bluuebunny/crossref_metadata_2025 huggingface dataset:
The Epidemiology of Syphilis in New York City: Historic Trends and the Current Outbreak Among Men Who Have Sex With Men, 2016
Authors: Schillinger Julia Ann , Slutsker Jennifer Sanderson , Pathela Preeti , Klingler Ellen J. , Hennessy Robin R. , Toro Brian , Blank Susan
Published: January 2018

Background

Male primary and secondary (P&S) and early latent syphilis cases have increased markedly in New York City (NYC) after a historic nadir in 1998. The majority of cases are among men who have sex with men (MSM). We describe the epidemiology of syphilis among NYC males to provide a model of how 1 jurisdiction collects, analyzes, interprets, uses, and disseminates local data to guide programmatic activities directed at syphilis control.

Methods

We analyzed trends in reported infectious syphilis cases using routinely collected surveillance and case investigation data. Human immunodeficiency virus (HIV) coinfection status was ascertained by routine deterministic match between sexually transmitted infection and HIV surveillance registries, and self-report. We mapped diagnosing facilities to display the relative contribution of different public/private facilities. Characteristics of male syphilis cases diagnosed in public sexual health (SH) clinics were compared to those diagnosed elsewhere.

Results

During 2012 to 2016, male P&S syphilis case rates increased 81%, from 24.8 to 44.8/100,000 (1832 cases in 2016); the highest rates were among black non-Hispanic men. Overall, 87.6% (902/1030) of interviewed men in 2016 disclosed 1 or more male partner. The HIV coinfection rates are high among MSM with P&S syphilis (43.4%; 394/907 in 2016), but appear to be decreasing (from 54.1% in 2012). Maps highlight SH clinics' contribution to diagnosing P&S syphilis cases among men of color. HIV coinfection rates were lower among men with P&S syphilis diagnosed in SH clinics than among those diagnosed elsewhere (34%, SH clinics vs 49%; other settings, P < 0.0001).

Conclusions

Syphilis infections continue to increase among MSM in NYC. Novel interventions responsive to the drivers of the current outbreak are needed.
Disclosure of Harmful Medical Error to Patients: A Review With Recommendations for Pathologists
Authors: Heher Yael K. , Dintzis Suzanne M.
Published: January 2018

Harmful error is an infrequent but serious challenge in the pathology laboratory. Regulatory bodies and advocacy groups have mandated and encouraged disclosure of error to patients. Many pathologists are interested in participating in disclosure of harmful error but are ill-equipped to do so. This review of the literature with recommendations examines the current state of the patient safety movement and error disclosure as it pertains to pathology and provides a practical and explicit guide for pathologists for who, when, and how to disclose harmful pathology error to patients. The authors provide a definition of harmful pathology error, and the rationale and principles behind effective disclosure are discussed. The changing culture of medicine and its effect on pathology is examined including the trend towards increasing transparency and patient engagement. Related topics are addressed including the management of expected adverse events, barriers to disclosure, and additional resources for the implementation of disclosure programs in pathology.
Early Noninvasive Ventilation and Nonroutine Transfusion for Acute Chest Syndrome in Sickle Cell Disease in Children: A Descriptive Study
Authors: Heilbronner Claire , Merckx Audrey , Brousse Valentine , Allali Slimane , Hubert Philippe , de Montalembert Mariane , Lesage Fabrice
Published: January 2018

Objectives:

To describe the need for transfusion and short- and long-term evolutions of pediatric sickle cell disease patients with acute chest syndrome for whom early continuous noninvasive ventilation represented first-line treatment.

Design:

Single-center retrospective chart study in PICU.

Setting:

A tertiary and quaternary referral PICU.

Patients:

All sickle cell disease patients 5–20 years old admitted with confirmed acute chest syndrome and not transfused in the previous month were included.

Interventions:

None.

Measurements and Main Results:

Demographic data, laboratory and radiologic findings, transfusions, invasive ventilation, oxygen and noninvasive ventilation settings, duration of opioid treatment, length of hospital stay, and severe sickle cell disease complications in the ensuing 2 years were extracted from medical charts. Sixty-six acute chest syndrome in 48 patients were included. Continuous early noninvasive ventilation was well tolerated in 65 episodes, with positive expiratory pressure 4 cm H2O and pressure support 10 cm H2O (median) administered continuously, then discontinued during 7 days (median). No patient necessitated invasive ventilation or died. Twenty-three acute chest syndrome (35%) received transfusions; none received blood exchange. Transfused patients had more frequent upper lobe radiologic involvement, more severe anemia, higher reticulocyte counts, and higher C-reactive protein than nontransfused patients. Their evolution was more severe in terms of length of opioid requirement, length of noninvasive ventilation treatment, overall time on noninvasive ventilation, and length of stay. At 2-year follow-up after the acute chest syndrome episode, no difference was observed between the two groups.

Conclusions:

Early noninvasive ventilation combined with nonroutine transfusion is well tolerated in acute chest syndrome in children and may spare transfusion in some patients. Early recognition of patients still requiring transfusion is essential and warrants further studies.
Screening of Pediatric Facial Fractures by Brain Computed Tomography
Authors: Ryu JongChan , Yun Seong Jong , Lee Sun Hwa , Choi Yoon Hee
Published: January 2018

Objectives

Facial bone fractures secondary to head trauma are more common in children than in adults. Recently, multidetector row computed tomography (CT) has been considered superior to conventional radiography. Some studies have reported that facial soft tissue injuries require both facial and brain CT and that brain CT is helpful in screening facial bone fractures. However, these studies included only adult patients. The aim of this study was to evaluate the diagnostic performance of brain CT and the need for additional facial CT to detect facial bone fractures in emergency pediatrics.

