bluuebunny/crossref_metadata_2025 huggingface dataset:
A genome-wide association study identified a novel genetic loci STON1-GTF2A1L/LHCGR/FSHR for bilaterality of neovascular age-related macular degeneration
Authors: Kawashima-Kumagai Kyoko , Yamashiro Kenji , Yoshikawa Munemitsu , Miyake Masahiro , Ming Gemmy Cheung Chui , Fan Qiao , Koh Jia Yu , Saito Masaaki , Sugahara-Kuroda Masako , Oishi Maho , Akagi-Kurashige Yumiko , Nakata Isao , Nakanishi Hideo , Gotoh Norimoto , Oishi Akio , Tamura Hiroshi , Ooto Sotaro , Tsujikawa Akitaka , Kurimoto Yasuo , Sekiryu Tetsuju , Matsuda Fumihiko , Khor Chiea-Chuen , Cheng Ching-Yu , Wong Tien Yin , Yoshimura Nagahisa
Published: July 2017

Bilateral neovascular age-related macular degeneration (AMD) causes much more handicaps for patients than unilateral neovascular AMD. Although several AMD-susceptibility genes have been evaluated for their associations to bilaterality, genome-wide association study (GWAS) on bilaterality has been rarely reported. In the present study, we performed GWAS using neovascular AMD cases in East Asian. The discovery stage compared 581,252 single nucleotide polymorphisms (SNPs) between 803 unilateral and 321 bilateral Japanese cases but no SNP showed genome-wide significance, while SNPs at six regions showedP-value < 1.0 × 10−5,STON1-GTF2A1L/LHCGR/FSHR, PLXNA1, CTNNA3,ARMS2/HTRA1,LHFP, andFLJ38725. The first replication study for these six regions comparing 36 bilateral and 132 unilateral Japanese cases confirmed significant associations of rs4482537 (STON1-GTF2A1L/LHCGR/FSHR), rs2284665 (ARMS2/HTRA1), and rs8002574 (LHFP) to bilaterality. In the second replication study comparing 24 bilateral and 78 unilateral cases from Singapore, rs4482537 (STON1-GTF2A1L/LHCGR/FSHR) only showed significant association. Meta-analysis of discovery and replication studies confirmed genome-wide level significant association (P = 2.61 × 10−9) of rs4482537 (STON1-GTF2A1L/LHCGR/FSHR) and strong associations (P = 5.76 × 10−7and 9.73 × 10−7, respectively) of rs2284665 (ARMS2/HTRA1) and rs8002574 (LHFP). Our GWAS for neovascular AMD bilaterality found new genetic lociSTON1-GTF2A1L/LHCGR/FSHRand confirmed the previously reported association ofARMS2/HTRA1.
Efficient functional neutralization of lethal peptide toxins in vivo by oligonucleotides
Authors: El-Aziz Tarek Mohamed Abd , Ravelet Corinne , Molgo Jordi , Fiore Emmanuelle , Pale Simon , Amar Muriel , Al-Khoury Sawsan , Dejeu Jérôme , Fadl Mahmoud , Ronjat Michel , Taiwe Germain Sotoing , Servent Denis , Peyrin Eric , De Waard Michel
Published: July 2017

Medical means to save the life of human patients affected by drug abuse, envenomation or critical poisoning are currently limited. While the compounds at risks are most often well identified, particularly for bioterrorism, chemical intervention to counteract the toxic effects of the ingested/injected compound(s) is restricted to the use of antibodies. Herein, we illustrate that DNA aptamers, targeted to block the pharmacophore of a poisonous compound, represent a fast-acting and reliable method of neutralization in vivo that possesses efficient and long-lasting life-saving properties. For this proof of concept, we used one putative bioweapon, αC-conotoxin PrXA, a marine snail ultrafast-killing paralytic toxin, to identify peptide-binding DNA aptamers. We illustrate that they can efficiently neutralize the toxin-induced (i) displacement of [125I]-α-bungarotoxin binding onto nicotinic receptors, (ii) inhibition of diaphragm muscle contraction, and (iii) lethality in mice. Our results demonstrate the preclinical value of DNA aptamers as fast-acting, safe and cheap antidotes to lethal toxins at risk of misuse in bioterrorism and offer hope for an alternative method than donor sera to treat cases of envenomation.
Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
Authors: Monti Serena , Palma Giuseppe , D’Avino Vittoria , Gerardi Marianna , Marvaso Giulia , Ciardo Delia , Pacelli Roberto , Jereczek-Fossa Barbara A. , Alterio Daniela , Cella Laura
Published: July 2017

The risk of radiation-induced toxicity in patients treated for head and neck (HN) cancer with radiation therapy (RT) is traditionally estimated by condensing the 3D dose distribution into a monodimensional cumulative dose-volume histogram which disregards information on dose localization. We hypothesized that a voxel-based approach would identify correlations between radiation-induced morbidity and local dose release, thus providing a new insight into spatial signature of radiation sensitivity in composite regions like the HN district. This methodology was applied to a cohort of HN cancer patients treated with RT at risk of radiation-induced acute dysphagia (RIAD). We implemented an inter-patient elastic image registration framework that proved robust enough to match even the most elusive HN structures and to provide accurate dose warping. A voxel-based statistical analysis was then performed to test regional dosimetric differences between patients with and without RIAD. We identified a significantly higher dose delivered to RIAD patients in two voxel clusters in correspondence of the cricopharyngeus muscle and cervical esophagus. Our study goes beyond the well-established organ-based philosophy exploring the relationship between radiation-induced morbidity and local dose differences in the HN region. This approach is generally applicable to different HN toxicity endpoints and is not specific to RIAD.
Femur First navigation can reduce impingement severity compared to traditional free hand total hip arthroplasty
Authors: Palit Arnab , Williams Mark A. , Turley Glen A. , Renkawitz Tobias , Weber Markus
Published: July 2017

