bluuebunny/crossref_metadata_2025 huggingface dataset:
Case 16
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Gynecology section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 24
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the First Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 26
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the First Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 31
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the First Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 35
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the First Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 40
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 41
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 44
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 45
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 53
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 59
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 62
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 69
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 70
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 76
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 78
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 81
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 82
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 83
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 84
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 85
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 86
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 91
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 98
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 102
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 104
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 116
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Abdomen section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 117
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 118
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 122
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 125
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 126
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 127
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 128
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 132
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 135
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 136
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 138
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 139
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 141
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 142
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 143
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 144
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 145
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Small Parts section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 149
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 150
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 151
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 153
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 155
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 163
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 167
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 168
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 170
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 172
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 176
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 177
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 180
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 181
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 185
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 186
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Case 187
Authors: Scoutt Leslie M. , Hamper Ulrike M. , Angtuaco Teresita L.
Published: January 2017

This is a case from the Vascular section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
Spine Oncology—Metastatic Spine Tumors
Authors: Choi David , Bilsky Mark , Fehlings Michael , Fisher Charles , Gokaslan Ziya
Published: January 2017

Surgery for spinal metastases remains the mainstay treatment for pain, instability, and neurological deterioration due to tumor infiltration of the spine. However, several new therapies are emerging which may improve outcomes further, and in some cases even replace the need for surgery. We now have a better understanding of which factors influence survival and quality of life after surgery, and this underpins the development and application of new treatments, and assessment of outcome.

Depending on genetic subtyping of tumors, novel immunotherapies and chemotherapies may be very effective in prolonging quality of life. New surgical techniques allow smaller, quicker, and safer operations with less blood loss, pain, and quicker recovery after surgery. Radiation treatments have also leapt forward with the greater accuracy and higher doses possible from intensity-modulated photon radiation, stereotactic body radiation treatment, proton beam therapy, or carbon ion treatment. Combined with more advanced materials for vertebral body stabilization, computer navigation systems, and robotics, more can be done at earlier or later stages of the spinal disease than was previously possible, resulting in more options and improved outcomes for patients.
Incidence and Management of Late Adverse Radiation Effects After Arteriovenous Malformation Radiosurgery
Authors: Pollock Bruce E , Link Michael J , Branda Megan E , Storlie Curtis B
Published: January 2017

BACKGROUND

Late adverse radiation effects (ARE) typically occur many years after stereotactic radiosurgery (SRS) of intracranial arteriovenous malformations (AVM). They are characterized by perilesional edema or cyst formation and are distinct from radiation-induced changes (RIC) noted in the first 1 to 2 years after AVM SRS and radiation necrosis.

OBJECTIVE

To determine the incidence of late ARE after AVM SRS.

METHODS

Retrospective review of 233 AVM patients having SRS from 1990 to 2009. Patients had sporadic AVM, no prior radiation, and a minimum of 5 years of magnetic resonance imaging (MRI) follow-up. The median MRI follow-up after SRS was 9.8 years (range, 5-24.2).

RESULTS

Late ARE were observed in 16 patients (6.9%) at a median of 8.7 years after SRS (range, 2.0-16.1). The 5-, 10-, and 15-year incidence of late ARE was 0.4%, 7.7%, and 12.5%, respectively. Eight patients (3.4%) were symptomatic at the time of ARE detection. Three of 8 patients who were initially asymptomatic had documented cyst progression (at 11, 40, and 42 months), for an overall symptomatic rate of 4.7%. Five patients with asymptomatic ARE have been observed for a median of 9.3 years (range, 2.0-14.1) without progression. Patients having early RIC (hazard ratio [HR] = 2.11, P < .001), patients having obliteration (HR = 1.24, P = .02), and patients having SRS before April 1997 (HR = 1.12, P = .02) were more likely to develop late ARE.

