big Five“ – Kataraktchirurgie bei multiplen okulären Komorbiditäten: individuelle Vorgehensweise zur Komplikationsvermeidung
Authors: Borkenstein Andreas , Borkenstein Eva-Maria 
Published: June 2018

ZusammenfassungDas Auftreten von 5 Komorbiditäten (Cataracta senilis, Pseudoexfoliatio lentis, Fuchs-Endotheldystrophie, altersbedingte Makuladegeneration, Keratoconjunctivitis sicca) kann zu einer massiven Einschränkung des Sehvermögens führen. Engmaschige Verlaufskontrollen und die gezielte Therapie jeder einzelnen Erkrankung sind notwendig, um mit den entsprechenden Vorsichtsmaßnahmen die erfolgreiche Operation des grauen Stars durchführen zu können. Diese Fallserie zeigt, dass die Kataraktoperation trotz infauster Prognose zu visueller Rehabilitation führen kann.
Childhood Craniopharyngioma: A 22-Year Challenging Follow-Up in a Single Center
Authors: Tosta-Hernandez Patrícia , Siviero-Miachon Adriana , da Silva Nasjla , Cappellano Andrea , Pinheiro Marcelo , Spinola-Castro Angela 
Published: June 2018

AbstractCraniopharyngioma is a sellar/suprasellar benign tumor whose aggressiveness may imply in endocrine disturbances (hypothalamic obesity and hormone deficiencies). Fifty-seven patients were evaluated according to clinical characteristics, hypothalamic involvement, type of treatment, anthropometric variables, adiposity indexes (body mass index Z score category at diagnosis and post-treatment, total body fat, visceral adipose tissue, and metabolic syndrome components) and analyzed through multiple regression and logistic models. Patients were stratified according to growth hormone deficiency and recombinant human growth hormone use. Mean ages at diagnosis and at study evaluation were 9.6 and 16.6 years old, respectively. A set of 43/57 (75.4%) patients presented with important hypothalamic involvement, 24/57 (42.1%) received surgical treatment and cranial radiotherapy, and 8/57 (14%) interferon-α exclusively. Fifty-five patients (96.5%) were considered growth hormone deficient, and 26/57 (45.6%) grew despite no recombinant human growth hormone replacement therapy. At diagnosis, 12/57 (21%) patients were obese, and 33/57 (57.9%) at study evaluation, and after 3.2 years (median) post first therapy. There was no influence of height Z score on body mass index Z score. Body mass index Z score at diagnosis positively influenced body mass index Z score, total body fat, waist circumference and the presence of the metabolic syndrome post-treatment. Replacement of recombinant human growth hormone decreased total body fat and visceral adipose tissue. Craniopharyngioma patients worsened body mass index Z score category 3.2 years (median) after first treatment. Body mass index Z score increased due to real weight gain, without height decrease. Replacement of recombinant human growth hormone had beneficial effect on adiposity.
Palliativmedizinisches Denken und Handeln im Notarztdienst – eine Befragung zur Strukturqualität
Authors: Tiesmeier Jens , Salomon Fred , Lehning Brigitte , Tomaszczyk Matylda , Henzler Dietrich , Jakob Thomas 
Published: June 2018

