bluuebunny/crossref_metadata_2025_split huggingface dataset:
Directionality of Lumbosacral Fractional Curve Relative to C7 Plumb Line, A Novel Index Associated with Postoperative Coronal Imbalance in Patients with Degenerative Lumbar Scoliosis
Authors: Zhang Jiandang , Wang Zheng , Chi Pengfei , Chi Cheng 
Published: November 2020

Study Design.
Retrospective case–control radiographic study.

Objective.
The aim of this study was to explore whether directionality of lumbosacral fractional curve relative to C7 plumb line (PL) affected postoperative coronal imbalance in patients with degenerative lumbar scoliosis (DLS).

Summary of Background Data.
The spatial relationship between lumbar main curve and C7 PL was reported to have impact on postoperative coronal imbalance in DLS. Although fractional curve played more important role than lumbar main curve in DLS, the spatial relationship between fractional curve and C7 PL and their impact on the postoperative coronal balance are still unknown.

Methods.
One hundred one DLS patients treated with posterior instrumented fusion were reviewed. Coronal measurements included C7 migration, fractional curve, L4/L5 coronal tilt, major Cobb angle. Based on directionality of fractional curve (orientation of L4 coronal tilt was used to represent it) relative to C7 PL preoperatively, coronal patterns was separated into: consistency pattern, L4 coronally tilts toward C7 PL; opposition pattern, L4 coronally tilts opposite C7 PL; the distributions of these two patterns and Type A, B,C were analyzed. According to postoperative C7 migration, patients were divided into imbalanced group and balanced group.

Results.
Compared to balanced group, the imbalanced group had higher percentage of preoperative consistency pattern (80.6% vs. 33.8%, P < 0.001) and Type C (36.1% vs. 7.7%, P < 0.001); larger fractional curve or L4 coronal tilt pre- and postoperatively, larger L5 coronal tilt postoperatively. Logistic regression analysis showed predictors for postoperative coronal imbalance were consistency pattern (odds ratio [OR] 5.103, 95% confidence interval [CI]: 1.660–15.687, P = 0.004) and type C (OR 4.061; 95% CI: 1.056–15.618; P = 0.041).

Conclusion.
Directionality of fractional curve relative to C7 PL was associated with postoperative coronal imbalance in DLS patients. In addition to type C, consistency pattern might be an independent risk factor for postoperative coronal imbalance.

Level of Evidence: 3
Bone Formation During Correction of Vertebral Rounding Deformity in a Rat Model of Pediatric Spondylolisthesis
Authors: Manabe Hiroaki , Yamashita Kazuta , Higashino Kosaku , Morimoto Masatoshi , Sugiura Kosuke , Ishihama Yoshihiro , Tezuka Fumitake , Takata Yoichiro , Sakai Toshinori , Sairyo Koichi 
Published: November 2020

Study Design.
A study using rat spondylolisthesis models.

Objective.
The aim of this study was to elucidate the mechanism for correction of vertebral rounding deformity.

Summary of Background Data.
Vertebral rounding deformity is the strongest risk factor for high-grade slippage associated with spondylolisthesis in adolescents. We previously reported that inadequate endochondral ossification of the anterior upper corner of the vertebral growth plate in response to mechanical stress could be the pathological mechanism of vertebral rounding deformity.

Methods.
We created a model of spondylolisthesis using 4-week-old rats. They were divided into a tail suspension group that underwent tail suspension to decrease mechanical stress starting at 2 weeks postoperatively and a ground control group with no intervention. Radiographs and microcomputed tomography scans were obtained once weekly for 6 weeks postoperatively. The lumbar spines were then harvested for histological analysis. Immunohistochemical studies detected types I, II, and X collagen in the growth plate cartilage. Bone histomorphometrical analysis was also performed.