Impingement is a major source of dislocation and aseptic loosening in total hip arthroplasty (THA). We compared impingement free range of motion (ROM) using a novel computer navigated femur first approach to conventional THA. In addition, impingement between genders was also explored. In a retrospective analysis of 121 THA patients, subject-specific post-operative ROM was simulated using post-operative 3D-CT data, and compared with the benchmark ROM, essential for activities of daily living. Three parameters were defined to express both implant-to-implant (ITI) and bone-to-bone (BTB) impingement - coverage percentage, third angle, and impingement severity. Although coverage percentage was similar between the navigated and conventional group for both ITI (p = 0.69) and BTB (p = 0.82) impingement, third angle was significantly reduced in the navigation group for both ITI (p = 0.02) and BTB (p = 0.05) impingement. Impingement severity for both ITI (p = 0.01) and BTB (p = 0.05) was significantly decreased in the navigation group compared to the conventional. Impingement severity in men was considerably higher compared to women for both ITI (p = 0.002) and BTB (p = 0.02). Navigation guided femur first THA is able to improve alignment of ROM axis, and consequently, to reduce impingement in THA. Men seem to be more prone to impingement than women.
Modulation of activation and inactivation by Ca2+ and 2-APB in the pore of an archetypal TRPM channel from Nematostella vectensis
Authors: Kühn Frank J. P. , Mathis Winking , Cornelia Kühn , Hoffmann Daniel C. , Lückhoff Andreas
Published: July 2017

The archetypal TRPM2-like channel of the sea anemone Nematostella vectensis is gated by ADPR like its human orthologue but additionally exhibits properties of other vertebrate TRPM channels. Thus it can help towards an understanding of gating and regulation of the whole subfamily. To elucidate further the role of Ca2+ as a co-factor of ADPR, we exploited 2-aminoethyl diphenylborinate (2-APB), previously shown to exert either inhibitory or stimulatory effects on diverse TRPM channels, or both in a concentration-dependent manner. 2-APB in high concentrations (1 mM) induced large, non-inactivating currents through nvTRPM2. In lower concentrations (≤0.5 mM), it prevented the fast current inactivation typical for nvTRPM2 stimulated with ADPR. Both these effects were rapidly reversed after wash-out of 2-APB, in contrast to a considerable lag time of their onset. A detailed analysis of nvTRPM2 mutants with modified selectivity filter or reduced ADP-ribose sensitivity revealed that the actions of 2-APB depend on its access to the pore which is enhanced by channel opening. Moreover, access of Ca2+ to the pore is decisive which again depends on the open state of the channel. We conclude that separate regulatory processes by Ca2+ on the pore can be discriminated with the aid of 2-APB.
High resolution 3-Dimensional imaging of the human cardiac conduction system from microanatomy to mathematical modeling
Authors: Stephenson Robert S. , Atkinson Andrew , Kottas Petros , Perde Filip , Jafarzadeh Fatemeh , Bateman Mike , Iaizzo Paul A. , Zhao Jichao , Zhang Henggui , Anderson Robert H. , Jarvis Jonathan C. , Dobrzynski Halina
Published: July 2017

Cardiac arrhythmias and conduction disturbances are accompanied by structural remodelling of the specialised cardiomyocytes known collectively as the cardiac conduction system. Here, using contrast enhanced micro-computed tomography, we present, in attitudinally appropriate fashion, the first 3-dimensional representations of the cardiac conduction system within the intact human heart. We show that cardiomyocyte orientation can be extracted from these datasets at spatial resolutions approaching the single cell. These data show that commonly accepted anatomical representations are oversimplified. We have incorporated the high-resolution anatomical data into mathematical simulations of cardiac electrical depolarisation. The data presented should have multidisciplinary impact. Since the rate of depolarisation is dictated by cardiac microstructure, and the precise orientation of the cardiomyocytes, our data should improve the fidelity of mathematical models. By showing the precise 3-dimensional relationships between the cardiac conduction system and surrounding structures, we provide new insights relevant to valvar replacement surgery and ablation therapies. We also offer a practical method for investigation of remodelling in disease, and thus, virtual pathology and archiving. Such data presented as 3D images or 3D printed models, will inform discussions between medical teams and their patients, and aid the education of medical and surgical trainees.
Magnesium Oxide (MgO) pH-sensitive Sensing Membrane in Electrolyte-Insulator-Semiconductor Structures with CF4 Plasma Treatment
Authors: Kao Chyuan-Haur , Chang Chia Lung , Su Wei Ming , Chen Yu Tzu , Lu Chien Cheng , Lee Yu Shan , Hong Chen Hao , Lin Chan-Yu , Chen Hsiang
Published: July 2017

Magnesium oxide (MgO) sensing membranes in pH-sensitive electrolyte-insulator-semiconductor structures were fabricated on silicon substrate. To optimize the sensing capability of the membrane, CF4 plasma was incorporated to improve the material quality of MgO films. Multiple material analyses including FESEM, XRD, AFM, and SIMS indicate that plasma treatment might enhance the crystallization and increase the grain size. Therefore, the sensing behaviors in terms of sensitivity, linearity, hysteresis effects, and drift rates might be improved. MgO-based EIS membranes with CF4 plasma treatment show promise for future industrial biosensing applications.
Silk-hydrogel Lenses for Light-emitting Diodes
Authors: Melikov Rustamzhon , Press Daniel Aaron , Kumar Baskaran Ganesh , Dogru Itir Bakis , Sadeghi Sadra , Chirea Mariana , Yılgör İskender , Nizamoglu Sedat
Published: July 2017

