bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed 68Ga-PSMA PET/CT Image-Guided Biopsy for Low-Grade Adenocarcinoma in Benign Prostatic Hyperplasia
Authors: Santhosh Sampath , Jeeva Godwin 
Published: November 2020

Abstract
Image-guided biopsy of prostate with multiparametric MRI is being adopted in the workup of prostate adenocarcinoma (PAC). 68Ga-PSMA PET/CT-guided biopsy has also been shown to be equally sensitive in the evaluation of higher-grade tumors with increased PSMA expression. The sensitivity of 68Ga-PSMA PET/CT, however, reduces with lesser PSMA expression in low-grade PAC. Herein, we demonstrate a case where delayed 68Ga-PSMA PET/CT imaging helped in detecting low-grade PAC in BPH.
Aesthetic Consideration in a Patient With Lipomatosis
Authors: Nagano Hisato , Aoki Shimpo , Azuma Ryuichi , Kiyosawa Tomoharu 
Published: November 2020

Abstract
This is the first report of multiple parosteal lipomas as a late complication of aesthetic procedures. A 70-year-old woman presented with multiple frontal nodules that had grown slowly over 5 years. She underwent forehead-lifting surgery 30 years ago and botulinum toxin injection 3 years ago. Computed tomography showed six low-density nodules measuring 10 to 20 mm just above the frontal bone. The tumors were resected via a parietal coronal incision. Histopathological findings revealed parosteal lipoma with foreign bodies. At 1 year postoperatively, there has been no recurrence or complications. The multiple lesions corresponded to the sites of the aesthetic procedures. The mesenchymal cells in the periosteum seemed to be stimulated by cytokines released from a postoperative hematoma or damaged periosteum, resulting in tumorigenesis. When performing aesthetic procedures in the face, care should be taken to avoid unnecessary injury to the periosteum, given the possibility of tumor development.
Level of evidence: Level V, case report
Sellar Floor Bone Flap With a Pedicled Nasoseptal Flap in Endoscopic Transnasal Pituitary Adenoma Surgery
Authors: Xing Mengyang , Lv Wenming , Wang Jing , Liu Sheng , Liu Pengfei , Wang Bo , Gao Wenbo , Zhang Liangwen 
Published: November 2020

Objective:
To explore the clinical effect of sellar floor bone flap with a pedicled nasoseptal flap in endoscopic transnasal pituitary adenoma surgery for skull base reconstruction.

Method: This was a retrospective clinical analysis of 30 patients with pituitary adenoma operated by the same neurosurgical team from June 2015 to June 2018. All patients were diagnosed with pituitary adenoma by pituitary magnetic resonance imaging, and the authors confirmed that the sellar floor bone was intact using sphenoid sinus computed tomography. All patients underwent an endoscopic transnasal approach, and the authors created a pedicled nasoseptal flap and sellar floor bone flap intraoperatively and reconstructed the skull base at the end of the surgery. Postoperative complications constituted cerebrospinal fluid leakage, brain tissue herniation, nasal discomfort, decreased sense of smell, and epistaxis.

Results:
Cerebrospinal fluid leakage occurred in 13 patients (43.3%) intraoperatively; small amounts in 6 patients (20.0%), moderate amounts in 3 patients (10.0%), and large amounts in 4 patients (13.3%). Only 1 patient (3.3%) with large-volume cerebrospinal fluid leakage intraoperatively experienced cerebrospinal fluid leakage postoperatively, and this resolved with lumbar catheter drainage and bed rest. The 6-month postoperative follow-up brain computed tomography findings revealed brain tissue herniation in no patients, nasal discomfort in 3 patients (10.0%), decreased sense of smell in 5 patients (16.7%), and epistaxis in 2 patients (6.7%).

Conclusion:
Reconstructing the skull base with a sellar floor bone flap and a pedicled nasoseptal flap played an important role in preventing cerebrospinal fluid leakage and brain tissue herniation in endoscopic transnasal pituitary adenoma surgery and did not increase the incidence of postoperative nasal discomfort, decreased sense of smell, or epistaxis.
Analysis of Cranial Base Suture Fusion Patterns
Authors: Rodriguez Jose J. , McLaughlin Caroline , Thompson James T. 
Published: November 2020

Purpose:
It is known from both anatomic and radiographic studies that the majority of cranial sutures begin fusing in early adulthood and are fused by late adulthood. However, most of the studies focus on the cranial vault rather than the cranial base. Most clinicians treating patients with craniosynostosis are interpreting the behavior of cranial sutures on CT imaging. Therefore, the purpose of this study was to further clarify the radiographic appearance of cranial base sutures over the natural human life span.