Results.
Radiological and histological evidence in the ground control group showed progress the rounding deformity with time as previously reported. Formation of normal cancellous bone was observed radiologically over time in the tail suspension group, indicating correction of rounding deformity. Histologically, the site showing radiological evidence of correction was derived from cartilage tissue. After starting tail suspension, the growth plate stained positive for type X collagen and the corrected site stained for types II and X collagen in a mosaic pattern. Chondrocytes expressing types I and II collagen and tartrate-resistant acid phosphatase-positive cells were also present at the corrected site. Histomorphometrically, more endochondral bone was detected at the corrected site than in the posterior aspect of the normal growth plate.

Conclusion.
Correction of vertebral rounding deformity was associated with improvement of chondrocyte differentiation; furthermore, there is possible involvement of a third mechanism, namely transchondroid bone ossification.

Level of Evidence: N/A
Reliability and Validity of the Thai Version of the Swiss Spinal Stenosis Questionnaire
Authors: Wilartratsami Sirichai , Santipas Borriwat , Jerapornprapa Rutchchayuth , Vamvanij Visit , Luksanapruksa Panya 
Published: November 2020

The original Swiss Spinal Stenosis (SSS) questionnaire was translated into the Thai version and culturally adapt for use in Thailand. The Thai version—SSS is valid and reliable to use in both clinical and research to address the functional, symptom severity, and satisfaction in Thai lumbar spinal stenosis patients.

Study Design..
Cross-sectional study.

Objective..
To evaluate the reliability and validity of the Thai version of the Swiss Spinal Stenosis (SSS) questionnaire.

Summary of Background Data..
The SSS questionnaire was developed to assess symptom severity, physical functional status, and patient satisfaction in spinal stenosis patients that was previously reported to have good reliability and validity. There is currently no Thai version of the SSS questionnaire.

Methods..
The SSS questionnaire was translated into Thai language to create the Thai version of the Swiss Spinal Stenosis (Thai-SSS) questionnaire. Translation was performed according to international standards using a forward-backward translation protocol. Translation was performed by two expert translators and one physician, and the final version was approved by an expert committee. Thai patients with degenerative lumbar spinal stenosis were enrolled and evaluated using the Thai-SSS questionnaire, the Thai version of the Short Form-36 (SF-36), and a visual analogue scale (VAS) before and after treatment. Reliability and validity of the Thai-SSS were assessed via comparison with the SF-36 and the VAS.

Results..
One hundred seven patients were included. Eighty patients underwent decompression and fusion surgery, and the others underwent decompression alone. Cronbach's alpha of all domains of the Thai-SSS showed excellent internal consistency (0.869–0.921). The intraclass correlation coefficient for test–retest reliability was 0.77 (95% CI: 0.65–0.85). Regarding concurrent validity, the physical function scale of the Thai-SSS was strongly correlated with the physical functioning domain of the SF-36 (r = 0.70). The symptom severity domain of the Thai-SSS was strongly correlated with the bodily pain domain of the SF-36 and the VAS (r = 0.76 and 0.78, respectively).

Conclusion..
The Thai-SSS was found to be a valid and reliable tool for evaluating symptom severity, physical function, and patient satisfaction after treatment in Thai patients with spinal stenosis.

Level of Evidence: 4
Novel Mutations in UTS2R are Associated with Adolescent Idiopathic Scoliosis in the Chinese Population
Authors: Dai Zhicheng , Wang Yuwen , Wu Zhichong , Feng Zhenhua , Liu Zhen , Qiu Yong , Cheng Jack Chun-Yiu , Xu Leilei , Zhu Zezhang 
Published: November 2020

Study Design.
A case-control study.

Objectives.
To investigate the association of urotensin II (UTS2) signals with the susceptibility of adolescent idiopathic scoliosis (AIS) in the Chinese Han population.

