bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic ultrasound-guided fine-needle aspiration vs fine-needle biopsy for the diagnosis of pancreatic neuroendocrine tumors
Authors: Eusebi Leonardo H. , Thorburn Douglas , Toumpanakis Christos , Frazzoni Leonardo , Johnson Gavin , Vessal Sheida , Luong Tu Vinh , Caplin Martyn , Pereira Stephen P. 
Published: October 2019

Abstract
Background and study aims Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a method of obtaining preoperative diagnosis of pancreatic neuroendocrine tumors (PanNETs) has been reported in several series. Fine-needle biopsies (FNB) are increasingly employed to obtain core specimens during EUS. However, the differences in efficacy between these sampling methods in the diagnosis of PanNETs still needs to be defined.
Patients and methods Over a 13-year period, all patients who underwent EUS-guided tissue sampling of suspicious pancreatic lesions with clinical, endoscopic and pathologic details were entered into an electronic database. Lesions underwent EUS-FNA or FNB sampling, or a combination of the two. The accuracy and safety of different EUS-guided sampling methods for confirmed PanNETs were investigated.
Results A total of 91 patients (M/F: 42/49, median age: 57 years), who underwent 102 EUS procedures had a final diagnosis of PanNET. Both EUS-guided sampling modalities were used in 28 procedures, EUS-FNA alone was used in 61 cases, while EUS-FNB alone in 13 cases. Diagnostic yield of EUS-FNA and EUS-FNB alone, including the inadequate specimens, was 77.5 % (95 %CI: 68.9 – 86.2 %) and 85.4 % (95 %CI: 74.6 – 96.2 %), respectively. The combination of both sampling modalities established the diagnosis in 96.4 % of cases (27/28) (95 %CI: 89.6 – 100 %), significantly superior to EUS-FNA alone (P = 0.023). Diagnostic sensitivity among the adequate samples for EUS-FNA, EUS-FNB and for the combination of the two methods was 88.4 % (95 %CI: 80.9 – 96.0 %), 94.3 % (95 %CI: 86.6 – 100 %) and 100 % (95 %CI: 100 – 100 %). There was one reported complication, a post-FNA bleeding, treated conservatively.
Conclusions EUS-FNB improves diagnostic sensitivity and confers additional information to cytological assessment of PanNETs.
Clinical and financial impacts of introducing an endoscopic mucosal resection service for treatment of patients with large colonic polyps into a regional tertiary hospital
Authors: Worland Thomas , Cronin Oliver , Harrison Benjamin , Alexander Linda , Ding Nik , Ting Alvin , Dimopoulos Stephanie , Sykes Racheal , Alexander Sina 
Published: October 2019

Abstract
Background and study aims Endoscopic mucosal resection (EMR) of large sessile or laterally spreading colonic lesions is a safe alternative to surgery. We assessed reductions in Surgical Resection (SR) rates and associated clinical and financial benefits following the introduction of an EMR service to a large regional center.
Patients and methods Ongoing prospective intention-to-treat analysis of EMR was undertaken from time of service inception in 2009 to 2017. Retrospective data for SR of large sessile/laterally spreading colonic lesions were collected for the period 4 years before commencement of the EMR service (2005 – 2008) and 9 years after its introduction (2009 – 2017).
Results From 2005 to 2008, 32 surgical procedures were performed for non-malignant colonic neoplasia (50 % male, median age 68 years, median Length of Stay (LoS) 10 days). Following the introduction of the EMR service, there was a 56 % reduction in the number of patients referred for surgery (32 surgical procedures, 47 % male, median age 70 years, median LoS 8.5 days). During this period, EMR was successfully performed in 183 patients with 216 lesions resected (60 % male, median age 68 years, median LoS 1 day). Compared to the SR group, the EMR cohort had a lower peri-procedural complication rate (7.7 % vs 54.7 %, P < 0.0001), and shorter average LoS (1 vs 9 days, P < 0.0001). A cost saving of AUD $ 19 543.5 was seen per lesion removed with EMR compared to SR.
Conclusions The introduction of a dedicated EMR service into a large regional center as an alternative to SR can lead to a substantial decrease in unnecessary surgery with subsequent clinical and financial benefits.
Endoscopic negative pressure therapy (ENPT) for duodenal leakage – novel repair technique using open-pore film (OFD) and polyurethane-foam drainages (OPD)
Authors: Loske Gunnar , Rucktaeschel Frank , Schorsch Tobias , Moenkemueller Klaus , Mueller Christian Theodor 
Published: October 2019