Methods:
Thirty CT scans of the head and face were reviewed for each decade starting at 1 year of life up to age 90. Scans were evaluated for the appearance of the occipitomastoid, petrosoocciptial, sphenosquamous, sphenopetrosal, frontosphenoidal, sphenozygomatic, petrososquamosal, frontoethmoidal, sphenoethmoidal and sphenoccipital sutures. Sutures were categorized as obliterated, present with fusion, present without fusion and unable to visualize.

Results:
The majority of cranial base sutures are visible up through the eighth decade, although evidence of ossification across the suture starts as early as the second decade. Some sutures such as the occipitomastoid appeared > 90% open even as late as the ninth decade. Other sutures such as the sphenosquamosal and frontozygomatic are mostly fused by that age.

Conclusion:
Cranial base sutures appear to behave radiographically similar, to the cranial vault sutures in that they largely remain visible throughout adulthood but show varying amounts of ossification. There are some cranial base sutures which appear to remain open throughout life although the significance of this has yet to be determined.
Facial Animation With Free Functional Gracilis Transfer Innervated by the Cross-Facial Nerve Graft
Authors: Liang Hongyu , Chen Sen , Yang Zhe , Ma Ning , Wang Weixin , Liu Qiyu , Wu Qi , Ji Xiuzhen , Li Yangqun 
Published: November 2020

Background:
The treatment of long-standing facial paralysis has always been a challenge for plastic surgery. The purpose of this study was to demonstrate that the free functional gracilis transfer innervated by the cross-facial nerve graft (CFNG) is still an ideal option, even though there are many new surgical options available.

Methods:
A retrospective survey was made on 12 patients who received free functional gracilis transfer innervated by the CFNG. A modified version of the House-Brackmann scale was used to evaluate the movement of the corners of mouth after surgery. Patients were also asked about their satisfaction with the operation. In addition, an objective test was performed to assess the postoperative angle improvement by measuring the angle formed between the horizontal line of both corners of the lips and the vertical midline.

Results:
All grafts survived well. No severe complication occurred. Three patients received further surgical operations for aesthetic reasons. The movement of the corners of mouth was classified as excellent in 8 cases, good in three cases, and fair in one cases. The static angle and dynamic angle of postoperation improved and the range of dynamic angle improvement was larger than that of static angle.

Conclusion:
Free functional gracilis transfer innervated by the CFNG is an ideal technique for facial paralysis. It can effectively improve the facial dynamic of the affected side.
Adenomatous Neuroendocrine Tumors of the Middle Ear in a Young Man With Conductive Hearing Loss
Authors: Zagaria Annamaria , Nicastro Viviana , Abita Pietro , Freni Francesco , Galletti Francesco 
Published: November 2020

Abstract
Neuroendocrine neoplasms of the ear pose a diagnostic challenge because clinical symptoms are no specific. Definite diagnosis is made by histopathological analysis with immunohystochemical evalutation. Therapy consists in a complete surgical resection. Controversial terminology of the neoplasm arises from the differentiation of these tumors composed of both endocrine and exocrine glands. Middle ear localization is an extremely rare presentation but less aggressive than gastrointestinal tract or lung localizations which are the most frequent. Radio-diagnostic analyses are necessary follow-up for preventing or detecting recurrence or metastasis. The authors present a case of neuroendocrine tumor of the middle ear in a young male of 37 years old who presented unilateral right hearing loss and tinnitus. A transcanal tympanoplasty was performed. There were no intraoperative complications and the postoperative period was uneventful.
The Likelihood of Orthognathic Surgery After Orofacial Cleft Repair
Authors: Choi Katherine J. , Wlodarczyk Jordan R. , Nagengast Eric S. , Wolfswinkel Erik , Munabi Naikhoba C.O. , Yao Caroline , Magee William P. 
Published: November 2020