Summary of Background Data.
Dysregulated UTS2 signals induced by impaired cerebrospinal fluid flow have been implicated in the development of idiopathic scoliosis through studies on zebrafish. Furthermore, mutations in urotensin II receptor (UTS2R) were reported to cause severe scoliosis in zebrafish. In spite of the evidence presented in animal models, there is still a lack of knowledge concerning the role of UTS2 signaling related genes in AIS.

Methods.
In the discovery stage, exons of UTS2, UTS2R, and UTS2D were sequenced for 200 AIS patients and 200 healthy controls. Newly identified mutations were further genotyped in another independent cohort of 1000 AIS patients and 1000 controls by allelic-specific multiple ligase detection reactions. Gene expression analysis was performed in 36 AIS patients and 36 age-matched congenital scoliosis patients. The Chi-square test was used to compare the genotyping data between the groups. Gene expression analysis was compared with the Student t test.

Results.
Association between two novel mutations (rs11654140, c.51T > C; rs568196624, c.1146C > G) and the development of AIS was identified. Allele C of rs11654140 and allele G of rs568196624 were significantly associated with the risk of AIS (1.5% vs. 0.5%, odds ratio = 3.02, P = 0.01 for rs11654140; 1.41% vs. 0.58%, odds ratio = 2.29, P = 0.04 for rs568196624). The mRNA expression of UTS2R in the AIS group was significantly higher as compared with that in the control group (0.059 ± 0.015 vs. 0.035 ± 0.013, P < 0.01).

Conclusions.
Rare mutations in UTS2R were significantly associated with AIS. Expression of UTS2R was significantly increased in AIS patients. The role of UTS2 signaling in the development of AIS is worthy of further investigation.

Level of Evidence: N/A
Body mass index is a promising predictor of response to oral rehydration saline in children with vasovagal syncope
Authors: Tao Chun-Yan , Chen Selena , Li Xue-Ying , Tang Chao-Shu , Du Jun-Bao , Jin Hong-Fang 
Published: November 2020

Abstract

Background:
Vasovagal syncope (VVS) greatly impairs quality of life. The therapeutic efficacy of oral rehydration saline (ORS) for unselected VVS patients is not satisfactory due to the diverse mechanisms of the disease. Body mass index (BMI) was demonstrated to reflect blood volume to a certain extent. Therefore, the present study explored the capability of BMI to predict the therapeutic response of children with VVS to ORS treatment.

Methods:
Seventy-four children with VVS who visited the Syncope Unit of Pediatrics at Peking University First Hospital from November 2010 to June 2019 receiving ORS treatment were enrolled for this retrospective case-control study. A comparison of demographic, clinical, and hemodynamic characteristics was performed between responders and non-responders. The correlation between baseline BMI and response time was analyzed. To determine the value of baseline BMI in predicting the therapeutic efficacy of ORS in children with VVS, a receiver operating characteristic curve analysis was performed.

Results:
Fifty-two children were identified as responders, and the remaining 22 children were identified as non-responders. The baseline BMI of the responders was much lower than that of the non-responders (16.4 [15.5, 17.8] kg/m2
vs. 20.7 ±e6 kg/m2, P < 0.001), and baseline BMI was positively correlated with response time in the head-up tilt test after adjusting for sex (r = 0.256, 95% confidence interval [CI]: 0.067–0.439, P = 0.029). The area under the receiver operating characteristic curve of baseline BMI was 0.818 (95% CI: 0.704–0.932, P < 0.001), and an optimal cut-off value of 18.9 kg/m2 yielded a sensitivity of 83% and a specificity of 73% to predict the efficacy of ORS in VVS.