Methods

This multicenter study was conducted retrospectively in 2 tertiary hospitals in Seoul, Republic of Korea. The data were collected from the medical records of pediatric patients younger than 8 years who had undergone both brain and facial CT on the same day in the emergency department. All CT scans were retrospectively and independently evaluated by 1 board-certified radiologist and 1 board-certified emergency medicine physician. A P value of <0.05 was considered statistically significant.

Results

Sensitivity was 92.31%, specificity was 100%, positive predictive value was 100%, negative predictive value was 99.31%, and accuracy was 99.36% for the emergency physician; all parameters were 100% for the radiologist.

Conclusions

Brain CT showed high diagnostic performance to detect facial bone fractures with high accuracy in pediatric patients. As emergency physicians, we should consider facial bone fractures when reviewing brain CT images of pediatric patients with blunt head and face trauma.
Endoscopic Findings Associated With Button Battery Ingestion in Children
Authors: Ríos Gloria , Rodríguez Lorena , Lucero Yalda , Miquel Isabel , Arancibia María Eugenia , Alliende Francisco
Published: January 2018

Background

Ingested button batteries (BB) can cause corrosive damage of digestive mucosa within minutes. Immediate endoscopic removal of esophageal BB has been clearly established, but the management of BB located in the stomach is still controversial.

Aim

To describe demographic, clinical, radiologic, and endoscopic characteristics of a series of pediatric patients evaluated for BB ingestion.

Methods

Retrospective analysis of clinical charts belonging to children younger than 15 years, who underwent endoscopic removal of BB at Clínica Alemana of Santiago, between November 2007 and November 2011.

Results

Twenty-five patients subjected to upper endoscopy were analyzed; median age, 31 months; 15 were male (60%), and 11 patients (46%) were symptomatic after ingestion. The BB ingestion was confirmed by radiograph. Endoscopy revealed 10 patients with BB in the esophagus, 12 patients in the stomach and 3 distal to duodenum. Range time between ingestion and endoscopy was 2 to 10 hours for esophageal BB and 2 hours to 3 days for gastric BB. Eight of the 22 BBs removed had a diameter of 20 mm or greater, 6 of them were located in the esophagus and 2 in stomach. The BB color changes were observed in 14 of the 22 BBs. Breakage of battery edges was present in 11 of the 22 batteries. All patients with esophageal BB and 6 of those 12 with gastric BB presented mucosal damage.

Conclusion

Esophageal BB cause damage within hours. The BB located in the stomach may also cause damage early. Extraction of gastric BB before 48 hours should be considered.
Canadian Consensus-based and Evidence-based Guidelines for Benign Endometrial Pathology Reporting in Biopsy Material
Authors: Parra-Herran Carlos , Cesari Matthew , Djordjevic Bojana , Grondin Katherine , Kinloch Mary , Köbel Martin , Pirzada Amrah , Plotkin Anna , Gilks C. Blake
Published: January 2018

Standardized terminology has proven benefits in cancer reporting; in contrast, reporting of benign diagnoses in endometrial biopsy currently lacks such standardization. Unification and update on the lexicon can provide the structure and consistency needed for optimal patient care and quality assurance purposes. The Special Interest Group in Gynecologic Pathology of the Canadian Association of Pathologists-Association Canadienne des Pathologistes (CAP-ACP) embarked in an initiative to address the current need for consensus terminology in benign endometrial biopsy pathology reporting. Nine members of the Special Interest Group developed a guideline for structured diagnosis of benign endometrial pathology through critical appraisal of the available peer-reviewed literature and joint discussions. The first version of the document was circulated for feedback to a group of professionals in akin fields, the CAP-ACP Executive Committee and the CAP-ACP general membership. The final 1-page document included 17 diagnostic terms comprising the most common benign endometrial entities, as well as explanatory notes for pathologists. The proposed terminology was implemented in the practice of 5 pathologists from the group, who applied the guideline to all benign endometrial biopsies over a 2-wk period. A total of 212 benign endometrial biopsies were evaluated in this implementation step; the recommended terminology adequately covered the diagnosis in 203 cases (95.8%). A list of terminology for benign endometrial biopsy reporting, based on expert consensus and critical appraisal of the available literature, is presented. On the basis of our results of implementation at multiple centers, the proposed guideline can successfully cover the large majority of diagnostic scenarios. The document has the potential to positively impact patient care, promote quality assurance, and facilitate research initiatives aimed at improving histopathologic assessment of benign endometrium.
Incidental Detection of a Melanoma by 18F-Fluorocholine PET/CT Performed for Evaluation of Primary Hyperparathyroidism
Authors: Burgers Anne Marij Geertruida , Wondergem Maurits , van der Zant Friso Martijn , Knol Remco Johannes Jacob
Published: January 2018

An 80-year-old woman was evaluated with 18F-fluorocholine PET/CT in suspicion of a parathyroid adenoma. No focal parathyroid tracer uptake suggestive of adenoma was found, and instead a unilateral multinodular goiter without elevated 18F-fluorocholine uptake was diagnosed. In addition, focal uptake was found in a cutaneous nodule dorsally on the right shoulder. Upon pathological evaluation, this proved to be a malignant melanoma.
Prostate Cancer Lytic Bone Metastases Imaged With 18F-Fluorocholine PET/CT
Authors: Alabed Yazan Z.
Published: January 2018

