bluuebunny/crossref_metadata_2025_split huggingface dataset:
BT-07 PATIENT DERIVED XENOGRAFT MODELS OF EPITHELIOID GLIOBLASTOMA AND THERAPEUTIC VULNERABILITY IN MOLECULAR TARGET THERAPY
Authors: Sasame Jo , Tateishi Kensuke , Ikegaya Naoki , Miyake Shigeta , Miyake Yohei , Nakamura Taishi , Udaka Naoko , Yamanaka Shoji , Yamamoto Tetsuya 
Published: December 2019

Abstract
Epithelioid glioblastoma (E-GBM) predominantly arises at younger age and promotes dismal prognosis. Because of its rare etiology, pathological and genetical characterization of E-GBM remains elusive. Herein, we report unique patient-derived E-GBM xenograft (PDX) models from 3 E-GBM patients (2 BRAFV600E mutant and 1 BRAFV600E wild-type). Two BRAF mutant E-GBM cells (YMG62 and YMG89) were originated from adolescent and young adult patients and harbored TERT promoter mutation and CDKN2A homozygous deletion, while 1 BRAFV600E E-GBM cell (YMG64) was from elderly patient and had TERT wild-type. YMG62 and YMG89 could be propagated at multiple passage in vitro, while YMG64 could not be maintained. PDX models were established from YMG62, YMG89, and YMG64. All PDX tumors were preferentially disseminated and negative expression of GFAP, which were recapitulated to the patient characteristics. BRAF and MEK inhibitor mildly suppressed cell viability in vitro. Collectively, E-GBM PDX models recapitulate patient characteristics, which may be helpful to elucidate tumor biology and establish novel therapeutic target in E-GBM.
CS-01 GIANT CELL TUMOR IN THE SKULL BASE BONE TREATED WITH ANTI-RANKL INHIBITOR
Authors: Kajiwara Yoshinori , Takechi Akihiko , Watanabe Yosuke , Miyoshi Hiroyuki , Shiraishi Takeshi 
Published: December 2019

Abstract
Giant cell tumor of bone is a rare and osteolytic neoplasm that that usually affecting the epiphyses in long bones of the extremities. They seldom occur in the skull, preferentially affecting the sphenoid and temporal bones. Most pathologically benign, and total removal by surgery was regarded as the first treatment, however, it was very difficult in skull lesion. In 2014 the molecular targeting drug anti-RANKL inhibitor was approved in Japan. We report a case in which an anti-RANKL inhibitor was administered to a skull base bone giant cell tumor that was difficult to remove completely. A 56-year-old man with a sudden right neck pain followed by dysphoria and dysphagia was referred to our hospital. Computed tomography showed 4.4 x 2.0 cm osteolytic lesion involving the right occipital bone and occipital condyle. Magnetic resonance imaging demonstrated an extensive soft-tissue mass occupying. Surgical biopsy was performed and the pathological diagnosis was giant cell tumor. Patient received the anti-RANKL inhibitor (Denosumab®). After 4 weeks, ossification was observed, and neurological symptoms were improved after 12 weeks. Patient has been on good course for 5 years without recurrence and is still following-up.
CS-11 PITUITARY EPENDYMOMA: A CASE REPORT
Authors: Fukami Tadateru , Yoshimura Yayoi , Fujikawa Ryoko , Nozaki Kazuhiko 
Published: December 2019

Abstract

INTRODUCTION
Neoplasms of the sellar region generally includes pituitary adenoma, craniopharyngioma, meningioma. We report a case of pituitary ependymoma.

CASE
A 39 years-old man. He experienced the sense of discomfort of the inside upper part field of vision of the left eye for a few months since May, 201X. Ophthalmological examination showed right homonymous hemianopia of right upper 1/4. He was introduced to the department of neurosurgery of nearby hospital. MRI showed intrasellar tumor and the lesion was partially removed because of solidness by endoscopic transsphenoidal surgery on July, 201X. Postoperative pathological diagnosis was pituitary adenoma. The residual tumor was followed up, but the compression to the left optic nerve was not resolved. So he was introduced to our hospital in January, 201X+1 and endoscopic transsphenoidal surgery was performed on May, 201X+1.

OPERATION
Supposing the change to extended transsphenoidal surgery, we prepared rescue flap. Enlarging the window of sellar floor and removing the tuberculum sellae, the tumor was totally removed. The boundary between the tumor and the normal pituitary gland was obscure. We inserted fat piece to the intrasellar space, and reconstructed the sellar floor with the absorbable plate following fixation with a polyglycolic acid sheet, fibrin glue, and sinus balloon.