Zusammenfassung
Fragestellung Je nach untersuchter Region beträgt der Anteil von Patienten mit einer palliativen Grunderkrankung 3 – 10 % (ca. 1 % in einer Terminalphase) der Gesamteinsätze im Rettungsdienst. Dabei ist ein breites Spektrum zu bewältigen. Es reicht von Symptomkrisen und psychosozialen Belastungen des Umfelds, über erkrankungsunabhängige Notfälle bis hin zur Frage der Durchführung einer Reanimation. Hierbei besteht ein Spannungsfeld zwischen dem kurativen Ansatz der Notfallrettung und dem Ansatz einer palliativen, symptomkontrollierenden Therapie vor Ort. Unter Zeitdruck müssen die Gesamtsituation erfasst und medizinische, juristische und ethische Aspekte im Sinne des Patienten gewürdigt werden. Es wurde der Frage nachgegangen, welche Strukturen und Hilfsmittel dem Notarzt für ein palliativmedizinisches Vorgehen und Denken im Einsatz zur Verfügung stehen.
Material und Methoden Datenerhebung zur Strukturqualität bei der Versorgung von Palliativpatienten mittels Fragebogen bei den Ärztlichen Leitern Rettungsdienst der Region Ostwestfalen-Lippe und der Stadt Münster.
Ergebnisse Rücklaufquote 8/8. Gesamtzahl der regelmäßig aktiven Notärzte pro Gebietskörperschaft 71 – 80; hiervon mit Zusatzweiterbildung Palliativmedizin 0 – 10. Fragenauswahl (in Klammern Anzahl der Nennungen), Strukturdaten Leitstelle: Kontaktdaten des ambulanten Palliativmediziners (z. B. Mobilfunknummer) für Disponenten zur Verfügung: ja (7), nein (1). Spezielle Schulungen der Disponenten: ja (1), nein (7). Strukturdaten zum Advance-Care Planning: Qualitätszirkel/Treffen Rettungsdienst/Palliativnetzwerk: ja (2), nein (6), geplant (1). Regional standardisierte Notfallausweise o. Ä.: ja (4), nein (4), geplant (1). Entscheidungshilfen im Einsatz: Standard operating Procedure (SOP) als Entscheidungspfad vorhanden: ja (3), nein (5), geplant (1). Ausstattung der Rettungsmittel: Port-Nadeln: ja (7), nein (1); MAD-Systeme (Intranasal Mucosal Atomization Device): ja (8), Gesamtmenge Morphinsulfat vor Ort ≥ 40 mg: ja (7), nein (1).
Diskussion und Schlussfolgerung Optionen, die ein palliativmedizinisches Vorgehen für die Notfallmedizin bieten können, wurden bislang uneinheitlich implementiert. Dies gilt für die Weiterbildung in medizinischen, rechtlichen und ethischen Fragen, die Ausstattung und Hilfsmittel auf den Rettungsmitteln sowie für die Kooperation mit den ambulanten Partnern. Mögliche Konflikt- und Schnittmengen sollten lokal und überregional erkannt und besprochen werden. Ziel ist ein souveränes und differenziertes Vorgehen zwischen kurativer Behandlungsoption und palliativer Symptomkontrolle, um im Sinne des Patienten handeln zu können.
Fibrinolysis and Fibrinogenolysis in Disseminated Intravascular Coagulation
Authors: Takahashi Hoyu , Tatewaki Wataru , Wada Ken , Niwano Hiroe , Shibata Akira 
Published: June 2018

SummaryIn order to assess precisely the fibrinolytic state in disseminated intravascular coagulation (DIC), plasma levels of fibrinogenolysis products (FgDP), fibrinolysis products (FbDP) and fibrinogenolysis plus fibrinolysis products (TDP) were measured with newly developed enzyme-linked immunosorbent assays based on monoclonal antibodies in 72 patients with DIC at presentation. Not only FbDP and TDP but also FgDP were markedly elevated in patients with DIC. When analyzed according to the underlying disease categories, the relative proportion of FgDP to TDP was high in patients with acute promyelocytic leukemia and vascular diseases, and it was the lowest in patients with sepsis. Correlation analysis revealed that plasma levels of FgDP correlated negatively with alpha 2-antiplasmin and positively with plasmin-alpha 2-antiplasmin complex (PAP) and a ratio of PAP to thrombin-antithrombin III complex (TAT). These findings indicate that besides fibrinolysis, fibrinogenolysis is markedly accelerated in the majority of the patients with DIC.
Hereditary Dysfunctional Protein C Molecules (Type II): Assay Characterization and Proposed Classification
Authors: Marlar Richard A , Adcock Dorothy M , Madden Renée M 
Published: June 2018