Today the high demand for electronics leads to massive production of waste, thus green materials based electronic devices are becoming more important for environmental protection and sustainability. The biomaterial based hydrogels are widely used in tissue engineering, but their uses in photonics are limited. In this study, silk fibroin protein in hydrogel form is explored as a bio-friendly alternative to conventional polymers for lens applications in light-emitting diodes. The concentration of silk fibroin protein and crosslinking agent had direct effects on optical properties of silk hydrogel. The spatial radiation intensity distribution was controlled via dome- and crater-type silk-hydrogel lenses. The hydrogel lens showed a light extraction efficiency over 0.95 on a warm white LED. The stability of silk hydrogel lens is enhanced approximately three-folds by using a biocompatible/biodegradable poly(ester-urethane) coating and more than three orders of magnitude by using an edible paraffin wax coating. Therefore, biomaterial lenses show promise for green optoelectronic applications.
Room temperature ferroelectricity in fluoroperovskite thin films
Authors: Yang Ming , KC Amit , Garcia-Castro A. C. , Borisov Pavel , Bousquet E. , Lederman David , Romero Aldo H. , Cen Cheng
Published: July 2017

The NaMnF3 fluoride-perovskite has been found, theoretically, to be ferroelectric under epitaxial strain becoming a promising alternative to conventional oxides for multiferroic applications. Nevertheless, this fluoroperovskite has not been experimentally verified to be ferroelectric so far. Here we report signatures of room temperature ferroelectricity observed in perovskite NaMnF3 thin films grown on SrTiO3. Using piezoresponse force microscopy, we studied the evolution of ferroelectric polarization in response to external and built-in electric fields. Density functional theory calculations were also performed to help understand the strong competition between ferroelectric and paraelectric phases as well as the profound influences of strain. These results, together with the magnetic order previously reported in the same material, pave the way to future multiferroic and magnetoelectric investigations in fluoroperovskites.
Selective cleavage of the polyphosphoester in crosslinked copper based nanogels: enhanced antibacterial performance through controlled release of copper
Authors: Padmavathy Nagarajan , Samantaray Paresh Kumar , Ghosh Lopamudra Das , Madras Giridhar , Bose Suryasarathi
Published: July 2017

Polymeric architectures with controlled and well-defined structural features render a sustainable antibacterial surface — a key requirement in the design of polymeric membranes for water purification.
Correction: Zwitterionic pyrrolidene-phosphonates: inhibitors of the glycoside hydrolase-like phosphorylase Streptomyces coelicolor GlgEI-V279S
Authors: Veleti Sri Kumar , Petit Cecile , Lindenberger Jared J. , Ronning Donald R. , Sucheck Steven J.
Published: July 2017

Correction for ‘Zwitterionic pyrrolidene-phosphonates: inhibitors of the glycoside hydrolase-like phosphorylase Streptomyces coelicolor GlgEI-V279S’ by Sri Kumar Veleti et al., Org. Biomol. Chem., 2017, 15, 3884–3891.
Stimulus-responsive block copolymer nano-objects and hydrogels via dynamic covalent chemistry
Authors: Deng Renhua , Ning Yin , Jones Elizabeth R. , Cunningham Victoria J. , Penfold Nicholas J. W. , Armes Steven P.
Published: July 2017

Dynamic covalent chemistry can be used to induce reversible morphological transitions for block copolymer nano-objects in mildly alkaline solution.
Post-synthetic diversification of pyrrole-fused benzosultams via trans-sulfonylations and reactions on the periphery of pyrrole
Authors: Laha Joydev K. , Bhimpuria Rohan A. , Kumar Aitha Manoj
Published: July 2017

The synthesis of pyrrole fused benzosultams and their trans-sulfonylation reactions providing workable access to (NH)-2-arylpyrroles containing ortho-sulfonamide functionality and fluorene tethered pyrrole fused benzosultam has been described.
Local structural studies on Co doped ZnS nanowires by synchrotron X-ray atomic pair distribution function and micro-Raman shift
Authors: Gawai U. P. , Dole B. N.
Published: July 2017

The atomic structures of nanowires were studied by X-ray atomic pair distribution function analysis and total synchrotron X-ray scattering data. A PDF method was used to describe a wurtzite and zinc-blended mixed phase model.
Lead-free and amorphous organic–inorganic hybrid materials for photovoltaic applications: mesoscopic CH3NH3MnI3/TiO2 heterojunction
Authors: Zhang Xianxi , Yin Jie , Nie Zhonghao , Zhang Qian , Sui Ning , Chen Baoli , Zhang Yingtian , Qu Konggang , Zhao Jinsheng , Zhou Huawei
Published: July 2017

A lead-free and amorphous a-MAMnI3 thin film was prepared by spin coating. The photovoltage of the optoelectronic device reached 300 mV under AM1.5, 100 mW cm−2 simulated illumination.
Blind curvelet watermarking method for high‐quality images
Authors: Kim W.‐H. , Nam S.‐H. , Lee H.‐K.
Published: July 2017