PATHOLOGY
Fusiform cells having an oval or a short spindle shape nucleus multiplied in strand and palisading pattern through capillary vessels were the main findings, and ependymal rosettes were confirmed. Immunohistchemical study showed chromograninA(focally+), synaptophysin (-), EMA (+, dot and ring pattern), CAM5.2(+), bcl-2(+), TTF-1(-), S100(focally+), GFAP(-). Final diagnosis was pituitary ependymoma. Mild diabetes insipidus was occurred postoperatively but it was controlled medically. Now he is followed up in outpatient department.

DISCUSSION
Pituitary ependymoma was reported only eight cases in the past literatures. Though it is extremely rare, pituitary ependymoma should be included as a differential diagnosis of the sellar tumors.
COT-13 THE USEFULNESS OF THE CEREBRAL ANGIOGRAPHY FOR RESECTION OF THE MALIGNANT GLIOMA
Authors: Matsumoto Yoshie , Saito Kuniaki , Shimada Daisuke , Amano Tatsuo , Sasamori Hiroki , Horikawa Hiroshi , Kobayashi Keiichi , Noguchi Akio , Shiokawa Yoshiaki , Nagane Motoo 
Published: December 2019

Abstract

OBJECTIVE
Maximal safe resection is a standard of care (SOC) for treatment of malignant glioma in light of quality of life (QOL) maintenance and better outcomes. This strategy is especially important when vital perforating arteries such as lateral striate arteries (LSA) and anterior choroidal arteries,are involved in tumor and its periphery,as their damage causes serious deterioration in the activities of daily life. Here we report a utility of preoperative cerebral angiography in glioma surgery.

METHODS
Six cases of perforator-involving malignant gliomas, consisting of five glioblastomas and one anaplastic ganglioma, operated from December 2018 to July 2019 were evaluated with preoperative imaging using sophisticated cerebral angiographic techniques and fusion imaging with MRI.

RESULTS
In all six cases, perforating arteries passed through or around the tumors. The cerebral angiography revealed the origin of LSA in all patients; one at M1,two at M1-M1 junction, and three at the superior trunk of M2. Anterior choroidal arteries and Heubner’s recurrent arteries were also identified preoperatively. By knowing the precise locations of these perforators,intraoperative resection of vascular-rich malignant gliomas could be performed with precaution of avoiding their unnecessary injury. No symptomatic complications occurred after angiography. Postoperative MRI disclosed a potential embolic infarction in the perforator territory in one patient,which resolved in a few days.

CONCLUSIONS
Visualization of perforators by angiography was helpful in detailed evaluation of surgical strategy and facilitated safe resection also leading to shortening of operating time. Compared to another modalities,angiography provided the best special resolution for visualization of vital perforating arteries involved in malignant gliomas.
COT-18 TWO CASES OF GLIOBLASTOMA WITH ASYMPTOMATIC PULMONARY ARTERY EMBOLISM AND DEEP VEIN THROMBOSIS FROM ADMISSION TO HOSPITAL
Authors: Kobayashi Yusuke , Kon Takashi , Shimizu Katsuyoshi , Tanioka Daisuke , Satou Yosuke , Mizutani Tohru 
Published: December 2019

Abstract
Patients with malignant tumors are susceptible to concurrent venous thromboembolism. We report two cases of glioblastomas that showed asymptomatic pulmonary embolism and deep vein thrombosis on admission. The first case was a 77-year-old male. He was referred to our clinic for a tumor found in the left temporal lobe on computed tomography scan performed when he suffered pneumonia. On admission,he had a Karnofsky performance status (KPS) score of 50 and an elevated D-dimer level (16.46 μg/ml). Pulmonary embolism and deep vein thrombosis were noted on detailed examination. Direct oral anticoagulant (DOAC) therapy resulted in the disappearance of pulmonary embolism. On biopsy,the tumor was diagnosed as glioblastoma. The patient underwent radiation therapy in combination with chemotherapy. The second case was a 71-year-old female. She developed a disorder of consciousness and was admitted to a clinic. Brain magnetic resonance imaging (MRI) revealed a high T2 signal area in the left temporal lobe. The patient was initially diagnosed with encephalitis. Though the consciousness disorder improved quickly,she was referred to our clinic after a hyperintense area was observed on MRI. On admission,she had a KPS score of 100,and an elevated D-dimer level (7.59μg/ml),revealing pulmonary embolism and deep vein thrombosis. She was started on a DOAC and underwent surgical removal of the tumor via craniotomy. She was diagnosed with glioblastoma and underwent radiation therapy in combination with chemotherapy. Approximately 20% of the patients with glioblastomas suffer concurrent symptomatic venous thromboembolism. The incidence of venous thromboembolism is further elevated in patients with a poor KPS score or elderly people. Many patients with glioblastomas suffer asymptomatic venous thromboembolism. In this report,asymptomatic venous thromboembolism was noted in patients with a good KPS score. In glioblastoma patients,it is necessary to test for venous thromboembolism by measuring D-dimer levels before surgery.
SCATTER RADIATION IN THE FLUOROSCOPY-GUIDED INTERVENTIONAL ROOM
Authors: Bohari Asmah , Hashim Suhairul , Mohd Mustafa Siti Norsyafiqah 
Published: December 2019