A 76-year-old man with metastatic prostate cancer and back pain was referred for palliative radiotherapy. Staging 18F-fluorocholine PET/CT scan revealed fluorocholine-avid prostate mass, extensive lymphadenopathy, lung nodules, and extensive osteolytic lesions throughout the axial skeleton. Prostate cancer bone metastases are predominantly sclerotic in nature. We present 18F-fluorocholine PET/CT imaging of prostate cancer with very rare lytic bone metastases.
Back Pain in a Patient With Parotid Carcinoma
Authors: Sharma Punit , Shahid Tanweer , Mukherjee Mukti
Published: January 2018

Nonmalignant incidental findings in patients undergoing 18F-fluorodeoxyglucose (18F-FDG) PET/CT for oncological indication are common. Here, we present such a case of a 40-year-old woman, treated case of adenoid cystic carcinoma of the left parotid gland, who subsequently presented with progressive back pain and deranged liver function tests. 18F-FDG PET/CT showed no definite malignancy but incidental finding of moderately severe acute pancreatitis, which was the cause of back pain.
Initial Clinical Investigation of [18F]Tetrafluoroborate PET/CT in Comparison to [124I]Iodine PET/CT for Imaging Thyroid Cancer
Authors: Samnick Samuel , Al-Momani Ehab , Schmid Jan-Stefan , Mottok Anja , Buck Andreas K. , Lapa Constantin
Published: January 2018

Aim

Recently, [18F]tetrafluoroborate ([18F]TFB) has been introduced as a versatile PET probe for imaging the human sodium/iodide symporter activity. This pilot study aimed to compare [18F]TFB-PET/CT with [124I]NaI-PET/CT imaging in thyroid cancer patients.

Methods

Nine patients with newly diagnosed differentiated thyroid cancer underwent both [18F]TFB- and [124I]NaI-PET/CT after total thyroidectomy. PET/CT scans were visually analyzed for the presence of remnant thyroid tissue and for metastatic lesions on a patient and lesion basis. For semiquantitative analysis, thyroid remnant/tumor to blood pool ratios were calculated.

Results

All patients presented with positive [18F]TFB and [124I]NaI-PET/CT scans. Retention of 124I in remnant thyroid tissue was significantly higher as compared with [18F]TFB (P < 0.01). In a lesion-based analysis, both tracers identified an almost equal number of foci with [18F]TFB depicting a total of 41 foci and 124I a total of 40 foci, respectively. In 6 of 9 patients, both radiopharmaceuticals returned an identical number of foci. Two 124I-positive benign thyroid remnants were missed by [18F]TFB-PET/CT in a single patient. In another case, both tracers identified different thyroid remnant tissues in the cervical region. Notably, [18F]TFB demonstrated additional (124I-negative) cervical lymph node metastases in 2 patients, leading to an overall agreement between the radiotracers of 91% (74/81 foci).

Discussion

In this pilot study, [18F]TFB-PET was not inferior to [124I]NaI-PET for detecting thyroid cancer and its metastases and was able to detect [124I]NaI-PET-negative viable differentiated thyroid cancer metastases. Further clinical evaluation as a PET tracer for imaging thyroid pathophysiology and human sodium/iodide symporter expressing neoplasms is highly warranted.
Posterior Reversible Encephalopathy Syndrome on 18F-FDG PET/CT in a Pediatric Patient With Burkitt’s Lymphoma
Authors: Saad Aldin Ehab , McNeely Parren , Menda Yusuf
Published: January 2018

We present a case of posterior reversible encephalopathy syndrome (PRES) in a pediatric patient with Burkitt's lymphoma predominantly involving the bone marrow. 18F-FDG PET/CT scan obtained after the first cycle of chemotherapy, complicated by acute kidney injury, hypertension, tumor lysis syndrome, and lethargy with focal neurological symptoms, showed a favorable marrow and lymph node response but increased FDG uptake in the bilateral frontal and occipital cortical/subcortical regions. Brain MRI was consistent with PRES. The patient was managed with IV hydration and blood pressure control with symptom resolution. This case shows the 18F-FDG uptake pattern of PRES in postchemotherapy setting.
Bowel Ultrasound for the Diagnosis of Necrotizing Enterocolitis
Authors: Cuna Alain C. , Lee Jacob C. , Robinson Amie L. , Allen Nancy H. , Foley Jennifer E. , Chan Sherwin S.
Published: January 2018

Radiographic evaluation for necrotizing enterocolitis (NEC) often yields nonspecific findings. Bowel ultrasound (BUS) provides additional information beyond that of abdominal radiographs and may be helpful in the diagnosis of NEC in neonates. We systematically reviewed and aggregated existing literature to get a better estimate of diagnostic accuracy of BUS in the diagnosis of NEC. A literature search was performed using PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature to identify studies in which infants with clinically suspected NEC were evaluated using BUS. Studies that used modified Bell staging criteria as the reference standard were included. Study quality was assessed, and pooled sensitivity and specificity of various BUS findings for diagnosing NEC were determined. Six articles with a total of 462 patients met eligibility and inclusion criteria. There was heterogeneity in BUS findings evaluated across studies. Ultrasound detection of classic signs of NEC (portal venous gas, pneumatosis, and free air) had pooled sensitivities ranging from 0.27 to 0.48 and pooled specificities ranging from 0.91 to 0.99. Bowel wall thinning and absent peristalsis had overall low sensitivity (0.22 and 0.30) but high specificity (0.96 and 0.96) for NEC. Assessment of abdominal fluid, which included ascites and focal fluid collection, also had overall low sensitivity and high specificity (simple ascites: 0.45 and 0.92; focal fluid collection: 0.19 and 0.98). In summary, individual BUS findings have low sensitivity and high specificity for diagnosis of NEC. Bowel ultrasound may be a useful adjunct to plain abdominal radiographs in the evaluation of infants with clinical suspicion of NEC.
Modified Methods of Fabricating Helix and Antihelix in Total Auricular Reconstruction Based on Different Length of Eighth Costal Cartilage
Authors: Yang Meirong , Jiang Haiyue , Li Huibin , Yu Xiaobo , Zhang Ye , Pan Bo
Published: January 2018