Abstract
Background and study aims Endoscopic negative pressure therapy (ENPT) is used to close transmural defects in the rectum and esophagus. Very few reports have described ENPT to manage duodenal defects. This study was designed to demonstrate ENPT in a population of 11 patients with transmural duodenal leakages.
Patients and methods The method of ENPT was adapted for duodenal use. Open-pore polyurethane-foam or a thin, open-pore double-layered film was wrapped around the distal end of a gastroduodenal tube. First, this open-pore element was placed on the inner wound in the duodenum with endoscopy. Second, continuous negative pressure of –125 mmHg was applied with an electronic pump. Drains were changed after 2 to 7 days.
Results Eleven patients were treated with duodenal leaks. Eight defects occurred after operative closure of perforated duodenal ulcers, papillectomy or stricturoplasty, one anastomotic leakage after Billroth – 1 distal gastric resection, one iatrogenic perforation in endoscopic retrograde cholangiopancreatography, and one by a surgical drain. Median duration of therapy was 11 days (range 7 – 24 days). Complete healing of defects was achieved in all patients.
Conclusion ENPT is an innovative endoscopic alternative for treatment of transmural duodenal defects.
Gastrointestinal involvement in patients with vasculitis: IgA vasculitis and eosinophilic granulomatosis with polyangiitis
Authors: Kawasaki Keisuke , Nakamura Shotaro , Esaki Motohiro , Kurahara Koichi , Eizuka Makoto , Okamoto Yasuharu , Hirata Takashi , Hirahashi Minako , Oshiro Yumi , Yanai Shunichi , Sato Kunihiko , Toya Yosuke , Maemondo Makoto , Terayama Yasuo , Sugai Tamotsu , Matsumoto Takayuki 
Published: October 2019

Abstract
Background and study aims Among vasculitides, IgA vasculitis (IgAV) and eosinophilic granulomatosis with polyangiitis (EGPA) frequently damage the gastrointestinal tract. However, only a few studies have investigated the entire gastrointestinal tract in patients with IgAV or EGPA by endoscopy. The aim of this study was to clarify endoscopic characteristics of patients with IgAV and those with EGPA.
Patients and methods Clinicopathological and endoscopic findings were retrospectively compared between 33 patients with IgAV and 19 patients with EGPA.
Results Gastrointestinal involvement was observed in 33 patients with IgAV (100 %) and in 8 patients with EPGA (42 %; P = 0.0001). Duodenal involvement was more frequent in patients with IgAV (75.8 %) than in those with EGPA (21.1 %, P = 0.0002). Jejunoileal involvement was frequent in both groups (IgAV 94.4 %; EGPA 77.8 %). Gastric mucosal erythema was more frequent in patients with IgAV (18.2 %) than in those with EGPA (0 %, P = 0.0481). Duodenal mucosal erythema (IgAV 54.6 %; EGPA 21.1 %, P = 0.0227), ulcer (IgAV 33.3 %; EGPA 0 %, P = 0.0041), and hematoma-like protrusion (IgAV 21.1 %; EGPA 0 %, P = 0.039) were more frequently observed in patients with IgAV than in those with EGPA.
Conclusions Frequent duodenal involvement, gastric mucosal erythema, and duodenal lesions including erythema, ulcer, and hematoma-like protrusion are characteristic of patients with IgAV. Because jejunoileal involvement was frequent in both groups of patients, small-bowel endoscopies should be performed for diagnosis of small-bowel lesions in patients with IgAV and EGPA.
Additional value of linked color imaging in colonoscopy: a retrospective study
Authors: Sakamoto Taku , Tomizawa Yutaka , Cho Hourin , Takamaru Hiroyuki , Sekiguchi Masau , Yamada Masayoshi , Matsuda Takahisa , Murakami Yoshitaka , Saito Yutaka 
Published: October 2019

Abstract
Background and study aims Linked color imaging (LCI), a newly developed optical modality, enhances mucosal surface contrast. We aimed to evaluate the efficacy and feasibility of insertion-phase LCI in terms of additional benefit of colorectal polyp detection over that obtained with white light imaging (WLI).
Patients and methods We consecutively enrolled eligible patients from November 2017 to June 2018. During colonoscopy, LCI or WLI was alternatively applied on scope insertion and LCI was applied on scope withdrawal. Patients were divided into two groups according to the protocolized difference of imaging modality used in the scope insertion phase (LCI and WLI groups). Group differences in clinical outcomes were evaluated.
Results A total of 138 patients were enrolled in this study, with equal numbers of patients assigned to the LCI and WLI groups. Most of the lesions located in the proximal colon were detected during the withdrawal phase, without a difference in proportions between the two groups. However, in the LCI group, eight of 49 lesions (16 %) located in the sigmoid and rectosigmoid colon were only detected during the insertion phase, and no such lesions (0 %) were detected during the insertion phase in the WLI group (P = 0.045).
Conclusions This study showed the efficacy and feasibility of LCI in improving colorectal polyp detection in the sigmoid colon, especially during insertion. Further studies are warranted to validate the results of our single-center study.
Visus und Gesichtsfeld bei Drusenpapillen
Authors: Kelbsch Carina , Sonntag Anton , Wilhelm Helmut , Tonagel Felix 
Published: October 2019