CONCLUSION

Late ARE are common in AVM patients who develop early RIC after SRS. Resection of the thrombosed AVM and the adjacent damaged tissue is effective at eliminating the mass effect and improving patients’ neurological condition.
Of Bubbles and Layers: Which Cerebral Cavernous Malformations are Most Difficult to Dissect From Surrounding Eloquent Brain Tissue?
Authors: Dammann Philipp , Wrede Karsten , Jabbarli Ramazan , Müller Oliver , Mönninghoff Christoph , Forsting Michael , Sure Ulrich
Published: January 2017

BACKGROUND: Cerebral cavernous malformations (CCM) may lead to repetitive intracerebral hemorrhage. In selected cases, a surgical resection is indicated.

OBJECTIVE: To identify magnetic resonance imaging (MRI) features of CCM that correlate with the difficulty of dissection and postoperative outcome.

METHODS: This study prospectively analyzed pre- and postoperative MRI features, intraoperative findings (surgical questionnaire), and postoperative outcome of 41 patients with eloquent CCM. Based on the results of the surgeon's questionnaire and postoperative MRI findings, all surgical procedures were dichotomized in a “difficult” (group A) or “not difficult” (group B) lesion dissection. Based on the correlation of preoperative MRI features with groups A and B, a 3-tiered classification was established and tested for sensitivity and specificity.

RESULTS: In 22 patients, dissection of the lesion was rated difficult. This was significantly correlated with amount of postoperative diffusion restriction on MRI (P = .001) and postoperative outcome (P = .05). Various preoperative MRI features were tested for correlation and combined in a 3-tiered classification. Receiver operating characteristics revealed excellent and good results for predicting difficulty of dissection for the different classification types.

CONCLUSION: We provide a meticulous analysis and new classification of preoperative MRI features that seem to be involved in the microsurgical resection of CCM.
The Health Impact of Adult Cervical Deformity in Patients Presenting for Surgical Treatment: Comparison to United States Population Norms and Chronic Disease States Based on the EuroQuol-5 Dimensions Questionnaire
Authors: Smith Justin S. , Line Breton , Bess Shay , Shaffrey Christopher I. , Kim Han Jo , Mundis Gregory , Scheer Justin K. , Klineberg Eric , O’Brien Michael , Hostin Richard , Gupta Munish , Daniels Alan , Kelly Michael , Gum Jeffrey L , Schwab Frank J. , Lafage Virginie , Lafage Renaud , Ailon Tamir , Passias Peter , Protopsaltis Themistocles , Albert Todd J. , Riew K. Daniel , Hart Robert , Burton Doug , Deviren Vedat , Ames Christopher P. , Group International Spine Study
Published: January 2017

BACKGROUND: Although adult cervical spine deformity (ACSD) is associated with pain and disability, its health impact has not been quantified in comparison to other chronic diseases.

OBJECTIVE: To perform a comparative analysis of the health impact of symptomatic ACSD to US normative and chronic disease values using EQ-5D (EuroQuol-5 Dimensions questionnaire) scores.

METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Baseline demographics and EQ-5D scores were collected and compared with US normative and disease state values.

RESULTS: Of 121 ACSD patients, 115 (95%) completed the EQ-5D (60% women, mean age 61 years, previous spine surgery in 44%). Diagnoses included kyphosis with mid-cervical (63.4%), cervico-thoracic (23.5%), or thoracic (8.7%) apex and primary coronal deformity (4.3%). The mean ACSD EQ-5D index was 0.511 (standard definition = 0.224), which is 34% below the bottom 25th percentile (0.780) for similar age- and gender-matched US normative populations. Mean ACSD EQ-5D index values were worse than the bottom 25th percentile for several other disease states, including chronic ischemic heart disease (0.708), malignant breast cancer (0.708), and malignant prostate cancer (0.708). ACSD mean index values were comparable to the bottom 25th percentile values for blindness/low vision (0.543), emphysema (0.508), renal failure (0.506), and stroke (0.463). EQ-5D scores did not significantly differ based on cervical deformity type (P = .66).