Background:

Attaining an ideal appearance of the reconstructed ear depends primarily on the fabricated cartilaginous ear framework. Despite the role of eighth costal cartilage, the length of the eighth rib cartilage is difficult to anticipate, and growth of the eighth cartilage is variable. The authors discussed modified methods of fabricating helix and antihelix based on different length of eighth costal cartilage.

Methods:

Based on the actual length of the eighth costal cartilage, patients were divided into group A and group B. In group A, the eighth costal cartilage was divided into 2 parts. Part I was used to fashion the helix, whereas part II was used to fabricate the antihelix and superior crus. In group B, the seventh costal cartilage was cut into 3 parts. Part I and part II were used to fashion the helix, antihelix, and superior crus as group A did. Part III was assembled to the lateral part of the framework to form the inferior crus.

Results:

A total of 56 patients underwent auricular reconstruction adopting the modified techniques between 2015 and 2016. Three cases have been selected to illustrate the favorable result achieved. They revealed that the helix, antihelix, superior crus, and inferior crus all appeared distinct and presented a favorable result of the contour of the reconstructed auricle.

Conclusions:

Based on different length of eighth costal cartilage, modified methods of fabricating helix and antihelix make full use of the autogenous costal cartilage, elevate anatomical details, and enhance the overall aesthetics of reconstructed ear. The great majority of patients have satisfactory surgical outcomes, demonstrating that personalized treatment is necessary.
Intralesional Bleomycin Injection for Propranolol-Resistant Hemangiomas
Authors: Chang Lei , Chen Hui , Yang Xi , Jin Yunbo , Ma Gang , Lin Xiaoxi
Published: January 2018

Propranolol has been the first-line treatment for alarming hemangiomas. However, some hemangiomas are propranolol-resistant. The authors reported 1 propranolol-resistant hemangioma which was treated with intralesional bleomycin injections. Sixteen months after 3 injections, the lesion still remained stable. Its potential mechanism was clarified by ultrasonic monitoring. Intralesional bleomycin injection can be considered an ideal option in treating propranolol-resistant hemangiomas.
The Infraorbital Foramen Is Located Midway Between the Nasospinale and Jugale: Considerations for Infraorbital Nerve Block and Maxillofacial Surgery
Authors: Zdilla Matthew J. , Koons Aaron W. , Russell Michelle L. , Mangus Kelsey R. , Bliss Kaitlyn N.
Published: January 2018

Identification of the infraorbital foramen is important in infraorbital nerve block and the prevention of iatrogenic injury of the infraorbital nerve in maxillofacial surgeries. This study assessed the location of 887 infraorbital foramina from 518 adult crania of varied sex and population. The study assessed the midpoint of a line segment spanning from nasospinale to jugale (NS-J) relative to the infraorbital foramen. The mean distance of the NS-J midpoint from the infraorbital foramen was 2.1 ± 1.9 mm (mean ± SD) with a mode of 0 mm (266:887; 30%). The NS-J midpoint was located in the same plane or inferior to the infraorbital foramen in 98.4% of sides (873:887). There were no significant differences between sexes, populations, or sides with regard to the NS-J midpoint to infraorbital foramen distance. The NS-J midpoint can be used to locate the infraorbital foramen in both females and males of varied populations regardless of craniofacial diversity. The results of this study will aid in infraorbital nerve block procedures and maxillofacial surgery.
Posterior Vault Distraction Osteogenesis in Nonsyndromic Patients: An Evaluation of Indications and Safety
Authors: Zhang Rosaline S. , Wes Ari M. , Naran Sanjay , Hoppe Ian C. , Sun James , Mazzaferro Daniel , Bartlett Scott P. , Taylor Jesse A.
Published: January 2018

Purpose:

The purpose of this study was to evaluate the indications, safety, and short-term outcomes of posterior vault distraction osteogenesis (PVDO) in patients with no identified acrocephalosyndactyly syndrome (study) and to compare those to a syndromic cohort (controls).

Methods:

Demographic and perioperative data were recorded and compared across the study and control groups for those who underwent PVDO between January 2009 and December 2016. Univariate analysis was conducted using χ
2 and Fisher exact tests for categorical variables, and Mann–Whitney U test for continuous variables.

Results:

Sixty-three subjects were included: 19 in the nonsyndromic cohort, 44 in the syndromic cohort. The cohorts had similar proportion of subjects exhibiting pansynostosis (42.1% of nonsyndromic versus 36.4% of syndromic, P = 0.667). The nonsyndromic cohort was significantly older (4.04 ± 3.66 years versus 2.55 ± 3.34 years, P = 0.046) and had higher rate of signs of raised intracranial pressure (68.4% versus 25.0%, P = 0.001) than the syndromic cohort. There was no significant difference in perioperative variables or rate of complications (P > 0.05). The mean total advancement distance achieved was similar, 27 ± 6 mm in the nonsyndromic versus 28 ± 8 mm in the syndromic cohort (P = 0.964). All nonsyndromic subjects with signs of raised intracranial pressure demonstrated improvement at an average follow-up of 22 months.