Zusammenfassung
Hintergrund Es wurde vermutet, dass die mit Drusenpapillen assoziierten Gesichtsfeldausfälle im Laufe des Lebens stetig langsam zunehmen oder aber in der Adoleszenz entstehen und sich im Laufe des Lebens nur unwesentlich verschlechtern. Wir überprüften diese Annahmen.
Material und Methoden Aus dem Patientenverwaltungssystem der Universitäts-Augenklinik Tübingen wurden 255 konsekutive Fälle mit Drusenpapillen identifiziert, die Richtigkeit der Diagnose verifiziert und, soweit vorhanden und qualitativ verwertbar, die Gesichtsfelder quantifiziert. Zusätzlich wurde der Visus ausgewertet.
Ergebnisse In 104 Fällen lagen beidseitig qualitativ gute, quantifizierbare Gesichtsfelder vor. Der Anteil an Patienten mit ausgeprägten Gesichtsfeldausfällen fiel insgesamt gering aus. Nur 3 Patienten zeigten beidseitig einen Gesichtsfeldverlust von ≥ 50%. Beide Augen waren meistens vergleichbar betroffen. Ein höheres Alter war mit größeren Gesichtsfeldausfällen korreliert. Lediglich 1 Patient (0,4%) erreichte beidseitig nicht den Visus 0,3.
Diskussion Anhand unseres Patientenkollektivs ist eine kontinuierliche leichte Verschlechterung des Gesichtsfelds mit dem Alter anzunehmen. Sehr ausgeprägte Gesichtsfeldausfälle waren selten. Dasselbe galt auch für den Visus, der erst im Alter ab 60 Jahren leichte Beeinträchtigungen aufwies.
Moderate-intensity Exercise Training in Sole and Simultaneous Forms with Insulin Ameliorates the Experimental Type 1 Diabetes-induced Intrinsic Apoptosis in Testicular Tissue
Authors: Samadian Zahra , Azar Javad Tolouei , Moshari Sana , Razi Mazdak , Tofighi Asghar 
Published: October 2019

AbstractThe aim of this study was to investigate the ameliorative effect of moderate-intensity exercise training in sole and simultaneous forms with insulin on experimental type 1 diabetes (T1D)-induced apoptosis. A total of 36 mature male Wistar rats were divided into six equally sized groups, including sedentary control (Con), moderate-intensity exercise training (E-sole), sedentary T1D-induced (D-sole), moderate-exercise-trained T1D-induced (DE), insulin-treated sedentary T1D-induced (DI) and exercise-trained, and insulin-treated T1D-induced (DEI) groups. The 6-week exercise training intervention was involved 30 min of moderate-intensity running on a treadmill once daily (5 days/week). Next, tubular differentiation (TDI) and spermiogenesis (SPI) indices were assessed. The Bcl-2, Bax and caspase-3 expressions were determined using RT-PCR, immunohistochemistry and western blot techniques. Finally, the TUNEL staining was used to analyze the apoptosis ratio. The moderate-intensity exercise training in the sole and when simultaneously considered with insulin (DEI) maintained testicular cellularity, up-regulated Bcl-2 expression, reduced Bax expression and ameliorated the diabetes-induced apoptosis. We failed to show remarkable alterations in caspase-3 mRNA and protein levels in the DE group versus D-sole animals. In conclusion, the moderate-intensity exercise training is able to potentially protect testicular cells from T1D-induced intrinsic apoptosis via up-regulating Bcl-2 and downregulating Bax expressions. Moreover, it amplifies the insulin-induced anti-apoptotic impacts.
Advanced multispectral image-processing endoscopy system for visualizing two-dimensional hemoglobin saturation and relative hemoglobin concentration
Authors: Chiba Toru , Obara Yoshimi , Murata Masaharu , Akahoshi Tomohiko 
Published: October 2019

