bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human Hair as a Possible Surrogate Marker of Retained Tissue Gadolinium
Authors: Hasegawa Makoto , Duncan Brianne R. , Marshall Desiree A. , Gonzalez-Cuyar Luis F. , Paulsen Michael , Kobayashi Masahiro , Simpson Christopher , Maravilla Kenneth R. 
Published: May 2020

Objectives
We used laser ablation inductively coupled plasma mass spectrometry to quantify gadolinium in hair samples from autopsy cases with gadolinium-based contrast agent (GBCA) exposure. Hair gadolinium data were correlated with gadolinium concentrations in brain, skin, and bone tissues from the same case to investigate a potential noninvasive method for gadolinium quantification and monitoring.

Materials and Methods
Medical records from autopsy cases at our institution were screened for history of GBCA exposure. Cases with exposure to a single type of GBCA with the most recent injection occurring within 1 year were identified and included in the study. The concentration of gadolinium in hair samples was analyzed by laser ablation inductively coupled plasma mass spectrometry, and brain (globus pallidus, dentate nucleus, white matter), bone, and skin tissues were analyzed by bulk inductively coupled plasma mass spectrometry. The mean of the maximum value in the hair samples was used to generate a representative measurement of the hair gadolinium concentration for each case. A linear regression analysis between each tissue type and hair was conducted to assess for possible correlation.

Results
Tissue and hair samples from 18 autopsies (16 cases with exposure to GBCA, 2 controls) were included in the study. Comparing the different tissues revealed good correlation between some tissue types. The best model fit occurred between white matter and hair (R
2 = 0.83; P < 0.0001) followed by the comparison between dentate nucleus and hair (R
2 = 0.72; P < 0.0001) and dentate nucleus and skin (R
2 = 0.70; P < 0.0001).

Conclusions
A significant correlation in this study between hair gadolinium concentrations and brain and skin gadolinium concentrations suggests that hair may serve as a safe and effective biomonitoring tissue for patients who receive GBCA injections.
FDG PET/CT in a Pregnant Woman With Breast Cancer
Authors: Drouet Clément , Vrigneaud Jean-Marc , Desmoulins Isabelle , Cochet Alexandre 
Published: May 2020

Abstract
This 37-year-old woman was diagnosed with breast cancer during pregnancy. After multidisciplinary meeting, she was referred to our department for an FDG PET/CT for staging, and chemotherapy with weekly infusion of paclitaxel was initiated before childbirth. We estimated the fetal dose from the PET/CT procedure, and our results show that, if deemed necessary, this examination can reasonably be performed during pregnancy. The patient gave birth vaginally at term to an apparently healthy girl.
18F-FDG PET/CT in Sporadic Creutzfeldt-Jakob Disease
Authors: Zizi Ghali , Berger Henri , Lalire Paul , Dejust Sébastien , Morland David 
Published: May 2020

Abstract
We report the case of a 64-year-old man referred for optic ataxia, constructional apraxia, and spatial orientation disorders evolving for 2 months. Benson syndrome (posterior cortical atrophy) was initially suspected. Brain 18F-FDG PET/CT depicted an asymmetric decreased uptake pattern consistent with Creutzfeldt-Jakob disease. 14-3-3 proteins were detected in the cerebrospinal fluid. Clinical evolution was quickly unfavorable. The patient died 1 month after the PET/CT, and Creutzfeldt-Jakob disease was confirmed on postmortem examination of brain tissue.
Is It Time to Introduce PET/CT in Colon Cancer Guidelines?
Authors: Maffione Anna Margherita , Rubello Domenico , Caroli Paola , Colletti Patrick M. , Matteucci Federica 
Published: May 2020