Conclusion:

As in the syndromic patient, PVDO is a safe and, in the short-term, effective modality for cranial vault expansion in the nonsyndromic patient. The benefits and favorable perioperative profile of PVDO may therefore be extended to patient populations other than those with syndromic craniosynostosis.
Effects of Nasoalveolar Molding Therapy on Alveolar and Palatal Cleft Deformities in Unilateral and Bilateral Cleft Lip and Palate
Authors: Isik Aslan Belma , Gülşen Ayşe , Findikçioğlu Kemal , Uzuner Deniz , Üçüncü Neslihan
Published: January 2018

Objective:

The purpose of this study was to evaluate and compare the efficacy of nasoalveolar molding (NAM) therapy in the improvement of alveolar and palatal cleft deformity on unilateral (UCLP) versus bilateral (BCLP) cleft lip and palate.

Materials and Methods:

A total of 19 UCLP (14 boys and 5 girls) and 8 BCLP (7 boys and 1 girl) infants completed NAM therapy were included in this study. Standardized parameters of cleft width of alveol and palate were measured on photocopies taken from the pre- and post-treatment plaster casts. To assess the intragroup differences, paired-samples test in UCLP and Wilcoxon test in BCLP groups were used. Mann–Whitney U test was used to evaluate the differences between the groups.

Results:

Significant decreases in alveolar and palatal cleft gaps were achieved in an average period of 3.3 ± 1.9 and 3.7 ± 1.6 months in UCLP and BCLP patients, respectively. The alveolar cleft decreased 7.85 ± 4.59 mm in UCLP and 4.25 ± 3.13 and 3.81 ± 3.50 mm in right and left alveolar cleft sides in BCLP, respectively. The palatal clefts were decreased 4.63 ± 2.44 mm in medial and 3.72 ± 2.62 mm in posterior parts in UCLP. The decrements in BCLP were 3.00 ± 2.75 mm in medial and 2.88 ± 2.75 mm in posterior palatal cleft distances. No significant differences were determined in the amount of alveolar or palatal cleft closure between UCLP and BCLP groups. The only decrease in arch width was 1.39 mm in medial part of palate in UCLP.

Conclusion:

The NAM device provides significant decreases in both alveolar and palatal cleft deformities in UCLP and BCLP infants, as compared with their birth status.
Uvula Abscess in a Newborn Infant
Authors: Tuncer Erkun , Ors Rahmi
Published: January 2018

Abscesses can be found in several places in the oral cavity, most commonly occurring in peritonsillar and periodontal regions. In this report, the authors described a uvula abscess in a 1-month-old term newborn who was brought to the pediatric outpatient clinic with the complaints of difficulty in sucking-swallowing and refusal to suck at the breast. To the best of the authors’ knowledge this is the first report of a uvula abscess in the literature.
Usefulness of Early Plate Removal in Patients With Occlusal Discrepancies After Sagittal Split Ramus Osteotomy
Authors: Kawase-Koga Yoko , Fujii Yasuyuki , Ikehata Mikiko , Ikehata Naoki , Kono Michihide , Kimoto Akira , Watanabe Masato , Chikazu Daichi
Published: January 2018

The aim of this study was to evaluate the effects of early removal of fixed plates in patients with occlusal discrepancies after sagittal split ramus osteotomy (SSRO) with a focus on the positional relationship of the temporomandibular joint (TMJ). Sagittal split ramus osteotomy with/without Le Fort I osteotomy was performed on 98 patients with mandibular prognathism. Of these 98 patients, 15 with occlusal discrepancies and/or TMJ symptoms underwent early plate removal after SSRO. Finally, 12 consecutive patients were evaluated in this study: 7 underwent bilateral SSRO, 1 underwent unilateral SSRO, and 4 underwent bilateral SSRO with maxillary advancement. The axiolateral TMJ Schuller method was used to evaluate the TMJ position. The authors measured 3 spaces (anterior, superior, and posterior joint spaces) between the condyle and glenoid fossa in the sagittal plane. The anterior and superior joint spaces were significantly larger immediately after the operation than before the operation. After early plate removal, these spaces significantly decreased in size. The posterior joint space increased, but with no significant difference. Three months after SSRO, the size of each of the 3 spaces was closely related to its preoperative size. In conclusion, these results suggest that early removal of fixed plates is 1 treatment option for postoperative occlusal discrepancies after SSRO.
Management of Temporomandibular Joint Ankylosis With Dentofacial Deformities in Children
Authors: Jiang Yangmei , Huang Yuanjin , Ye Bin , Li Yunfeng , Zhu Songsong
Published: January 2018

This retrospective study described the authors’ experience in the treatment of temporomandibular joint (TMJ) ankylosis with dentofacial deformities in 18 pediatric patients during a 4-year period. These patients underwent different types of arthroplasty with condylar reconstruction, simultaneously with treatment of dentofacial deformities. Re-ankylosis was confirmed if maximal incisal opening (MIO) was <20 mm. Clinical outcomes were evaluated in terms of oral function, radiography, and medical photography. Patients were followed up for a mean time of 24.8 months. No infections, re-ankylosis, or permanent facial nerve damage were found during the hospitalization or follow-up period. All patients achieved significant improvements in MIO and oral function. The dentofacial deformities in most patients were improved to varying degrees. The results provided more useful information for the management of the pediatric patients with TMJ ankylosis and secondary dentofacial deformities. Early treatment and close follow-up play an important role in the management of these patients.
The Measurement of Various Anatomical Structures and Assessment of Morphometric Development of Fetal Skull Base
Authors: Hamzaoglu Vural , Aktekin Mustafa , Ismi Onur , Ozalp Hakan , Karşiyaka Dilan , Baskan Fuat Cem , Vayisoglu Yusuf , Arpaci Rabia Bozdogan , Cayan Filiz , Eti Can Mehmet , Cakir Emine Ecem , Gocer Perihan , Turkegun Merve , Kanik Arzu , Bagdatoglu Celal , Talas Derya Umit
Published: January 2018