Conclusion:
Prior to treatment, baseline BMI is a promising predictor of response to ORS in children with VVS.
NLRP3 inflammasome: a new therapeutic target for high-risk reproductive disorders?
Authors: Zhou Feng , Li Chao , Zhang Song-Ying 
Published: November 2020

Abstract
The NOD-like receptor protein 3 (NLRP3) inflammasome is a key regulator of the host's immune response, and many immune and metabolic disorders are linked to its activation. This review aimed to investigate and clarify the relationship between this inflammasome and high-risk reproductive disorders. Papers cited here were retrieved from PubMed up to August 2020 using the keywords “NLRP3” or “NALP3”, “caspase-1”, “endometriosis”, “gestational diabetes”, “interleukin (IL)-18”, “IL-1β”, “pre-eclampsia (PE)”, “preterm birth”, “polycystic ovarian syndrome (PCOS)”, “recurrent spontaneous abortion (RSA)”, and combinations of these terms. The results show that NLRP3 inflammasome is associated with various high-risk reproductive disorders and many inflammatory factors are secreted during its activation, such as IL-1β induced during the development of endometriosis. PCOS is also associated with activation of the NLRP3 inflammasome, especially in overweight patients. It also participates in the pathogenesis of RSA and is activated in fetal membranes before preterm birth. The placentas of pregnant women with PE show higher expression of the NLRP3 inflammasome, and gestational diabetes mellitus occurs simultaneously with its activation. Current evidence suggest that the NLRP3 inflammasome plays an important role in female reproductive disorders. New treatment and management methods targeting it might help reduce the incidence of such disorders and improve neonatal outcomes.
A Case of Eosinophilic Pustular Folliculitis Associated With Herpes Zoster
Authors: Lee Jae-Ho , Lee Soo-Kyung , Kim Joong-Ho , Kim Ho-Young , Kim Myoung-Shin , Lee Un-Ha 
Published: November 2020

Abstract:
Patients with eosinophilic pustular folliculitis (EPF), a sterile eosinophilic infiltration of hair follicles, often present with papulopustules that tend to form annular plaques. Histopathologic examination revealed eosinophilic infiltration around the pilosebaceous units and eosinophilic microabscess formation. Although the pathogenesis of EPF is unknown, T-helper type 2 immune responses were suggested to be important based on their stimulating effect on the sebaceous glands. Here, we report the first case of EPF associated with herpes zoster, indicating that herpes zoster and EPF are correlated with T-helper type 2 immune responses.
COVID Purpura (Toes) Case Series: A Chilblains-Like Vasculopathy
Authors: Olsen Thomas G. , Shrit M. Atef , Feeser Theresa A. , Wargo Jeffrey J. 
Published: November 2020

Abstract:
Biopsies were taken from 4 patients who presented to their dermatologist with violaceous papules and plaques of the dorsal toes (COVID Toes) associated with varying degrees of severe acute respiratory syndrome coronavirus 2 exposure and COVID-19 testing. Major histopathologic findings were lymphocytic eccrine inflammation and a spectrum of vasculopathic findings to include superficial and deep angiocentric–perivascular lymphocytic inflammation, lymphocytes in vessel walls (lymphocytic vasculitis), endothelial swelling, red blood cell extravasation, and focal deposits of fibrin in both vessel lumina, and vessel walls. Interface changes were observed to include vacuolopathy and apoptotic keratinocytes at the basement membrane. Immunostains showed a dominant T-cell lineage (positive for T-cell receptor beta, CD2, CD3, CD5, and CD7). B-cells were rare and clusters of CD123-positive dermal plasmacytoid dendritic cells were observed surrounding eccrine clusters and some perivascular zones. The consistent perieccrine and vasculopathic features represent important pathologic findings in the diagnosis of COVID toes and are suggestive of pathogenetic mechanisms. Clinicopathologic correlation, the epidemiological backdrop, and the current worldwide COVID-19 pandemic favor a viral causation and should alert the physician to initiate a workup and the appropriate use of COVID-19 testing.
Systematic Review: Effects of Pterygium and Pingueculum on the Ocular Surface and Efficacy of Surgical Excision
Authors: Linaburg Taylor , Choi Daniel , Bunya Vatinee Y. , Massaro-Giordano Mina , Briceño César A. 
Published: November 2020

Purpose:
This systematic review examines the specific effects of pingueculum and pterygium on the ocular surface and evaluates the efficacy of surgical excision in reversing those effects.