Abstract
Radiation scattered throughout the room during fluoroscopy-guided interventional (FGI) procedures was quantified at different locations using nanoDot optically stimulated luminescence dosemeters. All the tube angulation imaging shows that the radiation spectrum resembled a single peak distribution. The left anterior oblique 90° shows the highest single peak distribution (28.65 mSv/h). The single peak distribution for standard anteroposterior, left anterior oblique 45° and right anterior oblique 45° imaging was 13.32, 22.99 and 17.40 mSv/h, respectively. All tube angulation shows that the position of the interventional radiologist experienced a higher radiation level compared to other staffs. The doses of radiation varied widely around the perimeter of the patient’s table and changed in accordance to imaging angles during procedures. Knowledge pertaining to radiation exposure levels is integral in order to avoid adverse risks, particularly among staff.
Therapeutic Advantages of Frequent Physical Therapy Sessions for Patients With Lumbar Spinal Stenosis
Authors: Minetama Masakazu , Kawakami Mamoru , Teraguchi Masatoshi , Kagotani Ryohei , Mera Yoshimasa , Sumiya Tadashi , Nakagawa Masafumi , Yamamoto Yoshio , Matsuo Sachika , Sakon Nana , Nakatani Tomohiro , Kitano Tomoko , Nakagawa Yukihiro 
Published: December 2019

Study Design.
A retrospective study of a randomized clinical trial and a prospective study of patients with lumbar spinal stenosis (LSS).

Objective.
The aim of this study was to identify the effects of the number of physical therapy (PT) sessions on clinical outcomes of patients with LSS.

Summary of Background Data.
Supervised PT for patients with LSS has been reported to lead to better short-term outcomes in terms of disability and leg pain than unsupervised exercise. However, no studies have investigated the relationship between the number of PT sessions and the therapeutic effects in patients with LSS.

Methods.
All patients received exercise therapy for 6 weeks. Included were 43 patients receiving supervised PT twice a week (P2 group), 38 patients receiving supervised PT once a week (P1 group), and 43 patients receiving a home exercise program alone (HE group). Clinical outcomes were measured using the Zurich Claudication Questionnaire (ZCQ), a numerical rating scale (NRS) of back pain and leg pain, the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) at baseline and at 6 weeks.

Results.
At 6 weeks, the P2 group showed significant improvements in ZCQ physical function, back and leg pain on the NRS compared with the P1 group (P < 0.05). Compared with the HE group, the P2 group showed significant improvements in ZCQ symptom severity and physical function, back and leg pain on the NRS, and JOABPEQ gait disturbance (P < 0.05). There were no significant differences in mean changes after 6 weeks between the P1 and HE groups.

Conclusion.
Six weeks of supervised PT twice a week resulted in significant short-term improvements in symptom severity, physical function, back and leg pain, and gait disturbance compared with once a week and/or home exercise alone. Patients with LSS should be treated with intensive and supervised exercise programs to obtain maximum benefit of exercise therapy.

Level of Evidence: 3
Disparities in Outcomes by Insurance Payer Groups for Patients Undergoing Anterior Cervical Discectomy and Fusion
Authors: Rasouli Jonathan J. , Neifert Sean N. , Gal Jonathan S. , Snyder Daniel J. , Deutsch Brian C. , Steinberger Jeremy , Caridi John M. 
Published: December 2019

Study Design.
Retrospective, observational study of clinical outcomes at a single institution.