Background:

As the skull base has a complex anatomy, we underline the importance of anomalies for side asymmetry. It is useful to investigate relationship between anatomical structures for the surgical procedure orientations. Dural adherence, enlarged superior petrosal sinus, influence of neural crest cells, and cranial base ossification are among the factors in morphometric growth on skull base.

Material and methods:

Twenty-five fetuses of an estimated gestational age ranging from 17 to 34 weeks were studied in the Anatomy Laboratory of Mersin University Medical Faculty. Craniotomy was made to each fetus and brain hemispheres were dissected. We put plates, passing from the external points of lateral and anterior-posterior borders of fetus heads that are perpendicular to each other. An analytical calculation was formulated for the angle of foraminae to the root of zygoma by using different formulations depending on their posterior or anterior location to the root of zygoma. Statistical method was based on correlation analysis, simple regression, independent 2 group t tests, SPSS20.0, and MedCalc 11.5 (MedicReS, New York, NY).

Results:

Neither side dominance for the jugular foramen, nor the differences of foramen rotundum, spinosum, and ovale to anterior skull wall, root of zygoma, and to midline were found to be significant.

Conclusion:

There is a debate on asymmetry of foramina of the skull base. No certain consensus about the initiation time and the causes of asymmetry in the past was documented. Studies are to be encouraged to further enlighten pre-postnatal factors affecting the fetal skull base morphometrism.
The Sellar Tumor: Metastasis or Chordoma?
Authors: Zhou Lin , Cui Daming , Feng Lijin , Gao Liang
Published: January 2018

Chordomas are uncommon, locally invasive chordate tumors, which are mostly observed in the axial skeleton. Numerous papers have described similar patients around different anatomic locations; however, rare document previously reported that intracranial chordoma was associated with clear cell renal cell carcinoma (ccRCC). The authors report a 51-year-old male patient with a history of right radical nephrectomy for ccRCC presented to us with progressive blurred vision. Ophthalmic examination showed vision loss and visual field defects. Magnetic resonance imaging demonstrated pituitary tumor with hemorrhage, which was compressing the optic chiasm. He underwent a transnasal endoscope resection of the sellar mass. The immediate postoperative pathologic result was simply considered to be pituitary metastasis from ccRCC. After further immunohistochemical study, pathology diagnosis was made the necessary corrections to be the sellar chordoma. The authors summarize this exceptional patient and review the pertinent literature briefly.
Subdural Abnormal Communicating Vessel in Chronic Subdural Hematoma
Authors: Tao Zhiqiang , Ding Shenghong , Hu Maotong , Huang Jianyue , Zu Zhigang , Chen Ruchang
Published: January 2018

Traditionally, lacerations of bridging vessels were surmised to cause chronic subdural hematoma (CSDH), although neither observation studies nor medical research was able to testify this. Nowadays, an inflammatory process is known to take place in the development of CSDH. Of note, post-traumatic angiogenesis at its early stage also features inflammation with immune cell infiltration. The authors found a patient suffering from CSDH with unusual angiogenesis between dura and pia matters. The observation of dura-and-pia angiogenesis may be a piece of evidence to underline compensatory reaction of central nervous system to offset the negative effects produced by CSDH, and points out to a possible approach of bolstering angiogenesis to manage ischemic diseases in cerebral hemispheres.
Condylar Hyperplasia in a Monozygotic Twin Girl: An Argument About Etiology
Authors: Goulart Douglas Rangel , Sigua-Rodriguez Eder Alberto , Fariña Rodrigo , Olate Sergio
Published: January 2018

The diagnosis of unilateral condylar hyperplasia (UCH) requires a combined assessment consisting of clinical, radiological, and histopathological examination. The etiology of this condition is unknown. The purpose of this study is to report a rare case of UCH in a monozygotic twin. A 15-year-old girl was referred to our department complaining of facial asymmetry and malocclusion. Computed tomography and single-photon emission computed tomography imaging reveal enlargement of the left condyle and condylar neck, and an increased uptake that was diagnosed as active UCH. During the investigation of family and co-twin facial profile, no cases of UCH were identified. From the case reported in this study, the authors raise a hypothesis that can exist some environmental factor that is related in the development of condylar hyperplasia given the occurrence of this disease in one of twins.
Evaluation of the Effect of Topical Application of Nigella sativa on Acute Radiation-Induced Nasal Mucositis
Authors: Çanakci Hasan , Yilmaz Ayşe Asli Şahin , Canpolat Mustafa Salih , Şeneldir Hatice , Kir Gözde , Eriş Ali Hikmet , Mayadağli Alpaslan , Oysu Çağatay
Published: January 2018

The goal of this study was to demonstrate the effect of radiotherapy (RT) on nasal mucosa in rats and to evaluate the radioprotective effects of the topical application of black seed oil (Nigella sativa [NS]) to treat acute radiation-induced nasal mucositis.