The proposed method is a watermarking method for high‐quality images that achieves high invisibility and good robustness using a curvelet domain. Recently, there has been a demand for a watermarking technique that does not impair image quality, as interest in high‐quality images has increased. To meet this demand, the authors adopted a method of minimising the watermark‐embedding energy by using the multi‐directional decomposition technique, curvelet transformation. However, if a watermark is inserted into the curvelet domain with the watermarking technique of the conventional domains, it is distorted during the forward and inverse curvelet transform. To solve this problem, they designed a watermarking method by considering the characteristics of the curvelet filter. By minimising the watermark distortion caused by the curvelet transform, high robustness is achieved with small watermarking energy. The proposed method shows very good invisibility and is difficult to distinguish the original. In terms of robustness, the correlation value increased by >80% and BER decreased by >20% compared with previous methods.
A Rare Case of Spontaneous Asymptomatic Renal Artery Pseudoaneurysm Treated with Coil Embolization: A Case Report
Authors: Chataut Dinesh , Maharjan Santosh , Panta Om , Ghimire Ram
Published: July 2017

Background Renal artery pseudoaneurysm (RAP) is a rare renal vascular abnormality but a life-threatening condition that requires multiple imaging modalities for diagnosis and successful management. It can occur as a complication associated with a percutaneous renal biopsy procedure, renal surgery, and trauma. Asymptomatic spontaneous RAP is also a rare entity and not reported in literature.

Case Presentation A 28-year-old patient presented to the outpatient department for ultrasound of the breast for mastalgia and routine ultrasound of the abdomen. Ultrasound breast was normal; however, a cystic lesion with color uptake with a yin–yang pattern and to-and-fro spectral waveform was seen in the lower pole of left kidney suggesting a pseudoaneurysm. A computed tomography renal angiogram confirmed the diagnosis. The patient was completely asymptomatic with no history of any renal surgery or intervention or any trauma to the abdomen. Her general and systemic examinations were unremarkable. Digital subtraction angiography and coil embolization of the pseudoaneurysm were performed. Absent of flow in the lesion was demonstrated in postembolization angiography images and ultrasound images.

Conclusion RAP has always been described in patients after renal biopsy, surgery, interventions, or trauma. However, we present a case of asymptomatic spontaneous RAP, which was incidentally discovered and effectively treated with coil embolization.
The Endovascular Armamentarium to Save the Dying Brain: Prospects and Challenges
Authors: Poyyamoli Santhosh , Muddhan Prakash Dilip , Ranasingh Rahul , Mehta Pankaj , Cherian Mathew
Published: July 2017

Purpose Acute ischemic stroke was not long ago the territory of the neurologist, where the endovascular surgeon had only started baby steps. The scenario has completely changed post-2015 and now mechanical thrombectomy holds centerstage of the treatment guidelines. The two basic techniques for clot retrieval are the stent retriever thrombectomy and a direct aspiration first-pass technique. Use of one device as an adjunct to the other also has a passing mention in the trials. Tandem occlusions pose issues in accessing the target vessel for clot retrieval, and emergency stenting of the carotid pathway opens further avenues in stroke care.

Cases The authors present four cases of acute ischemic stroke, three of them involving the anterior circulation and one involving the basilar artery. All the cases underwent endovascular therapy, albeit with different techniques. Through the cases, they present the current technology, and its implementation and challenges faced by the interventional radiologist.

Conclusion The availability of a diverse technical repertoire helps in tackling specific scenarios facing the stroke interventionist. The levels of evidence vary for the different weapons at hand, but it is not long before endovascular intervention becomes the panacea for stroke.
Left Common Carotid Artery Agenesis with Hypoplastic Left Internal Carotid Artery Originating from the Aortic Arch: A Rare Anomaly Presenting with Internal Carotid Artery Aneurysm and Subarachnoid Hemorrhage
Authors: Ghuman Mandeep , Gupta Vivek , Singh Shankhneel , Dhandapani S. , Khandelwal N.
Published: July 2017

Most arch anomalies are asymptomatic and detected incidentally on imaging or on autopsy. Occasionally, such anomalies can manifest clinically when associated with another vascular pathology such as an intracranial aneurysm. In this report, we describe a rare case of agenesis of the left common carotid artery with separate origin of the left internal carotid artery and the external carotid artery from the arch discovered on digital subtraction angiography performed during the evaluation of subarachnoid hemorrhage. Knowledge of such anomalies and radiographic appearance is essential for interventional neuroradiologist in planning treatment of such cases.
Viral Oncolytic Therapy
Authors: Zurkiya Omar , Ganguli Suvranu
Published: July 2017

Viral oncolysis broadly refers to the use of modified viruses to infect and subsequently lyse tumor cells. This concept arises from the observation that viral replication is itself effective in destroying tumor cells. This effect is then amplified by reinfection of adjacent tumor cells by the progeny virion released from lysed tumor cells. Herpes simplex virus 1 (HSV-1) has been the primary focus of current efforts in viral oncolysis. It is a double-stranded DNA virus that is a ubiquitous pathogen transmitted by direct mucosal contact. HSV-1 possesses several features well suited to viral oncolytic therapy. It does not integrate into the cellular genome, has a large transgene capacity of up to 50 kb, and is already highly prevalent in the general population. In addition, effective antiherpetic agents are available to stop unwanted viral replication. HSV-1 mutants that preferentially replicate in neoplastic cells rather than normal cells have been characterized, and several variants of replication deficient HSV-1 mutants have been created and studied. They follow a common theme in that their replication is significantly attenuated in normal cells, while activated in cancer cells. Studies have been performed in various strains including those known as G207, NV1020, talimogene laherparepvec, and rRp450, and are reviewed here. Viral oncolysis is an exciting area of research with applications to tumors throughout the body. It holds promise as a new treatment for primary and metastatic liver cancer and may soon become a relevant therapy in interventional oncology.
Combined Efficacy of Adrenal Vein Sampling and Imaging Findings in Predicting Clinical Outcomes Following Unilateral Adrenalectomy for Primary Aldosteronism
Authors: Srinivasa Rajiv , Anderson Matthew , Dackiw Alan , Pillai Anil , Trimmer Clayton , Kalva Sanjeeva , Reis Stephen
Published: July 2017