Objective.
To compare postoperative complication and readmission rates of payer groups in a cohort of patients undergoing anterior cervical discectomy and fusion (ACDF).

Summary of Background Data.
Studies examining associations between primary payer and outcomes in spine surgery have been equivocal.

Methods.
Patients at Mount Sinai having undergone ACDF from 2008 to 2016 were queried and assigned to one of five insurance categories: uninsured, managed care, commercial indemnity insurance, Medicare, and Medicaid, with patients in the commercial indemnity group serving as the reference cohort. Multivariable logistic regression equations for various outcomes with the exposure of payer were created, controlling for age, sex, American Society of Anesthesiology Physical Status Classification (ASA Class), the Elixhauser Comorbidity Index, and number of segments fused. A Bonferroni correction was utilized, such that alpha = 0.0125.

Results.
Two thousand three hundred eighty seven patients underwent ACDF during the time period. Both Medicare (P < 0.0001) and Medicaid (P < 0.0001) patients had higher comorbidity burdens than commercial patients when examining ASA Class. Managed care (2.86 vs. 2.72, P = 0.0009) and Medicare patients (2.99 vs. 2.72, P < 0.0001) had more segments fused on average than commercial patients. Medicaid patients had higher rates of prolonged extubation (odds ratio [OR]: 4.99; 95% confidence interval [CI]: 1.13–22.0; P = 0.007), and Medicare patients had higher rates of prolonged length of stay (LOS) (OR: 2.44, 95% CI: 1.13–5.27%, P = 0.004) than the commercial patients. Medicaid patients had higher rates of 30- (OR: 4.12; 95% CI: 1.43–11.93; P = 0.0009) and 90-day (OR: 3.28; 95% CI: 1.34–8.03; P = 0.0009) Emergency Department (ED) visits than the commercial patients, and managed care patients had higher rates of 30-day readmission (OR: 3.41; 95% CI: 1.00–11.57; P = 0.0123).

Conclusion.
Medicare and Medicaid patients had higher rates of prolonged LOS and postoperative ED visits, respectively, compared with commercial patients.

Level of Evidence: 3
What Is the Reliability of a New Classification for Bone Defects in Revision TKA Based on Preoperative Radiographs?
Authors: Belt Maartje , Smulders Katrijn , van Houten Albert , Wymenga Ate , Heesterbeek Petra , van Hellemondt Gijs 
Published: December 2019

Abstract

Background
Accurate quantification of bone loss facilitates preoperative planning and standardization for research purposes in patients who undergo revision TKA. The most commonly used classification to rate bone defects in this setting, the Anderson Orthopaedic Research Institute classification, does not quantify diaphyseal bone loss and reliability has not been well studied.

Questions/purposes
We developed a new classification scheme to rate bone defects in patients undergoing revision TKA and tested (1) the intraobserver and interobserver reliability of this classification for revision TKA based on preoperative radiographs, and (2) whether additional CT images might improve interobserver reliability.

Methods
This was a preregistered observational study. Interobserver reliability was analyzed using preoperative radiographs of 61 patients who underwent (repeat) revision TKA, and their bone defects were rated by five experienced orthopaedic surgeons. For intraobserver reliability, ratings were repeated at least 2 weeks after the first rating (Timepoints 1 and 2). Directly after the radiographic assessments of Timepoint 2, the observers were provided with CT images of each patient and asked to rate the bone defects for a third time (Timepoint 3), to assess the additional value of CT. Intraobserver and interobserver reliability were tested using Gwet’s agreement coefficient 2, which is a measure of agreement between observers in categorical data. Substantial agreement was defined as coefficients between 0.61 to 0.8 and almost perfect agreement as > 0.8.

Results
The intraobserver reliability varied between 0.55 (95% CI 0.40 to 0.71) and 0.87 (95% CI 0.78 to 0.96) in the epiphysis, between 0.69 (95% CI 0.58 to 0.80) and 0.98 (95% CI 0.95 to 1) in the metaphysis, and between 0.95 (95% CI 0.90 to 0.99) and 0.99 (95% CI 0.98 to 1) in the diaphysis. The interobserver reliability varied between 0.48 (95% CI 0.39 to 0.57) and 0.49 (95% CI 0.42 to 0.56) in the epiphysis and between 0.81 (95% CI 0.75 to 0.87) and 0.88 (95% CI 0.83 to 0.93) in the metaphysis, and was 0.96 (95% CI 0.93 to 0.99) in the diaphysis at Timepoint 1. The interobserver reliability at Timepoint 2 was similar to that of Timepoint 1. The addition of CT images did not improve reliability (Timepoint 3).