CONCLUSION: The health impact of symptomatic ACSD is substantial, with negative impact across all EQ-5D domains. The mean ACSD EQ-5D index was comparable to the bottom 25th percentile values for blindness/low vision, emphysema, renal failure, and stroke.
Understanding United States Investigational Device Exemption Studies—Clinical Relevance and Importance for Healthcare Economics
Authors: Ament Jared D. , Mollan Scott , Greenan Krista , Binyamin Tamar , Kim Kee D.
Published: January 2017

INTRODUCTION: The US Food and Drug Administration allows a previously unapproved device to be used clinically to collect safety and effectiveness data under their Investigational Device Exemption (IDE) category. The process usually falls under 3 different trial categories: noninferiority, equivalency, and superiority. To confidently inform our patients, understanding the basic concepts of these trials is paramount. The purpose of this manuscript was to provide a comprehensive review of these topics using recently published IDE trials and economic analyses of cervical total disc replacement as illustrative examples.

CASE STUDY: MOBI-C ARTIFICIAL CERVICAL DISC: In 2006, an IDE was initiated to study the safety and effectiveness of total disc replacement controlled against the standard of care, anterior cervical discectomy, and fusion. Under the IDE, randomized controlled trials comparing both 1 and 2 level cervical disease were completed. The sponsor designed the initial trial as noninferiority; however, using adaptive methodology, superiority could be claimed in the 2-level investigation.

REVIEWING HEALTHCARE ECONOMICS: Healthcare economics are critical in medical decision making and reimbursement practices. Once both cost- and quality-adjusted life-year (QALY) are known for each patient, the incremental cost-effectiveness ratio is calculated. Willingness-to-pay is controversial, but a commonly cited guideline considers interventions costing below 20 000 $/QALY strongly cost effective and more than 100 000 $/QALY as not cost effective.

CONCLUSION: While large Food and Drug Administration IDE studies are often besieged by complex statistical considerations and calculations, it is fundamentally important that clinicians understand at least the terminology and basic concepts on a practical level.
Predictors of Discharge to a Nonhome Facility in Patients Undergoing Lumbar Decompression Without Fusion for Degenerative Spine Disease
Authors: Murphy Meghan E. , Maloney Patrick R. , McCutcheon Brandon A. , Rinaldo Lorenzo , Shepherd Daniel , Kerezoudis Panagiotis , Gilder Hannah , Ubl Daniel S. , Crowson Cynthia S. , Freedman Brett A. , Habermann Elizabeth B. , Bydon Mohamad
Published: January 2017

BACKGROUND

Patients recovering from decompressive laminectomy without fusion may require assistance with activities of daily living and physical/occupational therapy upon hospital discharge.

OBJECTIVE

To examine comorbidities and perioperative characteristics of patients undergoing lumbar decompression for associations with discharge status using a multicenter database.

METHODS

A multicenter database was used for this retrospective cohort analysis. Patients admitted from home with degenerative spine disease for lumbar decompression without fusion were included. Thirty-day outcomes and operative characteristics were compared as a function of patient discharge using chi-square and Wilcoxon Rank Sum tests. Multivariable logistic regression was used to determine factors associated with discharge to a nonhome facility.

RESULTS

Of the 8627 patients included for analysis, 9.7% were discharged to a nonhome facility. On multivariable analysis, age (85+ vs <65, odds ratio [OR] 13.59), number of levels of decompression (3+ vs 1, OR 1.75), African American race vs Non-Hispanic or Hispanic White (OR 1.87), female vs male gender (OR 1.97), body mass index (BMI) (40+ vs 18.5-24.9, OR 1.74), American Society of Anesthesiologists physical classification status (4 vs 1 or 2, OR 2.35), hypertension (OR 1.29), dependent functional status (OR 3.92), diabetes (OR 1.47), smoking (OR 1.40), hematocrit (<35 vs 35+, OR 1.76), international normalized ratio (≥1.3 vs <1.3, OR 2.32), and operative time (3+ h vs <1 h, OR 5.34) were significantly associated with an increased odds of discharge to nonhome facilities.

CONCLUSION

Preoperative status and operative course variables can influence discharge disposition in lumbar decompression patients. Identifying specific factors that contribute to a greater likelihood of dismissal to skilled facility or rehabilitation unit can further inform both surgeons and patients during preoperative counseling and disposition planning.
Stabilization of Tumor-Associated Craniovertebral Junction Instability: Indications, Operative Variables, and Outcomes
Authors: Zuckerman Scott L. , Kreines Fabiana , Powers Ann , Iorgulescu J. Bryan , Elder James B. , Bilsky Mark H. , Laufer Ilya
Published: January 2017

BACKGROUND: Whether primary or metastatic, tumors of the craniovertebral junction (CVJ) are rare and challenging.