Abstract
Midface hypoplasia is one of the most significant sequelae of cleft lip and/or palate surgery. A complete understanding of the rate of orthognathic surgery across varying cleft phenotypes is a powerful tool for educating patients and families as to the treatment course that the patient will incur during their lifetime. Understanding the average rates of orthognathic intervention also can act to develop metrics for outcome evaluation with different treatment protocols. Attempting to identify the average rates of orthognathic intervention, the authors conducted a systematic review and meta-analysis by combining studies from 1987 to 2016 describing the frequency of orthognathic intervention on the different cleft phenotypes as the primary outcome. Secondary outcomes included identification of surgical protocol, age of patient at orthognathic intervention, and the method by which patients were evaluated for orthognathic intervention. The rate of orthognathic surgery was 38.1% for bilateral cleft lip and palate (BCLP), 30.2% for unilateral cleft lip and palate (UCLP), 4.4% for isolated cleft palate (ICP), and 1.8% for patients with isolated cleft lip (ICL). 71% (n = 10) reported using lateral cephalograms for orthognathic surgery evaluation and only one of those studies reported specific objective cephalometric measurements for orthognathic intervention. Our findings demonstrated that BCLP possessed the highest rate of orthognathic intervention followed by UCLP, ICP, and ICL. ICP and ICL both possessed low rates of orthognathic intervention. By sharing our findings, the authors hope to provide a useful tool for informing patients’ families as to their risk of needing orthognathic intervention.
Repair of Donor Site Defects After Forearm Free Flap Harvest With Dual Triangular Flaps and in Situ Small Full-thickness Skin Flaps
Authors: Yao Lin , Deng Zhang , Guo Mengmeng , Zeng Wei , Yao Lin 
Published: November 2020

Purposes:
The aim of this study was to introduce a method for repairing donor site defects after harvesting forearm free flaps with dual triangular flaps combined with in situ small full-thickness skin flaps.

Methods:
Free forearm skin flaps were applied to repair defects after tumor resection in 25 patients with oral squamous cell carcinoma. Although forearm free flaps were prepared, dual triangular flaps and adjacent full-thickness skin flaps were designed and fabricated to repair donor site defects in situ.

Results:
Twenty-five cases of forearm donor site defects were successfully repaired with dual triangular flaps combined with in situ small full-thickness skin grafts. All adjacent full-thickness skin grafts used to close the donor site defect of the forearm survived, and the wound healed well without delayed wound rupture or serious complications at the donor site. The movement of the elbow and wrist joint on the side of the flap was normal, the blood supply in the palm was normal, and the skin color at the donor site of the forearm skin flap was similar to that of the surrounding tissue. There was no dent deformity or contracture deformity. Moreover, there was no significant difference in swelling and wrist movement between the adjacent forearm skin grafting group and the abdominal skin grafting group, but the former technique reduced the risk of scar infection and tendon exposure and greatly improved the esthetics of the surgical site on the forearm.

Conclusions:
Modified donor dual triangular flaps combined with adjacent full-thickness skin grafts can reduce the recovery time during and after surgery and avoid trauma at a third surgical site. This method is worthy of practical application in the preparation of forearm skin flaps for oral and maxillofacial surgery.
The Impact of Racial Residential Segregation on Colorectal Cancer Outcomes and Treatment
Authors: Poulson Michael , Cornell Ella , Madiedo Andrea , Kenzik Kelly , Allee Lisa , Dechert Tracey , Hall Jason 
Published: November 2020

Objective:
We sought to examine the impact of racial residential segregation on Black-White disparities in colorectal cancer diagnosis, surgical resection, and cancer-specific survival.

Summary Background Data:
There are clear Black-White disparities in colorectal cancer diagnosis and treatment with equally disparate explanations for these findings, including genetics, socioeconomic factors, and health behaviors.

Methods:
Data on Black and White patients with colorectal cancer were obtained from SEER between 2005 and 2015. The exposure of interest was the index of dissimilarity (IoD), a validated measure of segregation derived from 2010 Census data. Outcomes included advanced stage at diagnosis (AJCC stage IV), resection of localized disease (AJCC stage I-II), and cancer-specific survival. We used Poisson regression with robust error variance for the outcomes of interest and Cox proportional hazards were used to assess cancer-specific 5-year survival.

Results:
Black patients had a 41% increased risk of presenting at advanced stage per IoD [risk ratio (RR) 1.41, 95% confidence intervals (CI) 1.18, 1.69] and White patients saw a 17% increase (RR 1.17, 95%CI 1.04, 1.31). Black patients were 5% less likely to undergo surgical resection (RR 0.95, 95%CI 0.90, 0.99), whereas Whites were 5% more likely (RR 1.05, 95%CI 1.03, 1.07). Black patients had 43% increased hazards of cancer-specific mortality with increasing IoD (hazard ratio (HR) 1.43, 95%CI 1.17, 1.74).