Conclusions
The bone defect classification was less reliable in the epiphyseal area compared with the metaphysis and diaphysis. This finding may be explained by prosthetic components obscuring this region or the more severe bone defects in this region. The addition of CT scans did not improve reliability. Further testing of reliability with observers from other institutions is necessary, as well as validity testing, by testing the classification in relation to intraoperative findings.

Level of Evidence
Level III, diagnostic study.
Suggested Training and Experience Qualifications for Health and Safety Officers During a Radiological Incident
Authors: Karam P. Andrew 
Published: December 2019

Abstract
During the response to any large-scale emergency, it is not unusual for emergency response organizations to assign Health and Safety Officer (HSO) duties to a qualified person who is responsible for seeing to the health and safety of personnel from their organization during all phases of the emergency response. This would likely occur during response to radiological and/or nuclear emergencies. Most emergency responders, however, have little formal training (and even less experience) in radiation safety. Thus, during a radiological or nuclear emergency, these HSOs are likely to lack the training and experience to prioritize radiological hazards compared to other risks present at the scene. A properly structured training program that includes both classroom and practical training will help to address this lack and will help those who complete it to see to the safety of their charges, even during a complex radiological or nuclear incident.
BLOOD PRESSURE VARIABILITY IN PATIENTS WITH BRANCH RETINAL VEIN OCCLUSION
Authors: Gulmez Mehmet , Tekce Abdulhakim 
Published: December 2019

Purpose:
To evaluate short-term blood pressure variability over 24 hours in patients with branch retinal vein occlusion (BRVO) versus controls.

Methods:
A sample of 80 patients with BRVO (i.e., Group 1) and 75 controls (i.e., Group 2) was formed for a prospective, cross-sectional, comparative, case–control study. In a 24-hour period, each participant's blood pressure was measured by ambulatory monitoring every 15 minutes during the day and every 30 minutes at night. Mean values of systolic blood pressure (SBP), diastolic blood pressure (DBP), arterial blood pressure (ABP), and a variability index recorded during the day, at night, and throughout the 24-hour period were subjected to statistical analyses.

Results:
Mean daytime, night-time, and 24-hour SBP, DBP, and ABP values did not significantly differ between the groups. However, mean variability index values of daytime, night-time, and 24-hour SBP, DBP, and ABP significantly increased in patients with BRVO versus controls. Multivariate logistic regression analyses revealed that 24-hour blood pressure variability in each of SBP, DBP, and ABP was an independent determinant of BRVO.

Conclusion:
Because the daytime, night-time, and 24-hour blood pressure variability in SBP, DBP, and ABP was significantly greater among patients with BRVO than among controls, blood pressure variability could factor into the pathogenesis of BRVO.
Is It Possible to Predict Progression of Childhood Myopia Using Short-Term Axial Change After Orthokeratology?
Authors: Zhao Yingying , Hu Peike , Chen Duya , Ni Hailong 
Published: December 2019

Objectives:
To investigate changes in axial length in children undergoing orthokeratology (OK) and evaluate short-term axial change in predicting post-OK myopia progression.

Methods:
In this retrospective study, the subjects included 70 myopic children aged 8 to 15 years wearing OK contact lenses for more than 3 years. Axial length changes at 0.5, 1, 2, and 3 years relative to the baseline were measured. Patients were evaluated for age, spherical equivalent refraction (SER), pupil size, and half-year axial change using repeated analysis of variance and multivariate linear regression analysis to predict half to 3 year-axial elongation (AE, seventh–36th month post-OK).

Results:
The axial length grew significantly during the 3 years; the mean annual axial growth was 0.20±0.12 mm. The half-year axial change was 0.04±0.12 mm. The univariate linear analyses showed that half to 3-year AE was correlated with baseline age (r=−0.393, P<0.001) and half-year axial change (r=0.379, P=0.001), but not pupil diameter (P=0.692) or SER (P=0.673). In a multiple linear regression model, the half to 3-year AE was related with the baseline age (standardized β=−0.312, P=0.007) and half-year axial change (standardized β=0.293, P=0.01). The model was fair (adjusted R
2=0.21) and statistically significant (F=10.24, P<0.001).

Conclusions:
It is practical to predict long-term AE with half-year axial change for children with OK correction. Therefore, this may aid in fast and timely measures in children who are predicted to have rapid myopia progression.