SummaryProtein C (PC) deficiency is among the increasing number of recognized causes of hereditary thrombotic disease. Two types of PC deficiency have been described: 1) Type I, which is characterized by a concomitant decrease in PC activity and antigen, and 2) Type II. characterized by disproportionately low activity compared to antigen (i.e. a dysfunctional molecule). To date, only a small number of Type II patients have been described. This study was undertaken to evaluate a number of dysfunctional PC molecules by comparing PC clotting and amidolytic activities with antigen levels. For these studies, an automated PTT-based clotting PC assay was developed. This assay was sensitive to 1% of a normal plasma pool, specific, accurate, and reproducible (± 12%). A good correlation (r = 0.918) of the clotting activity to antigen was found in normal individuals and Type I heterozygous and homozygous patients. To classify Type II PC deficient patients, the antigen, amidolytic and clotting PC levels were compared in ten affected families. The clotting activities were decreased in all affected members, whereas the antigen levels were within the normal limits. In four of the 10 families, the amidolytic activity was normal and similar to the antigen levels. This suggests that in certain families, defects in the PC molecule occur in regions not associated with amidolytic functions. From these studies, the molecular basis of Type II PC deficiency is varied and complex, involving different functional domains of the PC molecule. Therefore, we have suggested a nomenclature algorithm for Type II PC deficiency based on the location of the defect within the specific domains of the PC molecule.
Diagnosis of Protein C Deficiency in Patients on Oral Anticoagulant Treatment: Comparison of Three Different Functional Protein C Assays
Authors: Pabinger I , Kyrle P A , Speiser W , Stoffels U , Jung M , Lechner K 
Published: June 2018

SummaryThe efficacy of three different protein C activity assays and of protein C antigen determination for the diagnosis of protein C deficiency was studied in 13 protein C deficient patients (11 with type I, 2 with type II deficiency) and in 51 presumably nondeficient patients (control group), both groups being on oral anticoagulant (OAC) treatment. For protein C activity measurement (1) the assay according to Francis (slightly modified) with thrombin activation and measurement of activated protein C in the aPTT system, (2) an assay using Protac activation and chromogenic substrate (Protac-CS) and (3) an assay using Protac activation and the aPTT system (Protac-PTT) were used. Protein C antigen was determined by Laurcll immunoelec-trophoresis. The three activity assays gave different results, with the highest values obtained by the Protac-CS assay and the lowest values by the Protac-PTT assay. The Francis assay gave intermediate results.Protein C activity and antigen values were significantly lower in protein C deficient patients compared to the control group. Protein C activity tests had a higher discriminative power than the antigen determination. After taking into account the intensity of treatment, by the Francis assay all deficient and non-deficient patients were correctly classified, by the Protac-CS and the Protac-PTT assay 2 and 4 patients, respectively, were misclas-sified and by the antigen assay 8 patients were misclassified. Calculation of the ratios of protein C activity to factor II activity was of high discriminative power.We conclude that for diagnosis of protein C deficiency protein C activity tests are superior to antigen determination not only in type II but also in type I deficient patients. Certain statistical procedures can further improve the discrimination between deficient and non-deficient patients.
The Antithrombotic Properties of Human Prothrombin Fragment 1.2 in Mice
Authors: Chung Amy , Ofosu Frederick A , Blajchman Morris A 
Published: June 2018

SummaryWe have investigated the antithrombotic properties of prothrombin fragment 1.2 (F1.2) in this study. To do this, we established the minimum concentration of human placental tissue factor or human a-thrombin that was lethal in mice within 5 min after intravenous injection. Prothrombin F1.2 protected the mice from the lethal effect of tissue factor or α-thrombin in a dose dependent manner, with 500 μg (14 nmoles) of prothrombin F1.2 per mouse being the minimum amount required to protect all mice from the lethal effect of either thrombogenic stimulus. The minimum dose of heparin which protected mice from the lethal effect of thrombin or tissue factor was 6 units or ∼3.3 nmoles. The observation that prothrombin F1.2 has antithrombotic properties suggests prothrombin F1.2 can modulate coagulation in vivo, as it has previously been shown to do in vitro.
Characterization of a Panel of Monoclonal Antibodies to Human Coagulation Factor XI and Detection of Factor XI in Hep G2 Cell Conditioned Medium
Authors: Ohkubo Y , O’Brien D P , Kanehiro T , Fukui H , Tuddenham E G D 
Published: June 2018

SummaryWe have produced a panel of ten monoclonal antibodies specific to coagulation factor XI. Western blot analysis demonstrates that 9 of these antibodies react with the heavy chain of factor XI and one with the light chain. Seven of these antibodies inhibit factor XI and factor XIa activity.We have used immobilised monoclonal antibody for the production of factor XI deficient plasma and to purify factor XI to homogeneity with high yield in a simple two-step procedure. These monoclonal antibodies were used to develop highly sensitive immunoassays capable of detecting less than 0.01 u factor XI antigen ml−1. A strong correlation was found between antigen and activity levels in 11 patients with hereditary deficiency indicating that none was cross-reacting material positive. Cultured Hep G2 cells were found to synthesize small amounts of factor XI antigen and this could also be detected by functional assay and by western blot analysis.
The Dependence of the International Sensitivity Index on the Coagulometer Used to Perform the Prothrombin Time
Authors: Ray M J , Smith I R 
Published: June 2018