A total of 18 rats were randomized into 3 groups, with 6 animals per group. The rats in group 1 were topically administered saline in the nasal cavity after sham irradiation. Group 2 received saline at the same dose after irradiation. Group 3 was given NS after irradiation. The rats in groups 2 and 3 were irradiated with a single dose of 40 Gy to the nasal and paranasal area. Only one drop of saline (0.05 mL) was applied to each nostril in the first, second, and third days after RT in groups 1 and 2. One drop of cold press NS (0.05 mL) was applied to each nostril in group 3. Fourteen days after irradiation, the nasal mucosal tissues were excised for histopathological evaluation. Vascular dilatation, inflammatory cell infiltration, superficial erosion, and formation of exudates were classified according to the severity.

No evidence of mucositis was observed in group 1. Of all the parameters the only statistically significant difference between groups 2 and 3 were observed for “superficial erosion" (P < 0.05). Overall microscopic observations in the NS-treated group were better than in group 2.

The preliminary results of our study have shown that local application of NS to the nasal mucosa may be an effective treatment of acute nasal mucositis due to RT.
Polyomavirus BK Nephropathy-Associated Transcriptomic Signatures: A Critical Reevaluation
Authors: Pan Ling , Lyu Zili , Adam Benjamin , Zeng Gang , Wang Zijie , Huang Yuchen , Abedin Zahidur , Randhawa Parmjeet
Published: January 2018

Background

Recent work using DNA microarrays has suggested that genes related to DNA replication, RNA polymerase assembly, and pathogen recognition receptors can serve as surrogate tissue biomarkers for polyomavirus BK nephropathy (BKPyVN).

Methods

We have examined this premise by looking for differential regulation of these genes using a different technology platform (RNA-seq) and an independent set 25 biopsies covering a wide spectrum of diagnoses.

Results

RNA-seq could discriminate T cell–mediated rejection from other common lesions seen in formalin fixed biopsy material. However, overlapping RNA-seq signatures were found among all disease processes investigated. Specifically, genes previously reported as being specific for the diagnosis of BKPyVN were found to be significantly upregulated in T cell–mediated rejection, inflamed areas of fibrosis/tubular atrophy, as well as acute tubular injury.

Conclusions

In conclusion, the search for virus specific molecular signatures is confounded by substantial overlap in pathogenetic mechanisms between BKPyVN and nonviral forms of allograft injury. Clinical heterogeneity, overlapping exposures, and different morphologic patterns and stage of disease are a source of substantial variability in “Omics” experiments. These variables should be better controlled in future biomarker studies on BKPyVN, T cell–mediated rejection, and other forms of allograft injury, before widespread implementation of these tests in the transplant clinic.
Stresses and strains on the human fetal skeleton during development
Authors: Verbruggen Stefaan W. , Kainz Bernhard , Shelmerdine Susan C. , Hajnal Joseph V. , Rutherford Mary A. , Arthurs Owen J. , Phillips Andrew T. M. , Nowlan Niamh C.
Published: January 2018

Mechanical forces generated by fetal kicks and movements result in stimulation of the fetal skeleton in the form of stress and strain. This stimulation is known to be critical for prenatal musculoskeletal development; indeed, abnormal or absent movements have been implicated in multiple congenital disorders. However, the mechanical stress and strain experienced by the developing human skeletonin uterohave never before been characterized. Here, we quantify the biomechanics of fetal movements during the second half of gestation by modelling fetal movements captured using novel cine-magnetic resonance imaging technology. By tracking these movements, quantifying fetal kick and muscle forces, and applying them to three-dimensional geometries of the fetal skeleton, we test the hypothesis that stress and strain change over ontogeny. We find that fetal kick force increases significantly from 20 to 30 weeks' gestation, before decreasing towards term. However, stress and strain in the fetal skeleton rises significantly over the latter half of gestation. This increasing trend with gestational age is important because changes in fetal movement patterns in late pregnancy have been linked to poor fetal outcomes and musculoskeletal malformations. This research represents the first quantification of kick force and mechanical stress and strain due to fetal movements in the human skeletonin utero, thus advancing our understanding of the biomechanical environment of the uterus. Further, by revealing a potential link between fetal biomechanics and skeletal malformations, our work will stimulate future research in tissue engineering and mechanobiology.
A deep learning approach to estimate stress distribution: a fast and accurate surrogate of finite-element analysis
Authors: Liang Liang , Liu Minliang , Martin Caitlin , Sun Wei
Published: January 2018

Structural finite-element analysis (FEA) has been widely used to study the biomechanics of human tissues and organs, as well as tissue–medical device interactions, and treatment strategies. However, patient-specific FEA models usually require complex procedures to set up and long computing times to obtain final simulation results, preventing prompt feedback to clinicians in time-sensitive clinical applications. In this study, by using machine learning techniques, we developed a deep learning (DL) model to directly estimate the stress distributions of the aorta. The DL model was designed and trained to take the input of FEA and directly output the aortic wall stress distributions, bypassing the FEA calculation process. The trained DL model is capable of predicting the stress distributions with average errors of 0.492% and 0.891% in the Von Mises stress distribution and peak Von Mises stress, respectively. This study marks, to our knowledge, the first study that demonstrates the feasibility and great potential of using the DL technique as a fast and accurate surrogate of FEA for stress analysis.
Victorian telegrams: the early development of the telegraphic despatch and its interplay with the letter post
Authors: Fava-Verde Jean-François
Published: January 2018