Abstract
International colon cancer guidelines suggest 18F-FDG PET/CT in a few circumstances: (1) at disease presentation in case of suspected or proven metastatic synchronous adenocarcinoma; (2) in the workup of recurrent colon cancer with metachronous metastases documented by CT, MRI, or biopsy and in case of serial CEA elevation with negative colonoscopy and negative CT; and (3) in case of contraindication to iodine- and gadolinium-based contrast agents. However, review of the literature has shown that PET/CT can also be used in other scenarios with significant levels of diagnostic advantage. This review aims to emphasize differences between guidelines and scientific literature for the use of PET/CT in colon cancer.
Egested Feces Revealed Massive Protein Loss in 99mTc-HSA-D Scintigraphy
Authors: Matsusaka Yohji , Nakahara Tadaki , Iwabuchi Yu , Owaki Yoshiki , Narimatsu Hidetoshi , Jinzaki Masahiro 
Published: May 2020

Abstract
A 66-year-old man with severe diarrhea and severe hypoproteinemia was referred for 99mTc-DTPA-human serum albumin (HSA-D) scintigraphy. The scintigraphy at 24 hours postinjection showed strong accumulation of 99mTc-HSA-D in not only the colon but also all his diapers containing his egested feces. The ratio of the diapers counts to the total counts was 17.0%, and a considerable amount of protein loss was confirmed. 99mTc-HSA-D scintigraphy has an important role in diagnosing protein-losing enteropathy, but the abdomen is the only routinely scanned area. Additional scanning of egested radiotracer and the whole body can be useful for evaluating the disease severity.
Hepatobiliary Scintigraphy in Cholecystocolonic Fistula
Authors: Philip Justin T. , Noor Muhammad , Leyva Alexander , Contreras Francisco 
Published: May 2020

Abstract
We report a case of a 50-year-old man diagnosed with cholecystocolonic fistula (CCF), confirmed by scintigraphy. After negative initial radiologic workup, a colonoscopy revealed findings of right-sided ischemic colitis. Soon after, a febrile episode prompted a repeat abdominal CT scan demonstrating a possible CCF, later confirmed with a nuclear medicine hepatobiliary scintigraphy and treated surgically. Less than 10% of CCFs are diagnosed preoperatively.
Vanishing Bone Metastases in 18F-FDG PET/CT
Authors: Ainouche Alida , Morland David , Durot Carole , Hoeffel Christine , Papathanassiou Dimitri 
Published: May 2020

Abstract
A 36-year-old woman with a history of large B-cell lymphoma was referred for the exploration of sclerotic bone thoracic vertebral metastases discovered on a contrast-enhanced CT examination. 18F-FDG PET showed no pathological uptake in the affected vertebrae, as well as normal vertebral density on the coupled unenhanced CT. After review of the initial contrast-enhanced CT, a left brachiocephalic vein stenosis was noted, leading to a retrograde contrast filling of the accessory hemiazygos vein and the capillary spaces within the vertebrae, mimicking sclerotic metastases.
Alternative Perforator Options for Insufficient Profunda Artery Perforators
Authors: Winters Harm , Tielemans Hanneke J. P. , van Wegen Marsha , Hupkens Pieter , Slater Nicholas J. , Ulrich Dietmar J. O. 
Published: May 2020

Introduction
The profunda artery perforator (PAP) flap can be an alternative to the deep inferior epigastric artery flap. However, in some cases, the PAP may not be adequate to perfuse the whole flap. In this study, we describe 3 cases in which an alternative perforator was used for PAP flap perfusion. In addition, we describe an anatomical study to explore the perforasome of the PAP and alternative perforators.

Materials and Methods
Three cases are described in which an alternative perforator was used to successfully perfuse the pap flap. For the anatomical study, 7 PAP flaps were raised from cadavers. Ink was injected in the PAP, the gracilis perforator (GP) and the descending branch of the inferior gluteal artery perforator (DBIGA). Then, perfused area of the flap by each perforator was calculated.

Results
The 3 patients with alternative perforators recovered without complications, in addition, no signs of fat necrosis were observed. Concerning the anatomical study, mean perfusion area of the PAP pedicle was 204 ± 90 cm2 (range, 141–364 cm2). The GP and the DBIGA had a perfusion area of 182 ± 42 cm2 (range, 123–235 cm2) and 157 ± 22 cm2 (range, 136–192), respectively.