Conclusions:
Black patients with colorectal cancer living in more segregated counties are significantly more likely to present at advanced stage and have worse cancer-specific survival. Enduring structural racism in the form of residential segregation has strong impacts on the colorectal cancer outcomes.
Maintaining high thrombectomy rates during pandemics
Authors: Dobrocky Tomas , Kaesmacher Johannes , Pereira Vitor Mendes , Gralla Jan , Fischer Urs 
Published: November 2020

Purpose of review
The aim of this article is to review the current literature on endovascular treatment of acute ischemic stroke in the aftermath of the coronavirus disease 2019 (COVID-19) lockdown.

Recent findings
The outbreak of the COVID-19 has had effect of unprecedented magnitude on the social, economic and personal aspects around the globe. Healthcare providers were forced to expand capacity to provide care to the surging number of symptomatic COVID-19 patients, while maintaining a fully operating service for all non-COVID patients. The recent literature suggesting an overall decrease in acute ischemic stroke admissions as well as total number of endovascular treatments will be reviewed. Although the underlying reasons therefore remain the matter of debate, it seems that the imposed restrictions, requiring social distancing, and stopping all nonessential services, have led to a higher threshold for patients to seek medical attention, in particular in those with less severe symptoms. Thus, raising public awareness on the importance of strokes and transient ischemic attacks is even more important in the light of the current situation to avoid serious healthcare, economic consequences, and limit long term morbidity.

Summary
The priority remains maintaining a fast and efficient pre and in-hospital work-flow while mitigating nosocomial transmission and protecting the patient and the healthcare workers with appropriate personal protective equipment.
Addressing psychological resilience during the coronavirus disease 2019 pandemic: a rapid review
Authors: Blanc Judite , Briggs Anthony Q. , Seixas Azizi A. , Reid Marvin , Jean-Louis Girardin , Pandi-Perumal Seithikurippu R. 
Published: November 2020

Purpose of review
The mental health toll on populations exposed to COVID-19 is alarming, and there is a need to address this with urgency. This current review provides insights on how individuals, communities, and specific populations, such as healthcare workers and patients are leveraging pre-COVID-19 and peri-COVID-19 factors to reinforce their psychological resilience during the global public health crisis.

Recent findings
Examination of the extant literature indicated that populations around the world rely often on support from their loved-ones, closed significant others, outdoor and physical activities, and spirituality to cope with the COVID-19-related distress. Increased sense of meaning/purpose since the COVID-19 pandemic was also reported.

Summary
A portion of publications provided intervention models to reinforce resilience among specific populations during the COVID-19 pandemic. Nevertheless, it is not convincing that some of these models can be applied universally. Additionally, it is important to note that in this category, translational data was scarce.
SARS-CoV-2 Reinfection in Patients Negative for Immunoglobulin G Following Recovery from COVID-19
Authors: Ali Ayad M. , Ali Kameran Mohammed , Fatah Mohammed Hassan , Tawfeeq Hassan Mohammad , Rostam Hassan Muhammad 
Published: November 2020

AbstractWhile many patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) eventually produce neutralising antibodies, the degree of susceptibility of previously infected individuals to reinfection by SARS-CoV-2 is currently unknown. To better understand the impact of the immunoglobulin (IgG) level on reinfection in recovered coronavirus disease 2019 (COVID-19) patients, IgG levels against SARS-CoV-2 were measured in 829 patients with previously confirmed infection just after their recovery. Notably, 87 of these patients had no detectable IgG concentration. While there was just one case of asymptomatic reinfection 4.5 months after the initial recovery amongst patients with detectable IgG levels, 25 of the 87 patients negative for IgG were reinfected within one to three months after their first infection. Therefore, patients who recover from COVID-19 with no detectable IgG concentration appear to remain more susceptible to reinfection by SARS-CoV-2, with no apparent immunity. Also, although our results suggest the chance is lower, the possibility for recovered patients with positive IgG findings to be reinfected similarly exists.
Association of axial length with retinal thickness and choroidal thickness in diabetic patients
Authors: Liu Sen , Wang Lanhua , Wang Wei , Gong Xia , Li Yuting , Li Wangting , Liang Xiaoling , Liu Yizhi , Huang Wenyong 
Published: November 2020