OBJECTIVE: To examine the surgical indications, operative variables, and outcomes in patients with tumors of the CVJ undergoing occipitocervical (OC) stabilization.

METHODS: A single-institution, retrospective case series was performed from a prospectively maintained spine database. Patients with primary or metastatic tumors of the CVJ who underwent OC stabilization were identified. Out of 46 patients who underwent OC fusion, 39 were for tumor. Paired t-tests and Wilcoxon rank-sum tests were performed to assess for postoperative changes.

RESULTS: Ten patients (26%) harbored primary tumors, and the remaining 29 (74%) had metastatic disease. Of the metastatic patients, 14 had a neurological deficit, 10 had severe neck pain, and 5 were deemed mechanically unstable. Postoperative visual analog pain scores were significantly reduced at all 3 follow-up times (P < .001, 95% confidence interval [CI; 3.2, 6.0]; P = .001, 95% CI [2.6, 7.7]; P = .020, 95% CI [0.6, 5.5]). The percentage of patients who were ambulatory and neurologically improved or intact remained stable postoperatively with no significant declines. There were 2 perioperative mortalities (5%), and 13 patients (33%) experienced a major complication.

CONCLUSIONS: In patients with primary or metastatic tumor of the CVJ, OC stabilization using a cervical screw-rod system affixed to a midline-keel buttress plate, with or without posterior decompression, is a reliable method for CVJ stabilization in the oncologic setting. Improvement in pain and preservation of neurological function was seen.
Records of sunspot and aurora activity during 581–959 CE in Chinese official histories concerning the periods of Suí, Táng, and the Five Dynasties and Ten Kingdoms
Authors: Tamazawa Harufumi , Kawamura Akito Davis , Hayakawa Hisashi , Tsukamoto Asuka , Isobe Hiroaki , Ebihara Yusuke
Published: January 2017

Recent studies concerning radioisotopes in tree rings or ice cores suggest that extreme space weather events occurred during the pre-telescope age. Observational records of naked-eye sunspots and low-latitude auroras in historical documents during this age can provide useful information about past solar activity. In this paper, we present the results of a comprehensive survey of records of sunspots and auroras in Chinese official histories from the 6th century to the 10th century, in the period of Suí, Táng, the Five Dynasties and Ten Kingdoms. These official histories contain records of continuous observations with well-formatted reports conducted under the policy of the governments. A brief comparison of the frequency of observations of sunspots and auroras based on observations of radioisotopes as an indicator of solar activity during the corresponding periods is provided. Using our data, we surveyed and compiled the records of sunspots and auroras in historical documents from various locations and in several languages, and ultimately provide these as open data to the scientific community.
Ultraviolet to optical diffuse sky emission as seen by the Hubble Space Telescope Faint Object Spectrograph
Authors: Kawara Kimiaki , Matsuoka Yoshiki , Sano Kei , Brandt Timothy D. , Sameshima Hiroaki , Tsumura Kohji , Oyabu Shinki , Ienaka Nobuyuki
Published: January 2017

We present an analysis of the blank-sky spectra observed with the Faint Object Spectrograph on board the Hubble Space Telescope. We study the diffuse sky emission from ultraviolet to optical wavelengths, which is composed of zodiacal light (ZL), diffuse Galactic light (DGL), and residual emission. The observations were performed towards 54 fields distributed widely over the sky, with spectral coverage from 0.2 to 0.7 μm. In order to avoid contaminating light from earthshine, we use the data collected only in orbital nighttime. The observed intensity is decomposed into the ZL, DGL, and residual emission, in eight photometric bands spanning our spectral coverage. We found that the derived ZL reflectance spectrum is flat in the optical, which indicates major contribution of C-type asteroids to the interplanetary dust (IPD). In addition, the ZL reflectance spectrum has an absorption feature at ∼0.3 μm. The shape of the DGL spectrum is consistent with those found in earlier measurements and model predictions. While the residual emission contains a contribution from the extragalactic background light, we found that the spectral shape of the residual looks similar to the ZL spectrum. Moreover, its optical intensity is much higher than that measured from beyond the IPD cloud by Pioneer 10/11, and also than that of the integrated galaxy light. These findings may indicate the presence of an isotropic ZL component, which is missed in the conventional ZL models.
Imprints of zero-age velocity dispersions and dynamical heating on the age–velocity dispersion relation
Authors: Kumamoto Jun , Baba Junichi , Saitoh Takayuki R.
Published: January 2017