The objective of this study was to investigate the combined efficacy of adrenal vein sampling (AVS) and imaging findings in predicting successful clinical outcomes following unilateral adrenalectomy for primary aldosteronism (PA). A retrospective chart review of 137 patients who underwent AVS between 2009 and 2014 at two hospitals in a single academic institution was performed. Preprocedure demographic, imaging, medication, and laboratory values were reviewed. In general, patients were considered for adrenalectomy when lateralization was suggested on AVS. Clinical outcomes such as improved blood pressure control and preserved renal function after adrenalectomy were correlated with preprocedure variables. AVS was technically successful in 120 out of 137 patients. Lateralization was seen in 64 patients and 48 out of 64 patients underwent adrenalectomy. Out of 48, 43 patients had an adrenal nodule on preoperative imaging, while 5 did not. 28 patients showed improvement in blood pressure after adrenalectomy, all of which had a nodule on imaging. Of the 28 patients, 22 also showed preservation of renal function. None of the remaining 5 (out of 48) patients who demonstrated lateralization on AVS and had no nodule on imaging showed clinical improvement following adrenalectomy. The presence of an adrenal nodule on preoperative imaging was also associated with improved blood pressure control (p = 0.022) and preserved renal function (p = 0.048) following adrenalectomy. Improved blood pressure control and preserved renal function in patients with PA who underwent adrenalectomy following lateralization on AVS are associated with the identification of an adrenal nodule on preoperative imaging.
Flow Diversion in Ruptured Blood Blister Aneurysms: Single Centre Experience
Authors: Kumar Dilip , R. Rahul , P. Santhosh , Mehta Pankaj , Cherian Mathew , Kheradia Dharav , Anand Rinoy
Published: July 2017

Blood blister aneurysms are extremely rare, and its treatment continues to be controversial. Although surgery was the only available treatment a decade ago, today newer endovascular devices such as flow diverters (FDs) appears to have very low complication rates with good long-term results. We analyzed our data of seven patients who angiographically had features of a blister aneurysm. All these patients presented with subarachnoid hemorrhage (SAH). Six of these were in anterior circulation, all of which were in internal carotid artery (ICA) and one was in a P1 segment of posterior cerebral artery (PCA). All of the patients except one in PCA were treated with FDs. One of the patients died (14.3%) following the procedure secondary to thrombosis of FD. Rest of the patients did well postprocedure with the good clinical outcome (modified Rankin Scale [mRS] of less than or equal to 2 at 1-month follow-up) in 85.7% patients. Five of the patients showed complete obliteration of an aneurysm (83.3%) on 6-month follow-up angiography. The only patient with an aneurysm in PCA showed persistence of an aneurysm and this particular lesion was instead treated by a single stent. Blister aneurysms pose diagnostic and therapeutic challenges and demand prompt treatment. Considering that all patients who were treated with FD had complete obliteration, it can be inferred that FD can be the treatment of choice in patients with blister aneurysms presenting with SAH. Further, with the introduction of small vessel FD, thrombotic complications may reduce, lowering the morbidity and mortality. Isolated stenting may not be an optimal treatment of a blister aneurysm.
Hepatic Hydrothorax: The Conundrum and the Oxymoron
Authors: Kumar Sachin , Patidar Yashwant , Maiwall Rakhi
Published: July 2017

Hepatic hydrothorax (HH) is an infrequent but a well-known complication of portal hypertension. Medical management of this condition often fails, and there are no large randomized-controlled trials establishing the best treatment strategies. HH thus represents a formidable entity in the management of end-stage liver disease, and the only definitive treatment is liver transplantation. Despite documented ominous outcome, tube thoracostomy (TT) is still a widely practiced approach to HH mostly by the unaware primary care physician. This communication reports the occurrence of pleurosubcutaneous fistula as a presenting complication of TT in a patient with HH. TT should thus be avoided at all costs in this subset of patients because it is fraught with multiple complications. This report reinforces the importance of clinical education and awareness of these complications and outcomes of TT in a cirrhotic patient with HH.
Analytical Evaluation of a Vancomycin Immunoassay in Synovial Fluid
Authors: Luceri Francesca , Balboni Fiamma , Balato Giovanni , Pezzati Paola , Cini Nicoletta , Virgili Gianni , Baldini Andrea
Published: July 2017

In clinical laboratories performing routine activities, the need to answer the burning clinical question in emerging field may be limited by lack of technology support or assays accessibility. Commercially available methods, although originally validated for specific biological matrices, may be employed for other matrices, following appropriate guidelines such as Clinical and Laboratory Standards Institute (CLSI) EP 19. We investigated the use of a vancomycin assay with synovial fluid samples, in view of a possible employment in vancomycin release study. The standard of care of periprosthetic joint infection is a two-stage revision surgery with antibiotic-loaded bone cement implantation. Vancomycin, for its activity against gram-positive bacteria even multidrug-resistant staphylococci, is the most widely used antibiotic. Despite the widespread use of such devices, little is known about the in vivo elution in the joint space. Clinical laboratories equipped with a validated, affordable method to quantify vancomycin in synovial fluid, may support clinical research, and give an important contribution to the study of the pharmacokinetics of antibiotic release from bone cement matrix.
Transient Common Peroneal and Tibial Nerve Palsy Following Knee Arthroscopy for the Treatment of Discoid Lateral Meniscus
Authors: Bernardi Gabriele , Tudisco Cosimo
Published: July 2017