Abstract
Background and study aims The association of tumor hypoxia and vascularization with malignant progression is recognized, and detection by measuring tissue hemoglobin (Hb) saturation and concentration has attracted attention. In this study, we designed a simple algorithm and multispectral image-processing endoscopy system to map relative Hb concentration and Hb saturation for detection of tumors in small animal viscera in vivo.
Materials and methods We designed and validated an optical filter-equipped endoscope system for two-dimensional visualization of Hb concentration and saturation maps and used it in a real-time video examination. A simplified method based on spectral data capture and analysis of defuse reflection of mucosa, including image capture and data processing of the spectral features of Hb oxygenation, was developed.
Results An Hb saturation calibration curve was obtained. Then, differences in oxygenation levels between normal mucosa and in vivo tumors in a small animal model were determined by using the new method and endoscope system.
Conclusions A multispectral image-processing endoscopic system with a mapping frame rate comparable to that of white light imaging systems (7.5 frames/second) was developed.
Update Breast Cancer 2019 Part 4 – Diagnostic and Therapeutic Challenges of New, Personalised Therapies for Patients with Early Breast Cancer
Authors: Schütz Florian , Fasching Peter A. , Welslau Manfred , Hartkopf Andreas D. , Wöckel Achim , Lux Michael P. , Janni Wolfgang , Ettl Johannes , Lüftner Diana , Belleville Erik , Kolberg Hans-Christian , Overkamp Friedrich , Taran Florin-Andrei , Brucker Sara Y. , Wallwiener Markus , Tesch Hans , Fehm Tanja N. , Schneeweiss Andreas , Müller Volkmar 
Published: October 2019

AbstractThe further development of therapies for women with early breast cancer is progressing far more slowly than in the case of patients with advanced breast cancer and is additionally delayed compared to developments in metastatic breast cancer. Nonetheless, significant advancements have been able to be recorded recently. This review summarises the latest developments in view of the most recent publications and professional conferences. For hormone-receptor-positive patients, new aspects for the duration of antihormone therapy and with regard to the benefits of multigene tests have been published. In the case of HER2-positive patients, the value of post-neoadjuvant therapy and de-escalation of the therapy is discussed. In patients with triple-negative breast cancer, there is a question of whether the knowledge of the biological background of a homologous recombination deficiency (HRD) helps develop new therapies for this subtype. In particular the “use” of a BRCA1/2 mutation or the biological characteristic HRD as a potential motive for therapy plays a role here in specifying the significance of platinum therapy and therapy with PARP inhibitors.
Small Fiber Neuropathy
Authors: Zhou Lan 
Published: October 2019

AbstractSmall fiber neuropathy (SFN) is common, and can be associated with many medical conditions. The majority of the patients with SFN suffer from painful paresthesia which can negatively impact their quality of life. Skin biopsy with intraepidermal nerve fiber density evaluation is the gold standard diagnostic test. Autonomic function testing is useful when autonomic symptoms are present. Screening for associated conditions should be done in every patient, even when a known underlying associated condition is present, before the neuropathy evaluation. Etiology-specific treatment, lifestyle modification, and pain control are the key elements of SFN management. This article will review the clinical presentation, skin biopsy procedure, utility of diagnostic tests, associated conditions, management, and prognosis of SFN.
Vasculitic Neuropathies
Authors: Beachy Nathaniel , Satkowiak Kelsey , Gwathmey Kelly Graham 
Published: October 2019

AbstractVasculitic neuropathies are disorders that result from inflammation in the peripheral nerves' vascular supply, resulting in ischemic injury. These disorders may be a result of systemic inflammation or may be confined to the peripheral nervous system. Causative etiologies include primary systemic vasculitis, vasculitis secondary to other conditions such as primary connective tissue disorders, infectious, paraneoplastic, and drug-induced conditions, and nonsystemic vasculitic neuropathy. Early recognition and treatment of these conditions is imperative to prevent substantial morbidity and mortality. The goal of this review is to provide an organization of the vasculitic neuropathies and an overview of principles of diagnosis and treatment for the clinical neurologist.
Neuropathy Associated with Systemic Amyloidosis
Authors: Kaku Michelle , Berk John L. 
Published: October 2019