The paper examines the early development of the Victorian inland telegraph, and more precisely the telegraphic despatches, or telegrams, as they became widely known. The first telegram service in Britain was launched by the Electric Telegraph Company two decades before nationalization of the telegraphs in 1870. It is argued that this service was not as innovative as the electric telegraph technology that underpinned it. Attention is drawn to the parallels between the telegram and mail services. To this end, the evolution of postal communication is first explored, with a focus on the nineteenth century, when innovations such as mail-trains and prepayment by stamp considerably accelerated the mail and increased the volume of letters from 67 million in 1839 to a staggering 741 million in 1865. It was in this context that the telegram service was introduced to the public. The operating model adopted by the Electric Telegraph Company to deliver this service is deconstructed to show the similarities with the mail service and to demonstrate that a telegram was not always faster than letter post.
Seeding of proteins into amyloid structures by metabolite assemblies may clarify certain unexplained epidemiological associations
Authors: Sade Dorin , Shaham-Niv Shira , Arnon Zohar A. , Tavassoly Omid , Gazit Ehud
Published: January 2018

The accumulation of various metabolites appears to be associated with diverse human diseases. However, the aetiological link between metabolic alteration and the observed diseases is still elusive. This includes the correlation between the abnormally high levels of homocysteine and quinolinic acid in Alzheimer's disease, as well as the accumulation of oncometabolites in malignant processes. Here, we suggest and discuss a possible mechanistic insight into metabolite accumulation in conditions such as neurodegenerative diseases and cancer. Our hypothesis is based on the demonstrated ability of metabolites to form amyloid-like structures in inborn error of metabolism disorders and the potential of such metabolite amyloids to promote protein aggregation. This notion can provide a new paradigm for neurodegeneration and cancer, as both conditions were linked to loss of function due to protein aggregation. Similar to the well-established observation of amyloid formation in many degenerative disorders, the formation of amyloids by tumour-suppressor proteins, including p53, was demonstrated in malignant states. Moreover, this new paradigm could fill the gap in understanding the high occurrence of specific types of cancer among genetic error of metabolism patients. This hypothesis offers a fresh view on the aetiology of some of the most abundant human maladies and may redirect the efforts towards new therapeutic developments.
Pre-linguistic infants employ complex communicative loops to engage mothers in social exchanges and repair interaction ruptures
Authors: Bourvis Nadège , Singer Magi , Saint Georges Catherine , Bodeau Nicolas , Chetouani Mohamed , Cohen David , Feldman Ruth
Published: January 2018

Language has long been identified as a powerful communicative tool among humans. Yet, pre-linguistic communication, which is common in many species, is also used by human infants prior to the acquisition of language. The potential communicational value of pre-linguistic vocal interactions between human infants and mothers has been studied in the past decades. With 120 dyads (mothers and three- or six-month-old infants), we used the classical Still Face Paradigm (SFP) in which mothers interact freely with their infants, then refrain from communication (Still Face, SF), and finally resume play. We employed innovative automated techniques to measure infant and maternal vocalization and pause, and dyadic parameters (infant response to mother, joint silence and overlap) and the emotional component of Infant Directed Speech (e-IDS) throughout the interaction. We showed that: (i) during the initial free play mothers use longer vocalizations and more e-IDS when they interact with older infants and (ii) infant boys exhibit longer vocalizations and shorter pauses than girls. (iii) During the SF and reunion phases, infants show marked and sustained changes in vocalizations but their mothers do not and (iv) mother–infant dyadic parameters increase in the reunion phase. Our quantitative results show that infants, from the age of three months, actively participate to restore the interactive loop after communicative ruptures long before vocalizations show clear linguistic meaning. Thus, auditory signals provide from early in life a channel by which infants co-create interactions, enhancing the mother–infant bond.
Control of the mixing time in vessels agitated by submerged recirculating jets
Authors: Kennedy Stephen , Bhattacharjee Pradipto K. , Bhattacharya Sati N. , Eshtiaghi Nicky , Parthasarathy Rajarathinam
Published: January 2018

Submerged recirculating jet mixing systems are an efficient and economical method of agitating large tanks with a high hydraulic residence time. Much work has been carried out in developing design correlations to aid the predictions of the mixing time in such systems, with the first such correlation being developed nearly 70 years ago. In most of these correlations, the mixing time depends directly on the volume of the vessel and inversely on the injection velocity of the submerged jet. This work demonstrates, for the first time, that the distance between the injection and suction nozzles also significantly affects the mixing time and can be used to control this time scale. The study introduces a non-dimensional quantity that can be used as an adjustable parameter in systems where such control is desired.
Eco-dyeing with biocolourant based on natural compounds
Authors: Wang Fubang , Gong Jixian , Ren Yanfei , Zhang Jianfei
Published: January 2018

Biomass pigments have been regarded as promising alternatives to conventional synthetic dyestuffs for the development of sustainable and clean dyeing. This investigation focused on
in situ
dyeing of fabrics with biopigments derived from tea polyphenols via non-enzymatic browning reaction. The average particle size of dyed residual liquor with natural tea polyphenol was 717.0 nm (ranging from 615.5 to 811.2 nm), and the
Integ
value of dyed wool fabrics was the greatest compared to those of counterparts. In addition, the
Integ
values of dyed fabrics with residual liquor were much bigger than those with the first reaction solutions when dyed by identical dyeing liquor. As a result, the dyeing process could be carried out many times because the concentration of the residual liquor was relatively superior. All dyed fabrics acquired admirable rubbing as well as washing fastness, and the relevant dyeing mechanism has been analysed in the paper.