SummaryThis study was designed to detect any effect that different types of coagulation instrument may have on the International Sensitivity Index (ISI) of a thromboplastin.Manufacturers of commercial thromboplastins now calibrate their reagents against the World Health Organization international reference preparation to assign them an IST. This enables the prothrombin time (PT) estimated with that reagent to be expressed as an International Normalised Ratio (INR).One batch of Thromborel S was calibrated against the Australasian Reference Thromboplastin (ART). The Thromborel S was used on three photo-optical instruments, the Automated Coagulation Laboratory (ACL) (Instrumentation Laboratory), the Cobas Fibro (Roche), and the Coag-a-Pet (General Diagnostics). PTs using ART were performed manually using the reference method.The ISIs calibrated in our laboratory when the ACL and Cobas Fibro were used were not significantly different at the 95% level, being 1.102 ± 0.018 and 1.134 ± 0.022 respectively. The ISI with the Coag-a-Pet of 1.223 ± 0.023 was significantly different to that of the ACL and the Cobas Fibro at the 95% level.The flowcharts for a computer program to perform the necessary calculations are provided. The program allows for the entry and editing of data from the calibration procedure, and provides a mean normal PT and normal range, the ISI and 95% confidence limits of the calibration, and a chart for the conversion of the test PTs to INRs.The authors have made available an IBM compatible program for the calibration of thromboplastins.
Isolation of Human Fibrinogen and its Derivatives by Affinity Chromatography on Gly-Pro-Arg-Pro-Lys-Fractogel
Authors: Kuyas C , Haeberli A , Walder P , Straub P W 
Published: June 2018

SummaryWith an immobilized synthetic pentapeptide GlyProArgProLys comprising the N-terminal sequence GlyProArg of the α-chain of fibrin, a new affinity method for the quantitative isolation of fibrinogen out of anticoagulated plasma was developed. The method proved to be superior to all known isolation methods in respect to ease of use and yield, since fibrinogen could be isolated in one step out of plasma with a recovery of more than 95% when compared to the immunologically measurable amounts of fibrinogen. Moreover the amounts of contaminating proteins such as fibronectin, factor XIII or plasminogen were negligible and the purity of the isolated fibrinogen was higher than 95% as measured by polyacrylamide gel electrophoresis. The clottability was 90% and more. Another advantage of this affinity purification method is the possibility to isolate fibrinogen quantitatively out of small plasma samples (<5 ml). Further, abnormal fibrinogen molecules, provided their complementary binding site for GlyProArg is preserved, may also be quantitatively isolated independent of any solubility differences as compared to normal fibrinogen. In addition fibrin(ogcn) fragments originating from plasmic digestion can be separated on the basis of their affinity to GlyProArg. The described affinity gel can be used more than 50 times without any loss of capacity.
The Fibrinolytic Potential of the Normal Primate following the Generation of Thrombin In Vivo
Authors: Giles Alan R , Nesheim Michael E , Herring Steven W , Hoogendoorn Hugh , Stump David C , Heldebrant Charles M 
Published: June 2018