AbstractPeripheral neuropathy occurs in the setting of both hereditary and acquired amyloidosis. The most common form of hereditary amyloidosis is caused by 1 of 140 mutations in the transthyretin (TTR) gene, which can lead to neuropathic hereditary transthyretin amyloidosis (hATTR; previously referred to as transthyretin familial amyloid polyneuropathy), whereas acquired immunoglobulin light chain (AL) amyloidosis is the most common acquired form. Patients typically present with a sensorimotor polyneuropathy, focal neuropathy such as carpal tunnel syndrome, or autonomic neuropathy. When neuropathy is the sole or dominant presenting symptom, the diagnosis is commonly delayed. With the advent of new drug therapies for AL amyloidosis and hATTR amyloidosis, including proteasome inhibitors, TTR silencers, and TTR protein stabilizers, the neurologist is uniquely positioned to diagnose neurologic manifestations of systemic amyloidosis, leading to earlier disease identification and treatment. This article reviews the epidemiology, clinical presentations, pathophysiology, diagnostic workup, and treatment of neuropathy in the setting of amyloidosis.
Inherited Neuropathies
Authors: Carroll Antonia S. , Burns Joshua , Nicholson Garth , Kiernan Matthew C. , Vucic Steve 
Published: October 2019

AbstractThe inherited neuropathies are a common and heterogeneous group of slowly progressive disorders affecting motor, sensory, and autonomic nerves. These hereditary conditions can be confined to the peripheral nervous system, termed the primary hereditary neuropathies, or can occur as part of a multisystem disease. Identification of systemic involvement is necessary to distinguish the primary and secondary hereditary neuropathies to prevent the misdiagnosis of potentially treatable entities. Recent genetic and technological advances have dramatically improved our understanding of the underlying pathophysiology of these inherited neuropathies and hence provide the correct milieu for the future development of disease-modifying therapies. This review provides clinical, neurophysiological, genetic, pathophysiological, and treatment insights into the primary inherited neuropathies, and those associated with multisystem diseases, including porphyria and mitochondrial disorders.
Dorsal Augmentation in Facial Profiloplasty
Authors: Jang Yong Ju , Yoo Shin Hyuk 
Published: October 2019

AbstractNasal profile line has central importance in forming an aesthetically balanced facial profile. Thus, rhinoplasty is a critically necessary surgery in shaping ideal profile line. For successful rhinoplasty, meticulous preoperative evaluation and proper planning should be performed before surgery. The nasal dorsum is the broadest and most prominent part of the nose; any minor imperfection is readily appreciated by an observer. Thus, dorsal augmentation is one of the most challenging areas in rhinoplasty as there is virtually no single ideal graft material and method for the nasal dorsum, which is free of aesthetic complication The surgeon should be able to discern the pattern of the abnormal nasal profile and to strategize the best possible surgical option to create a long-lasting, aesthetically pleasing dorsal line in good harmony with the overall facial profile. This study addresses our strategy to deal with various types of aesthetically unpleasant nasal profile line. The characteristics of augmentation materials and considerations in surgical technique are also addressed.
The Use of Spreader Grafts or Spreader Flaps—or Not—in Hump Reduction Rhinoplasty
Authors: Gerecci Deniz , Perkins Stephen W. 
Published: October 2019

AbstractHump reduction is one of the most common reasons patients seek cosmetic rhinoplasty. Spreader grafts or spreader flaps have become a key maneuver in supporting and reconstructing the nasal midvault after reductive profileplasty to prevent long-term functional and cosmetic sequelae. This article reviews the pertinent anatomy, describes indications for spreader graft or spreader flap placement, discusses surgical techniques and approaches for spreader graft placement, and describes complications of spreader graft use after hump reduction.
Reductive Nasal Profileplasty
Authors: Shadfar Scott 
Published: October 2019

AbstractReductive nasal profileplasty is often the pillar of aesthetic nasal surgery. The surgeon must be knowledgable in the key tenants of preoperative analysis and examination to better approach the core elements for hump takedown. Photo imaging or morphing is a practical and technically easy means to open the discussion with the patients to determine their specific goals and ensure that these goals align with their needs functionally. Various approaches can be taken dependent upon the demands from the patient's anatomy and surgical goals planned preoperatively. The component resection technique is described in detail, as well as discussions regarding the need to predict and prophylactically treat the possible long- and short-term sequelae that can occur with reductive nasal profileplasty. Complementary procedures should also be considered to achieve the most balanced nasal and facial aesthetic.
The Graduated Approach to Surgical Neck Contouring
Authors: Gerecci Deniz , Perkins Stephen W. 
Published: October 2019

AbstractAchieving a more youthful neckline is one of the most common reasons why patients seek facial plastic surgery. A variety of treatment options are available to contour the neck, ranging from injectable medications to minimally invasive energy devices to surgery. A spectrum of surgical procedures can be offered to contour the neck, including liposuction, submentoplasty, necklift, and facelift, all with or without implants. The ideal neck aesthetic, pertinent anatomy, patient evaluation process, indications, and techniques for the aforementioned procedures are discussed in this article. A graduated approach to neck contouring based on the senior author's long-term experience is provided.