Methods:
A systematic review was performed according to the Preferred Reporting Items for the Systematic Review and Meta-Analyses statement and included 59 articles studying the effects of pterygium and pingueculum on the ocular surface as measured by tear break-up time (TBUT), Schirmer testing, tear osmolarity, Ocular Surface Disease Index (OSDI), and the effects of surgical removal on these ocular surface parameters.

Results:
In most studies, eyes with pterygium or pingueculum when compared with control eyes had a statistically significantly lower TBUT (average 3.72 s), lower Schirmer I without anesthesia (average 3.01 mm), lower Schirmer II (average 4.10 mm), higher tear osmolarity (average 12.33 mOsm/L), and higher OSDI (average 6.82 points). Moreover, excision of pterygium and pingueculum led to a statistically significantly higher TBUT (average 3.15 s higher at 1 mo postexcision), lower tear osmolarity (average 3.10 mOsm/L lower at 3 mo postexcision), and lower OSDI score (average 2.86 points lower 1 mo postexcision) in most of the studies. The effect of excision on Schirmer test scores was equivocal because most studies did not reach significance.

Conclusions:
Our data confirm the relationship between pterygium and pingueculum and abnormal tear function and symptoms of dry eye disease. Furthermore, the data suggest that tear film parameters might improve after surgical removal of pterygium or pingueculum. Future studies would be helpful in exploring the potential role of pterygium and pingueculum excision in the management of dry eye disease.
Long-Term Visual Outcomes and Clinical Course of Patients With Peters Anomaly
Authors: Elbaz Uri , Strungaru Hermina , Mireskandari Kamiar , Stephens Derek , Ali Asim 
Published: November 2020

Purpose:
To present long-term clinical and visual outcomes of patients with Peters anomaly.

Methods:
The charts of all patients diagnosed with Peters anomaly from January 2000 to December 2012 were reviewed retrospectively. Peters anomaly was classified as type I (with no lens involvement) or type II (presence of keratolenticular adhesions or cataract), with further severity grading to mild, moderate, and severe disease depending on corneal opacity location and size. Mild cases were observed. Moderate cases were managed with pupillary dilation either pharmacologically or surgically. Penetrating keratoplasty (PKP) was reserved for more severe opacity. The main outcome measures were final best spectacle-corrected visual acuity (BSCVA), incidence of glaucoma, graft survival, and nystagmus rates.

Results:
Sixty eyes of 40 patients were included in the study. The median age of patients at presentation was 0.5 ± 20.7 months (range, 0.0–111.0 months), with a mean follow-up time of 75.8 ± 52.9 months (range, 12.1–225.3 months). Overall, final best spectacle-corrected visual acuity ranged from 0.1 logMAR to no light perception with 33 eyes (55.9%) achieving vision of 1.0 logMAR or better. Clear grafts at the last follow-up were obtained in 67.6% (25/37) of transplanted eyes, 76.0% (19/25) in Peters type I, and 50.0% (6/12) in Peters type II (P = 0.11). The probability of a clear graft at 10 years was 74.2% and 38.9% for type I and type II, respectively. Glaucoma was diagnosed in 33.3% eyes, 90.0% of which occurred after PKP. Nystagmus was highly associated with PKP intervention, occurring in 81.1% (30/37) of eyes undergoing PKP compared with 34.8% (8/23) of eyes with no PKP (P = 0.0003).