SummaryParameters of the fibrinolytic system were studied in a primate model where the generation of thrombin was promoted in vivo. The procoagulant stimulus used was a combination of human factor Xa in combination with phosphatidylcholine/phos-phatidylserine lipid vesicles (PCPS) as the source of coagulant active phospholipid. The dosage of each component was formulated to provide a gradation of thrombin generating potential assessed prior to in vivo study in an in vitro clotting assay. These ranged from 25.25 - 36.60 pMole/kg (factor Xa) and 18.85 - 56.30 nMole/kg (PCPS). In each case, the ratio of the dose of factor Xa/PCPS was maintained at 0.65 (pMole factor Xa/ nMole PCPS). Individual dosage combinations producing recalcification clotting times in vitro of 15, 20, 25 and 30 s were used in detailed in vivo studies. Previous studies in dogs had confirmed the thrombin generating potential of factor Xa/PCPS infusions and demonstrated an associated activation ot protein C and increased fibrinolytic activity. This has now been extensively characterized in the chimpanzee as follows: 10 min after the infusion of the highest dose (36.6 pMole factor Xa/56.3 nMole PCPS kg bodyweight), the level of circulating t-PA had risen to 900 ng/ml (antigen), 885 IU/ml (functional). Dosage was observed with the lowest dose of 12.25 pMole factor Xa and 18.85 nMole PCPS being associated with relatively minor increases in circulating t-PA activity. There were no changes in u-PA at any dosage during the full time course of the experimental period (90 min). Plasminogen activation was also apparent with alpha-2 antiplasmin levels falling to 30 - 40% of pre-infusion levels at the highest dosages. There was also a significant consumption of fibrinogen and evidence of active fibrinolysis manifested by major increases in the levels of FDP, D-dimer and B-beta 1-42. The data strongly suggested that this was predominantly fibrinolysis rather than fibrinogenolysis and that the fibrinolytic response observed resulted from a major release of t-PA from available stores consequent to thrombin generation and presumably subsequent fibrin generation. These data illustrate the enormous fibrinolytic potential of the intact normal primate and may provide a model for study of the mechanism(s) by which the regulation of t-PA availability can be up- or down-regulated in health and disease.
Physico-Chemical Properties of Recombinant Desulphatohirudin
Authors: Electricwala A , Irons L , Wait R , Carr R J G , Ling R J , Grossenbacher H , Atkinson T 
Published: June 2018

SummaryPhysico-chemical properties of recombinant desulphatohirudin expressed in yeast (CIBA GEIGY code No. CGP 39393) were reinvestigated. As previously reported for natural hirudin, the recombinant molecule exhibited abnormal behaviour by gel filtration with an apparent molecular weight greater than that based on the primary structure. However, molecular weight estimation by SDS gel electrophoresis, FAB-mass spectrometry and Photon Correlation Spectroscopy were in agreement with the theoretical molecular weight, with little suggestion of dimer or aggregate formation. Circular dichroism studies of the recombinant molecule show similar spectra at different pH values but are markedly different from that reported by Konno et al. (13) for a natural hirudin-variant. Our CD studies indicate the presence of about 60% beta sheet and the absence of alpha helix in the secondary structure of recombinant hirudin, in agreement with the conformation determined by NMR studies (17)
Ethanol Inhibition of Thrombus Formation on Collagen-Coated Glass
Authors: Owens Charlene K , Mclntire Larry V , Lasslo Andrew 
Published: June 2018

SummaryEpi-fluorescent video microscopy was used to evaluate the effect of ethanol on platelet mural thrombus formation. Whole blood, treated with ethanol, was perfused over collagen coated glass in a parallel-plate flow chamber at a shear rate of 1,000/s. Digital image processing and photodiode measurements were used to analyze the dynamics of thrombus growth on this surface. Ethanol concentrations as low as 0.02% v/v were found to inhibit 45 + 33% (± S.D.) of normal platelet accumulation on the slide while 0.2% v/v ethanol effected an 82 ± 15% inhibition of mural thrombus formation. While platelet adhesion to the collagen surface appeared unaffected by ethanol concentrations up to 0.1% v/v, 0.2% v/v ethanol had an effect on adhesion as well as aggregation. These results imply that low ethanol concentrations inhibit the formation of mural thrombi in a model of a damaged blood vessel at physiological shear rates. This inhibition would not be detected in systems which measure bulk aggregation, e.g. in aggregometric determinations.
Proteolytic and Immunologic Comparison of Human and Bovine von Willebrand Factor
Authors: Bakhshi Meenakshi R , Kirby Edward P 
Published: June 2018

SummaryThe structures of bovine and human vWF were compared by proteolysis with Staphylococcus aureus V8 protease and rattlesnake venom Protease I. Fragments were analyzed for chain composition, heparin binding, collagen binding, platelet agglutinating activity and recognition by a panel of monoclonal antibodies which reacted with both bovine and human vWF. Similar large fragments from the C-terminal domain of vWF were seen in each case. The N-terminal domain resulting from cleavage of bovine vWF was much smaller than that seen upon digestion of human vWF with V8 protease. Protease I destroyed the heparin binding domain in human vWF. Bovine vWF was much less sensitive to proteolysis than was human vWF.