Plasma exchange (PE) is used for blood purification to modulate proteins involved in pathological processes. As the number of patients receiving PE treatment and the heterogeneity of the underlying diseases is steadily increasing, we evaluated the most frequent complications and analyzed causes leading to adverse reactions. 883 PE procedures in 113 patients between the years 2000 to 2006 were retrospectively analyzed with respect to complications. Additionally, underlying diseases and settings of PE procedure were analyzed to identify high-risk patients and respective PE settings. A total of 226 adverse reactions were recorded (25.6% of all PE procedures). Most complications were mild (n = 121, 13.7%) or moderate (n = 98, 11.0%). In seven cases (n = 7, 0.7%), severe, life-threatening adverse events were induced by PE either due to severe allergic reactions (n = 4, 0.5%) or to sepsis (n = 3, 0.3%). Patients with neurologic diseases had a significantly higher risk to develop complications compared to those with internal diseases (P = 0.013). This was due to a higher rate of PE associated adverse events (in particular hypotension) and complications associated with vascular access. Among patients from internal medicine those with hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) had the highest risk to develop complications. Patients with neurological diseases compared to those with medical conditions and patients with HUS/TTP compared to those with other diseases had a higher risk to develop complications. However, severe adverse events are rare. Thus, PE seems to be a safe and recommendable procedure.

No abstract

Patients with deletions in 22q13 are known to have phenotypic features that include normal or accelerated growth, large hands and feet, hypotonia, delayed psychomotor development and mild facial dysmorphism. To date, very few cases have been investigated by detailed molecular genetic analysis. We have analyzed three new patients with terminal deletions in 22q. We compared the cytogenetic observations with molecular data assessed by fluorescence in situ hybridization and an array of characterized bacterial artificial chromosome recombinants. The shortest region of deletion overlap is localized in 22q13.2-qter distal to the marker D22S94, but the telomeric repeat in the deleted chromosome appears to remain intact. When parental alleles were investigated in two of the three patients, the aberrant homolog was found to be of paternal origin in both cases. Although the deleted region still spans >20 cM, molecular analysis of additional patients and screening for new genes might help in elucidating candidate genes connected with the dysmorphisms defined by deletions of 22q13.

Findings of a new representative of the Laophontodinae Lang, 1944 (Copepoda, Harpacticoida) from the Napoleon Reef (Gulf of Aqaba, Red Sea, Egypt) provided new insights into the systematics of the type genus Laophontodes T. Scott, 1894. Bicorniphontodes clarae gen. et sp. nov., which is described in the present contribution, shares exclusively six derived characters with Laophontodes bicornis A. Scott, 1896, L. horstgeorgei George & Gheerardyn, 2015, and partly with L. hamatus (Thomson, 1883), and L. ornatus Krishnaswamy, 1957: (1) cephalothorax medio-laterally with triangular extensions and (2) postero-laterally with paired cuticular processes, (3) free body somites except telson dorsally with hyaline frills ending in rounded lappets, (4) furcal setae I and II displaced subapically, (5) antennar allobasis lacking abexopodal seta on endopodal half, (6) outer spines of the last segment of swimming legs 2 and 3 unipinnate and comb-like, with the pinnae being extremely long and set widely apart. Thus, the named species are excluded from Laophontodes and united together with B. clarae gen. et sp. nov. in Bicorniphontodes gen. nov. as Bicorniphontodes bicornis comb. nov., B. hamatus comb. nov., B. horstgeorgei comb. nov., and B. ornatus comb. nov.. Beside the description of B. clarae gen. et sp. nov., a detailed phylogenetic discussion regarding the systematic relationships of the named species and the justification of the erection of Bicorniphontodes gen. nov. is given, including its distribution in the world’s oceans. A key to species is also provided.

PurposeStrategic entrepreneurship (SE) depicts the nexus of strategic management and entrepreneurship, suggesting that firms can create superior wealth when simultaneously pursuing advantage-seeking and opportunity-seeking behavior. As the rapid growth in SE research led to a multidisciplinary, scattered and fragmented literature landscape, the authors aim to structure this research field.Design/methodology/approachThe authors employ a bibliographic coupling and literature review of the strategic entrepreneurship research field.FindingsThe authors identify and describe five major research streams with 15 sub-themes in recent SE research. Based on our findings, the authors propose an integrated research framework and research gaps for future research.Originality/valueTo the authors’ knowledge, this is the first review on SE based on a bibliographic coupling.

No abstract

Allotransplant rejection is a T-cell-dependent reaction. Functional in vitro T-cell assays are being used widely for donor-recipient matching in bone marrow transplantation and have recently been used in some centres for transplant monitoring. In order to assess tolerance induction after clinical transplantation, we measured the T-cell response of the host against donor spleen cells of 33 kidney transplant patients before and every 3 months after transplantation over a period of 18 months. The T-cell reactivity before transplantation was not significantly different in any of the assays in rejecting and non-rejecting patients. In the classical mixed lymphocyte culture (MLC), a donor-specific loss of reactivity was seen only in a patient with a CMV-associated irreversible transplant rejection. One patient with chronic rejection acquired a very high MLC response against donor spleen cells and a high response against third-party cells. Little or nonspecific changes were seen in the MLCs of all other patients. Using the method of limiting dilution analysis (LDA), we found a significant reduction of donor-specific cytotoxic T-cell precursors (CTL-p) within the first 3 months after transplantation in most patients with high antidonor CTL-p frequencies before transplantation. The reduction of donor-specific CTL-p was seen in patients with rejection episodes as well as in patients without. Thus we conclude, in contrast to others, that MLC and CTL-p LDA have no predictive value on the outcome of clinical transplantation.

Seasonal allergic conjunctivitis (SAC) is a frequent disease, which is often associated with allergic rhinitis and subsequently manifested as allergic rhinoconjunctivitis. In contrast to other types of chronic allergic conjunctivitis, the course of SAC is not sight-threatening. Pathogenetically, the underlying cause of SAC is an immunoglobulin E (IgE) mediated, Th2-driven type 1 hypersensitivity reaction. Clinically it presents with itching, light-red conjunctival injection as well as chemosis that exceeds the extent of conjunctival injection. The goals of treatment are relief of acute signs and symptoms, control of the underlying inflammatory process and utilization of preventive options. Dually effective local therapeutics combine the advantages of rapid action with a relatively long-lasting effect by a two-fold active approach. Specific immunotherapy is useful in selected patients.