Conclusion
Although the PAP flap has considerable benefits over the more traditional inferior gluteal artery perforator and transverse upper gracilis flaps, a plastic surgeon might encounter a PAP flap perforator that is not deemed viable for flap perfusion. In these cases, the GP and DBIGA may be suitable “escape” alternatives to complete the reconstruction.
Reconstruction of Complex Abdominal Wall Defect With Autogenous Pedicled Demucosalized Seromuscular Flap
Authors: Asaad Malke , Vyas Krishna S. , Tran Nho V. 
Published: May 2020

Abstract
Abdominal wall reconstruction is indicated when 1 or more of the abdominal wall components (skin, fascia, or muscle) are either injured or absent. When faced with defects requiring flap reconstruction, the decision regarding flap choice should take into consideration the volume of soft tissue required, the extent of the defect, donor site morbidity, and prior surgical scars that affect flap vascularity. We present a case of an abdominal wall defect with limited reconstructive options in which a spare ileal bowel segment was filleted to create a seromuscular flap for improving the abdominal wall blood supply. The postoperative course was complicated by abdominal fluid collection, which resolved following an ultrasound-guided drain. The patient had normal wound healing and recovery without further postoperative complications at the 7-month follow-up. Seromuscular flaps are a practical option in the armamentarium of plastic surgeons performing abdominal wall reconstruction, especially when other alternatives are limited.
Thermoneutral Housing Temperature Improves Survival in a Murine Model of Polymicrobial Peritonitis
Authors: Carpenter Kelsey C. , Zhou Yesen , Hakenjos John M. , Fry Christopher D. , Nemzek Jean A. 
Published: May 2020

ABSTRACT
Regulatory guidelines mandate housing for laboratory mice at temperatures below their thermoneutral zone, creating chronic cold stress. However, increases in housing temperature could alter immune responses. We hypothesized housing mice at temperatures within their thermoneutral zone would improve sepsis survival and alter immune responses. Male C57BL/6 mice were housed at 22°C or 30°C after cecal ligation and puncture (CLP) for 10 days. Survival of mice housed at 30°C (78%) after CLP was significantly increased compared with mice housed at 22°C (40%). Experimental groups were repeated with mice euthanized at 0, 12, 24, and 48 h post-surgery to examine select immune parameters. Raising housing temperature minimally altered systemic, peritoneal, or splenic cell counts. However, IL-6 levels in plasma and peritoneal lavage fluid were significantly lower at 12 h post-surgery in mice housed at 30°C compared with 22°C. Bacterial colony counts from peritoneal lavage fluid were significantly lower in mice housed at 30°C and in vivo studies suggested this was the result of increased phagocytosis by neutrophils. As previously demonstrated, adoptive transfer of fibrocytes significantly increased sepsis survival compared with saline at 22°C. However, there was no additive effect when adoptive transfer was performed at 30°C. Overall, the results demonstrated that thermoneutral housing improves survival after CLP by increasing local phagocytic activity and technical revisions may be necessary to standardize the severity of the model across different housing temperatures. These findings stress the pronounced impact housing temperature has on the CLP model and the importance of reporting housing temperature.
Fibrinogen Activates PAK1/Cofilin Signaling Pathway to Protect Endothelial Barrier Integrity
Authors: Wu Feng , Chipman Amanda , Dong Jing-Fei , Kozar Rosemary Ann 
Published: May 2020

ABSTRACT

Introduction:
We recently demonstrated that fibrinogen stabilizes syndecan-1 on the endothelial cell (EC) surface and contributes to EC barrier protection, though the intracellular signaling pathway remains unclear. P21 (Rac1) activated kinase 1 (PAK1) is a protein kinase involved in intracellular signaling leading to actin cytoskeleton rearrangement and plays an important role in maintaining endothelial barrier integrity. We therefore hypothesized that fibrinogen binding to syndecan-1 activated the PAK1 pathway.

Methods:
Primary human lung microvascular endothelial cells were incubated in 10% lactated Ringers (LR) solution or 10% fibrinogen saline solution (5 mg/mL). Protein phosphorylation was determined by Western blot analysis and endothelial permeability measured by fluorescein isothiocyanate (FITC)-dextran. Cells were silenced by siRNA transfection. Protein concentration was measured in the lung lavages of mice.