The number of knee arthroscopies has increased rapidly since the 1980s and are among the most common orthopedic procedures today. It is generally considered a minimally invasive surgery with relatively low morbidity, but it is not without risk of complications. We report the case of a 14-year-old boy who developed a lesion of common peroneal nerve and tibial nerve after knee arthroscopy for a torn discoid lateral meniscus, which was confirmed by electromyogram study.
Arthroscopic Reduction with Endobutton Fixation for Glenoid Fracture
Authors: Taverna Ettore , Guarrella Vincenzo , Freehill Michael , Garavaglia Guido
Published: July 2017

Glenoid rim fractures, accompanied by acute glenohumeral dislocation or subluxation usually results in persistent instability. Traditionally open reduction and internal fixation has been recommended in displaced intra-articular glenoid fractures. However, open reduction is difficult, and it may not be possible to address the associated intra-articular soft-tissue injuries. A few reports of arthroscopic-assisted fixation of these fractures have been recently published. The most anatomic method for addressing an acute glenoid rim lesion is a reduction (either open or arthroscopic) and internal fixation. We are reporting a case of arthroscopic reduction and fixation of a glenoid fracture utilizing Endobuttons with clinical and radiological results at 18 months follow-up.
Early Efficacy of Intra-Articular HYADD® 4 (Hymovis®) Injections for Symptomatic Knee Osteoarthritis
Authors: Priano Ferdinando
Published: July 2017

Purpose The aim of the study was to evaluate the clinical effects of HYADD® 4, an hydrogel based on a hyaluronic acid derivative, in patients with symptomatic knee osteoarthritis, on symptoms, and joint function.

Methods This retrospective study of patients with Kellgren–Lawrence grade II to IV knee osteoarthritis (American College of Rheumatology criteria) enrolled patients who had received two infiltrations of HYADD® 4, (24 mg/3 mL) 1 week apart, and evaluated: pain at rest, pain with movement, change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score; change in nonsteroidal anti-inflammatory drugs (NSAIDs)/acetaminophen use; satisfaction with therapy; tolerability. Study duration was 6 months for all predefined endpoints, with a 6-month extension for pain symptoms only.

Results After 6 months, all predefined endpoints were evaluable in 698 of 937 enrolled patients (74.5%). Mean WOMAC scores were reduced by 56.3% from baseline (p < 0.05). NSAIDs/acetaminophen use ≥2 times/week (48.8% of patients at baseline) was substantially reduced after 1 month and was 19.6% after 6 months. After 6 months, 85.6% of patients were satisfied about efficacy. There were no significant adverse effects. The effect on resting pain was rapid, strong, and lasting: reduction from baseline was 45.1% at 1 month (p < 0.05), 56.8% at 6 months (p < 0.05), and 53.6% at 12 months (p < 0.05). Pain on moving was reduced by 47.4% after 6 months (p < 0.05) and 46.0% after 12 months (p < 0.05), results at 6 and 12 months were similar.

Conclusion HYADD® 4 is a new-generation hyaluronic acid with distinctive viscoelastic and rheological properties. In patients with mild-to-severe knee OA (Kellgren–Lawrence grades II–IV), two consecutive infiltrations 1 week apart reduced WOMAC scores and NSAIDs/acetaminophen consumption for at least 6 months. In a subpopulation (n = 106), efficacy on pain lasted approximately 12 months. Adverse events were reported in 11.2% of patients; the most frequent were arthralgias. No cases of allergic reactions or systemic effects were recorded.

Level of Evidence Level IV, retrospective case series.
Is Selfie a New Cause of Increasing Rhinoplasties?
Authors: Özgür Erdoğan , Cingi Cemal , Muluk Nuray
Published: July 2017

The digital world and social media are becoming increasingly important. Social media connect people together in a visual manner. Profile photographs are required by most social networking sites. A trend toward the increasing popularity of selfies on social media has rendered people more aware of their appearance. A selfie is a photograph that one takes of oneself, usually employing a smartphone or webcam, which is then shared on social media. Thus, the demand for aesthetic procedures correcting imperfections such as a prominent nose has increased, for which the technique is a rhinoplasty. Patients with reasonable expectations, treated by skilled surgeons, are usually very happy with the results. Rhinoplasty does not cure low self-esteem, but does correct more visible imperfections of the face. Although some hope that a rhinoplasty will resolve many unwanted facial features besides nose problems, it can only change the size and shape of the nose, improving its form. However, in the age of the selfie, everyone wants to look better. Self-consciousness is increasing, as are concerns over grooming and appearance at work and social events. These issues have become more important in recent years with the increase in selfie-taking; people are now more aware of how their nose appears to others. In this review, we discuss whether selfie-taking has triggered a rise in rhinoplasties along with a detailed survey of the literature.
Care of the Cocaine User with Nasal Deformity
Authors: Joshi Anil , D'Souza Alwyn , Walker Abigail
Published: July 2017