AbstractBackgroundUnderstanding the associations of axial length (AL) with retinal thickness (RT) and choroidal thickness (CT) at different subgrids among diabetic participants are of great important in exploring potential protective mechanism and pathogenesis of diabetic retinopathy (DR) in myopic eyes. Therefore, this study aimed to investigate the associations of AL with RT and CT among participants with type-2 diabetes mellitus (T2DM).MethodsParticipants with T2DM and registered with the government-monitored diabetes communities near Zhongshan Ophthalmic Center, Guangzhou, China, were consecutively invited to participate in the current study from October 2017 to April 2019. High-definition retina and choroid images of the macular area were obtained using swept-source optical coherence tomography.AL and other ocular biometrics were measured using Lenstar900. Linear regression models were used to assess relationships between AL and RT as well as CT.ResultsA total of 1378 participants with a mean age of 63.8±7.75 years and mean AL of 23.6±1.15 mm were included in the current study. In the multivariate linear regression models, AL was positively associated with the central RT (β=4.11 per mm increased in AL, 95%confidence interval (CI)=2.66 to 5.56, P<0.001), but negatively associated with the RT of the outer ring (β=-3.37 per mm increased in AL, 95%CI=-4.19 to -2.56, P<0.001).Longer AL tended to have thinker CTs in the central (β=-27.4 per mm increased in AL, 95%CI=-31.2 to -23.7, P<0.001),outer ring (β=-20.8 per mm increased in AL, 95%CI=-23.8 to -17.7, P<0.001) and inner ring (β=-24.6 per mm increased in AL, 95%CI=-28.1 to -21.1, P<0.001).ConclusionsMyopic ocular elongation is accompanied by retinal thinning of the outer ring and retinal thickening of the foveal area. The CT of the macular area tended to become thinner with elongated AL among the diabetic subjects.
Association between Renal Function and Retinal Neurodegeneration in Chinese Patients with Type 2 Diabetes Mellitus
Authors: Gong Xia , Wang Wei , Li Wangting , Jin Ling , Wang Lanhua , Meng Jie , Xiong Kun , Li Yuting , Han Xiao , Liang Xiaoling , Liu Yizhi , Huang Wenyong 
Published: November 2020

AbstractBackgroundChronic kidney disease (CKD) and diabetic retinopathy (DR) are two serious complications of diabetes. However, the association between retinal neurodegeneration in DR and renal function decline is still unclear. Our objective was to evaluate the association by measure estimated glomerular filtration rate (eGFR), macular ganglion cell–inner plexiform layer (GC–IPL) and ganglion cell complex (GCC) thickness in patients with type 2 diabetes mellitus (T2DM).MethodsWe analyzed the baseline data of the Guangzhou Diabetic Eye Study. T2DM patients from communities in Guangzhou were enrolled and all participants went through ophthalmic and general examinations. The thickness of the macular GC–IPL and GCC in their right eyes were measured by swept-source optical coherence tomography. CKD was defined as eGFR < 60 mL/min/1.73 m2.Results1,309 patients were included (mean age 64.4 ± 7.6 years, 59.1% female), and fifty-eight (4.4%) of them had CKD. Average macular GC-IPL thickness was significantly thinner in CKD patients (96.5 ± 9.1 μm) than non-CKD patients (101.3 ± 9.2 μm) (p < 0.01). Average macular GCC thickness was also significantly thinner in CKD patients (123.5 ± 13.2 μm) than non-CKD patients (129.9 ± 12.8 μm) (p < 0.01). The significant thinning of macular GC-IPL and GCC thickness presented in every gird in macula (all, p < 0.05) except for central grid (p ≥ 0.05). In the patients without DR, the eGFR was linearly correlated with the average macular GC–IPL thickness (β = 0.07 [95% CI 0.02–0.12], p < 0.01) and GCC thickness (β = 0.09 [95% CI 0.03–0.16], p < 0.01) after adjustment for age, sex, axial length, intraocular pressure and combination of hypertension. However, no linear correlation was found between eGFR and macular GC-IPL or GCC thickness in DR patients.ConclusionsRenal function decreases is associated with the thinning of the macular GC–IPL and GCC in T2DM patients, suggesting the potential value of ganglion cell lose to detect early function decline in the kidney in diabetic patients, especially in patients without DR.