Results:
Fibrinogen treatment resulted in increased syndecan-1, PAK1 activation (phosphorylation), cofilin activation (dephosphorylation), as well as decreased stress fibers and permeability when compared with LR treatment. Cofilin is an actin-binding protein that depolymerizes F-actin to decrease stress fiber formation. Notably, fibrinogen did not influence myosin light chain activation (phosphorylation), a mediator of EC tension. Silencing of PAK1 prevented fibrinogen-induced dephosphorylation of cofilin and barrier integrity. Moreover, to confirm the in vitro findings, mice underwent hemorrhagic shock and were resuscitated with either LR or fibrinogen. Hemorrhage shock decreased lung p-PAK1 levels and caused significant lung vascular leakage. However, fibrinogen administration increased p-PAK1 expression to near sham levels and remarkably prevented the lung leakage.

Conclusion:
We have identified a novel pathway by which fibrinogen activates PAK1 signaling to stimulate/dephosphorylate cofilin, leading to disassembly of stress fibers and reduction of endothelial permeability.
Current Evidence for Minimally Invasive Surgery During the COVID-19 Pandemic and Risk Mitigation Strategies
Authors: Chadi Sami A. , Guidolin Keegan , Caycedo-Marulanda Antonio , Sharkawy Abdu , Spinelli Antonino , Quereshy Fayez A. , Okrainec Allan 
Published: May 2020

Objective:
Our objective was to review the literature surrounding the risks of viral transmission during laparoscopic surgery and propose mitigation measures to address these risks.

Summary Background Data:
The SARS-CoV-2 pandemic has caused surgeons the world over to re-evaluate their approach to surgical procedures given concerns over the risk of aerosolization of viral particles and exposure of operating room staff to infection. International society guidelines advise against the use of laparoscopy; however, the evidence on this topic is scant and recommendations are based on the perceived most cautious course of action.

Methods:
We conducted a narrative review of the existing literature surrounding the risks of viral transmission during laparoscopic surgery and balance these risks against the benefits of minimally invasive approaches. We also propose mitigation measures to address these risks that we have adopted in our institution.

Results and Conclusion:
While it is currently assumed that open surgery minimizes operating room staff exposure to the virus, our findings reveal that this may not be the case. A well-informed, evidence-based opinion is critical when making decisions regarding which operative approach to pursue, for the safety and well-being of the patient, the operating room staff, and the healthcare system at large. Minimally invasive surgical approaches offer significant advantages with respect to both patient care, and the mitigation of the risk of viral transmission during surgery, provided the appropriate equipment and expertise are present.
Live Donor Liver Transplantation in the United States: Impact of Share 35 on Live Donor Utilization
Authors: Braun Hillary J. , Dodge Jennifer L. , Grab Joshua D. , Schwab Marisa E. , Liu Iris H. , Glencer Alexa C. , Stock Peter G. , Hirose Ryutaro , Roberts John P. , Ascher Nancy L. 
Published: May 2020

Background.
Share 35 was a policy implemented in 2013 to increase regional sharing of deceased donor livers to patients with model for end-stage liver disease ≥ 35 to decrease waitlist mortality for the sickest patients awaiting liver transplantation (LT). The purpose of this study was to determine whether live donor liver transplantation (LDLT) volume was impacted by the shift in allocation of deceased donor livers to patients with higher model for end-stage liver disease scores.

Methods.
Using Network for Organ Sharing/Organ Procurement and Transplantation Network Standard Transplant Analysis and Research files, we identified all adults who received a primary LT between October 1, 2008, and March 31, 2018. LT from October 1, 2008, through June 30, 2013, was designated as the pre-Share 35 era and July 1, 2013, through March 31, 2018, as the post-Share 35 era. Primary outcomes included transplant volumes, graft survival, and patient survival in both eras.