Cocaine is the most commonly used stimulant in the Western world, and its use is increasing not only in young people but also in people older than 40 years. Intranasal use is associated with several pathologies, ranging from crusting and blockage, to fibrosis and scarring, to destruction of the osteocartilaginous structures of the midface. As its use becomes more prevalent in society, the reconstructive surgeon can accordingly expect to be faced with an increasing number of patients with cocaine-related nasal deformity. However, the use of cocaine adds a significant layer of complexity to the perioperative and operative care that requires careful consideration by the whole health care team. We present a practical evidence-based guide to management of reconstruction of the cocaine nose, taking in all aspects of periprocedural care. Finally, we present a model for surgical approach based on best evidence and the experience of the senior author. A search was performed of the Medline, Embase, and Cochrane Collection database using both MeSH keywords and free text words, identifying key articles on the epidemiology, pathophysiology, and medical and psychiatric comorbidities of cocaine users. Both case series and case reports reporting cocaine-associated defects and their reconstruction were reviewed together with the senior authors (A.D.S., A.J.), and a series of recommendations synthesized based on these recommendations. The nasal deformities associated with cocaine use represent only the tip of the iceberg of underlying associated pathology. The surgeon who embarks upon reconstruction of the cocaine nose should be aware of possible coexisting medical and psychiatric comorbidities that may complicate both the patient's motivations for surgery and their fitness to undergo anesthesia. Ultimately, successful reconstructive outcomes are critically dependent on holistic perioperative care and the surgeon's ability to be flexible in their surgical approach.
The Human Sense of Olfaction
Authors: Hummel Thomas , Walliczek-Dworschak Ute
Published: July 2017

The sense of olfaction is important not only for the detection of potential dangers such as fire or spoilt food, but also for the quality of life of human beings. In this article, we review the characteristics of the sense of smell and give a short overview about possible olfactory dysfunctions and their therapy.
How to Manage a Failed Cartilage Repair: A Systematic Literature Review
Authors: Rosa Donato , Di Donato Sigismondo , Balato Giovanni , D'Addona Alessio , Smeraglia Francesco , Correra Gaetano , Di Vico Gianni
Published: July 2017

Purpose The aims of this paper are to report the rate and risk factors for the failure of the most common cartilage repair technique, and analyze the most important factors that could influence the choice of a specific surgical treatment to revise a failed cartilage repair.

Methods A review of the literature was performed focusing on failed cartilage repair and related treatments. Two of the authors independently screened articles. Conflicts about the inclusion of a paper was resolved by further evaluation by the senior author. Review articles, articles written in languages different from/other than English, case reports, and papers that did not evaluate the outcomes of interest were excluded. Full-text version of each included paper was obtained and relevant data were extracted and collected in a database.

Results At the end of the screening process, 31 articles were included. Microfractures and mosaicplasty showed a nonnegligible failure rate at short- and midterm. Better results, especially in terms of time to failure or revision, were reported with the use of autologous chondrocyte implantation (ACI) and osteochondral allograft (OCA) transplantation. Regarding the treatment of failed cartilage repair, the use of OCA transplantation in patients with previous failed cartilage repair may be a safe option. The revision of failed OCA transplantation with further OCA seems to have a greater failure rate. Patients with previous failed ACI or matrix-induced autologous chondrocyte implantation (MACI) who underwent further MACI or ACI reported acceptable results. Otherwise, ACI in patients with history of previous subchondral marrow stimulation (SMS) demonstrated a greater failure rate.

Conclusion From the analysis of the literature, OCA transplantation seems to be the most reliable treatment of a failed SMS. ACI or MACI showed acceptable results in patients with previously failed MACI or ACI.

Level of Evidence Level IV, systematic review of level I-IV studies.
Psychotherapy in Neurorehabilitation
Authors: Schmidt Roger , Piliavska Kateryna , Maier-Ring Dominik , van Husen Dominik , Dettmers Christian
Published: July 2017

The range of treatments available for neurorehabilitation must include appropriate psychotherapeutic approaches, if only because of the frequent occurrence of psychological co-morbidities, not always diagnosed and appropriately treated. The current situation is characterized by a large variety of available treatments, dearth of treatment studies and proven evidence. This state of affairs emphasizes the diversity and complexity of neurological disease. The presence of collateral psychological problems in particular requires individually tailored treatments. Damage to the CNS requires that particular attention be paid to the closely interwoven functions of the body and mind. What follows is the need for multimodal psychotherapy, grounded in neurology. Taking into account the various treatment approaches and regimens, therapy needs to be directly integrated in a meaningful, coherent way into other measures of neurological rehabilitation. Against this background, the paper gives an overview of clinical needs and therapeutic procedures as well as regarding the requirements and perspectives in the further development of psychotherapy in neurorehabilitation.
Seltene Ursache eines Spontanpneumothorax
Authors: Lepiorz M. , Großer C. , Hofmann H.-S. , Pfeifer M.
Published: July 2017

Ein junger Patient stellte sich mit plötzlichen, atemabhängigen rechtsthorakalen Schmerzen im Notfallzentrum vor. In der Auskultation fiel bereits ein abgeschwächtes Atemgeräusch der rechten Seite auf. Die Röntgenuntersuchung zeigte einen Pneumothorax, welcher gleich mittels Thoraxdrainage versorgt wurde. In der Computertomografie (CT) des Thorax sah man dann kleinste subpleurale Bullae. Es erfolgte eine videoassistierte Thorakoskopie (VATS) wegen anhaltender Fistelung über die Drainage. Histologisch konnten die subpleuralen, bullösen und emphysematösen Veränderungen bestätigt werden. Die Ursachenabklärung führte zum Nachweis eines Alpha-1-Antitrypsin-Mangels (AATM). Bei dem Patient liegt ein Pi MZ Genotyp vor. Es werden nur wenige Fälle von Spontanpneumothoraces als Erstmanifestation eines Alpha-1-Antitrypsin-Mangels beschrieben. Fazit: Beim primären Spontanpneumothorax sollte auch an einen Alpha-1-Antitrypsin-Mangel gedacht werden.
Usefulness of a newly designed plastic stent for endoscopic re-intervention in patients with malignant hilar biliary obstruction
Authors: Tomoda Takeshi , Kato Hironari , Kawamoto Hirofumi , Muro Shinichiro , Akimoto Yutaka , Uchida Daisuke , Matsumoto Kazuyuki , Horiguchi Shigeru , Tsutsumi Koichiro , Okada Hiroyuki
Published: July 2017