Observations of stars in the the solar vicinity show a clear tendency of old stars to have larger velocity dispersions. This relation is called the age–velocity dispersion relation (AVR) and it is believed to provide insight into the heating history of the Milky Way galaxy. Here, in order to investigate the origin of the AVR, we performed smoothed particle hydrodynamic simulations of the self-gravitating multiphase gas disks in the static disk-halo potentials. Star formation from cold and dense gas is taken into account, and we analyze the evolution of these star particles. We find that exponents of simulated AVR and the ratio of the radial to vertical velocity dispersion are close to the observed values. We also find that the simulated AVR is not a simple consequence of dynamical heating. The evolution tracks of stars with different epochs evolve gradually in the age–velocity dispersion plane as a result of: (1) the decrease in velocity dispersion in star-forming regions, and (2) the decrease in the number of cold/dense/gas as scattering sources. These results suggest that the AVR involves not only the heating history of a stellar disk, but also the historical evolution of the ISM in a galaxy.
Detailed modeling of dust distribution in the disk of HD 142527
Authors: Soon Kang-Lou , Hanawa Tomoyuki , Muto Takayuki , Tsukagoshi Takashi , Momose Munetake
Published: January 2017

We investigate the dust distribution in the crescent disk around HD 142527 based on the continuum emission at 890 μm obtained by ALMA Cycle 0. The map is divided into 18 azimuthal sectors, and the radial intensity profile in each sector is reproduced with a two-dimensional disk model. Our model takes account of scattering and inclination of the disk as well as the azimuthal dependence in intensity. When the dust is assumed to have the conventional composition and a maximum size of 1 mm, the northwestern region ($\mathit {PA}=291^{\circ }$–351°) cannot be reproduced. This is because the model intensity becomes insensitive to the increase in surface density due to heavy self-scattering, reaching its ceiling much lower than the observed intensity. The ceiling depends on the position angle, $\mathit {PA}$. When the scattering opacity is reduced by a factor of 10, the intensity distribution is reproduced successfully in all the sectors, including those in the northwestern region. The best-fitting model parameters depend little on the scattering opacity in the southern region where the disk is optically thin. The contrast ratio of dust surface densities along $\mathit {PA}$ is derived to be about 40, much smaller than the value in the case of conventional opacities (70–130). These results strongly suggest that the albedo is lower than that considered for some reason, at least in the northwestern region.
A formulation of consistent particle hydrodynamics in strong form
Authors: Yamamoto Satoko , Makino Junichiro
Published: January 2017

In fluid dynamical simulations in astrophysics, large deformations are common and surface tracking is sometimes necessary. The smoothed particle hydrodynamics (SPH) method has been used in many such simulations. Recently, however, it has been shown that SPH cannot handle contact discontinuities or free surfaces accurately. There are several reasons for this problem. The first one is that SPH requires that the density is continuous and differentiable. The second one is that SPH does not have consistency, and thus the accuracy is of the zeroth-order in space. In addition, we cannot express accurate boundary conditions with SPH. In this paper, we propose a novel, high-order scheme for particle-based hydrodynamics of compressible fluid. Our method is based on a kernel-weighted high-order fitting polynomial for intensive variables. With this approach, we can construct a scheme which solves all of the three problems described above. For shock capturing, we use a tensor form of von Neumann–Richtmyer artificial viscosity. We have applied our method to many test problems and obtained excellent results. Our method is not conservative, since particles do not have mass or energy, but only their densities. However, because of the Lagrangian nature of our scheme, the violation of the conservation laws turned out to be small. We name this method Consistent Particle Hydrodynamics in Strong Form (CPHSF).