Conclusions:
Visual rehabilitation in Peters anomaly remains a challenge, but outcomes can be optimized using a comprehensive clinical management algorithm according to disease severity.
Microthin Descemet Stripping Automated Endothelial Keratoplasty Versus Descemet Membrane Endothelial Keratoplasty: A Randomized Clinical Trial
Authors: Matsou Artemis , Pujari Rathin , Sarwar Hammad , Rana Mrinal , Myerscough James , Thomson Susan M. , Nandakumar Girinath , Zhang Jufen , Rajan Madhavan S. 
Published: November 2020

Purpose:
To compare visual outcomes, complications, and vision-related quality of life (QoL) after microthin Descemet stripping automated endothelial keratoplasty (MT-DSAEK) versus Descemet membrane endothelial keratoplasty (DMEK) for the management of corneal endothelial dysfunction in Fuchs dystrophy.

Methods:
This is a prospective, double-blinded randomized controlled clinical trial. Patients with visually significant endothelial decompensation from Fuchs dystrophy were prospectively randomized to receive MT-DSAEK or DMEK surgery. The primary outcome was best spectacle-corrected visual acuity (BSCVA) at 12 months. Secondary outcomes included refraction, keratometry, endothelial cell count, complications, and vision-related QoL at 6 and 12 months postoperatively.

Results:
A total of 56 eyes of 56 patients were enrolled, 28 in each group. Postoperatively, LogMAR mean BSCVA in the MT-DSAEK group was 0.17 ± 0.08 and 0.11 ± 0.09 at 6 and 12 months compared with 0.09 ± 0.13 and 0.04 ± 0.13 after DMEK (P = 0.03, P = 0.002 respectively) with the DMEK cohort achieving 3.5 logarithm of the minimum angle of resolution letters better BSCVA at 1 year compared with MT-DSAEK. Complication rates were similar with 3.5% rebubbling rate in both groups, 1 primary graft failure in DMEK and a single endothelial rejection in the MT-DSAEK arm. Vision-related QoL was comparable at 6 and 12 months postoperatively, and no eyes demonstrated loss of vision from preoperative BSCVA.

Conclusions:
DMEK surgery resulted in significantly better BSCVA at 1, 3, 6, and 12 months postoperatively compared with MT-DSAEK. Patient satisfaction was similar with no differences reported in vision-related QoL scores, as was the complications profile between groups. Thus, our results favor DMEK as the better choice procedure for eyes with Fuchs-related corneal decompensation without ocular comorbidities.
Sebaceous Gland Carcinoma: Influence of Age at Presentation on Outcomes
Authors: Kaliki Swathi , Morawala Ashi , Krishnamurthy Ajay , Divya Jajapuram Sai , Mohamed Ashik 
Published: November 2020

Purpose:
To assess the relationship between age at presentation and outcomes of patients with periocular sebaceous gland carcinoma.

Methods:
Retrospective case series of 241 patients.

Results:
Of 241 cases, 29 (12%) were young adults (≤40 years), 122 (51%) were middle-aged adults (41–60 years), and 90 (37%) were older adults (>60 years). Based on the eighth edition of American Joint Committee on Cancer, most tumors belonged to T1 category (n = 78, 32%) on presentation. Wide excisional biopsy was the most common treatment modality (n = 183, 79%). There were no statistically significant differences in the clinical presentation, treatment approaches, and histopathology features amongst different age groups, except pagetoid spread which was higher in middle-aged adults (61%, p = 0.004). The incidence of tumor recurrence was higher in older age group compared to younger age groups, with 5-year, 10-year Kaplan-Meier estimate at 31%, 31% in young adults, 38%, 38% in middle-aged adults, and 45%, 100% in older adults (p = 0.03), respectively. The 10-year Kaplan-Meier estimate rate of locoregional lymph node metastasis, systemic metastasis, and death was higher in young adults (51%, 48%, and 48%, respectively) compared to middle-aged (30%, 17%, and 12%, respectively) and older adults (24%, 25%, and 27%, respectively), but the differences were not statistically significant.

Conclusions:
There is no difference in the clinical presentation of periocular sebaceous gland carcinoma based on age. However, the tumor recurrence rate is much higher in the older age group and death higher in younger patients despite the same treatment strategies in all age groups.