Background and study aims We designed a new 7-Fr plastic stent for treating self-expandable metal stent (SEMS) obstruction in patients with malignant hilar biliary obstruction (MHBO) via endoscopic re-intervention with the stent-in-stent (SIS) method and evaluated its efficacy.

Patients and methods A total of 33 consecutive patients who underwent endoscopic re-intervention for metal stent obstruction after multi-branched SEMS placement were enrolled. The initial SEMSs were placed in two or three biliary branches in 14 and 19 patients, respectively. We retrospectively evaluated the technical and clinical success, and adverse events. Technical success was defined as successful plastic stent placement into all target branches through the lumen of the SEMS.

Results The technical success rates were 85.7 % (12/14) and 78.9 % (15/19) in patients who underwent two- or three-branched biliary drainage, respectively. The clinical success rate was 100 % in the 27 patients in whom technical success was achieved. We achieved successful plastic stent placement in more than two branches, using the new plastic stent combined with a conventional plastic stent, in 97.0 % (32/33).

Conclusions This new plastic stent was technically feasible for treating stent obstruction via re-intervention with SIS methods.
Harmonic spectral components in time sequences of Markov correlated events
Authors: Mazzetti Piero , Carbone Anna
Published: July 2017

The paper concerns the analysis of the conditions allowing time sequences of Markov correlated events give rise to a line power spectrum having a relevant physical interest. It is found that by specializing the Markov matrix in order to represent closed loop sequences of events with arbitrary distribution, generated in a steady physical condition, a large set of line spectra, covering all possible frequency values, is obtained. The amplitude of the spectral lines is given by a matrix equation based on a generalized Markov matrix involving the Fourier transform of the distribution functions representing the time intervals between successive events of the sequence. The paper is a complement of a previous work where a general expression for the continuous power spectrum was given. In that case the Markov matrix was left in a more general form, thus preventing the possibility of finding line spectra of physical interest. The present extension is also suggested by the interest of explaining the emergence of a broad set of waves found in the electro and magneto-encephalograms, whose frequency ranges from 0.5 to about 40Hz, in terms of the effects produced by chains of firing neurons within the complex neural network of the brain. An original model based on synchronized closed loop sequences of firing neurons is proposed, and a few numerical simulations are reported as an application of the above cited equation.
Origin of thermally stable ferroelectricity in a porous barium titanate thin film synthesized through block copolymer templating
Authors: Suzuki Norihiro , Osada Minoru , Billah Motasim , Alothman Zeid Abdullah , Bando Yoshio , Yamauchi Yusuke , Hossain Md. Shahriar A.
Published: July 2017

A porous barium titanate (BaTiO3) thin film was chemically synthesized using a surfactant-assisted sol-gel method in which micelles of amphipathic diblock copolymers served as structure-directing agents. In the Raman spectrum of the porous BaTiO3 thin film, a peak corresponding to the ferroelectric tetragonal phase was observed at around 710 cm−1, and it remained stable at much higher temperature than the Curie temperature of bulk single-crystal BaTiO3 (∼130 °C). Measurements revealed that the ferroelectricity of the BaTiO3 thin film has high thermal stability. By analyzing high-resolution transmission electron microscope images of the BaTiO3 thin film by the fast Fourier transform mapping method, the spatial distribution of stress in the BaTiO3 framework was clearly visualized. Careful analysis also indicated that the porosity in the BaTiO3 thin film introduced anisotropic compressive stress, which deformed the crystals. The resulting elongated unit cell caused further displacement of the Ti4+ cation from the center of the lattice. This displacement increased the electric dipole moment of the BaTiO3 thin film, effectively enhancing its ferro(piezo)electricity.
Effect of nanostructure on radiation tolerance and deuterium retention in tungsten
Authors: Ogorodnikova O. V.
Published: July 2017

Understanding of radiation tolerance and hydrogen accumulation in nanomaterials is an urgent challenge since it may open new perspectives to design advanced materials for extreme conditions, for example, nuclear energy systems. In this work, intrinsic defects in nanostructured tungsten (W) films with different grain sizes were studied by decoration with deuterium (D). This method was also successfully applied to detect defects at the interface between the coating and the substrate, as well as radiation-induced defects. The build-up of D at the interface between the coating and the substrate was observed, which can be a concern for both un-irradiated and neutron-irradiated materials. It was found that the concentration of D in W materials drastically increases with decreasing mean grain size. However, the D concentration at radiation-induced defects produced by self-ion irradiation at room temperature to 3 displacements per atom is the same for all types of coatings, and it is the same as for polycrystalline W. This implies that the density of radiation-induced defects is the same for all types of W coatings, regardless of the crystalline structure of a W material. In this respect, a compromise in the development of new promising nanostructured tungsten films is necessary to ensure the radiation resistance, keeping the hydrogen concentration at an acceptable level and reducing/preventing high density of defects at the interface between the nanostructured coating and the substrate.