Results.
In total, 48 779 primary adult single-organ LT occurred during the study period (22 255 pre-Share 35, 26 524 post). LDLT increased significantly (6.8% post versus 5.7% pre, P < 0.001). LDLT volume varied significantly by region (P < 0.001) with regions 2, 4, 5, and 8 demonstrating significant increases in LDLT volume post-Share 35. The number of centers performing LDLT increased only in regions 4, 6, and 11. Throughout the 2 eras, there was no difference in graft or patient survival for LDLT recipients.

Conclusions.
Overall, LDLT volume increased following the implementation of Share 35, which was largely due to increased LDLT volume at centers with experience in LDLT, and corresponded to significant geographic variation in LDLT utilization.
Variations in secondary health resource utilisation post Clozapine initiation
Authors: de Silva Prasanna N. 
Published: May 2020

AbstractThis study looks at secondary care utilisation metrics as an effectiveness indicator of Clozapine initiation in 89 patients over the following year compared to the year prior to initiation. It was found that there was an overall reduction of outpatient use and crisis activity, with a marginal drop in bed usage. Medical outpatient use increased, as did physical health monitoring. Overall, compared with costs over the year preceding Clozapine initiation, an estimated saving per patient of £1800 was estimated over the first year post initiation, increasing to £3100 per patient if those with premorbid dissocial and substance misuse traits were excluded, raising the issue of better treatment targeting.
Glial Hedgehog and lipid metabolism regulate neural stem cell proliferation inDrosophila
Authors: Dong Qian , Zavortink Michael , Froldi Francesca , Golenkina Sofya , Lam Tammy , Cheng Louise Y. 
Published: May 2020

AbstractThe final size and function of the adult central nervous system (CNS) is determined by neuronal lineages generated by neural stem cells (NSCs) in the developing brain. InDrosophila, NSCs called neuroblasts (NBs) reside within a specialised microenvironment called the glial niche. Here, we explore non-autonomous glial regulation of NB proliferation. We show that lipid droplets (LDs) which reside within the glial niche are closely associated with the signalling molecule Hedgehog (Hh). Under physiological conditions, cortex glial Hh is autonomously required to sustain niche chamber formation, and non-autonomously restrained to prevent ectopic Hh signalling in the NBs. In the context of cortex glial overgrowth, induced by Fibroblast Growth Factor (FGF) activation, Hh and lipid storage regulators Lsd-2 and Fasn1 were upregulated, resulting in activation of Hh signalling in the NBs; which in turn disrupted NB cell cycle progression and reduced neuronal production. We show that the LD regulator Lsd-2 modulates Hh’s ability to signal to NBs, and de novo lipogenesis gene Fasn1 regulates Hh post-translational modification via palmitoylation. Together, our data suggest that the glial niche non-autonomously regulates NB proliferation and neural lineage size via Hh signaling that is modulated by lipid metabolism genes.
Use and abuse of potential rates in soil microbiology
Authors: Hazard Christina , Prosser James I. , Nicol Graeme W. 
Published: May 2020

AbstractPotential rate assays are used in soil microbial ecology to determine the rates of a functional process in environmental samples under a defined set of conditions. While they can be used appropriately to provide mechanistic insights, potential rates are also often used to estimate the abundance of specific taxonomic groups and theirin situactivity. These estimates incorrectly assume that all contributing organisms in a community are active at a maximum rate under one set of ‘optimal’ incubation conditions and that potential rates reflect activity in the soil. While investigators now recognise that populations within communities are physiologically diverse, they often ignore the consequent suboptimal activity, or even inactivity, of the majority of community members performing that function. In this short perspective article, we discuss when potential assays can be informative and highlight the underlying conceptual problems under circumstances where potential assays are misused, using potential nitrification rate (PNR) as an example. PNR was originally developed to estimate the size of active ammonia oxidising communities in environmental samples. It is routinely determined in short-term shaken slurry incubations by measuring assumed maximum rates of nitrate or nitrite production under optimal, non-substrate-limiting conditions. As with other functional processes, it is now recognised that a broad diversity of organisms contribute to aerobic ammonia oxidation in terrestrial and other habitats, and this diversity represents a substantial range of physiologies, including variation in substrate affinity, ammonia tolerance, cell specific activity and substrate preference. Despite this, PNR, and other potential rate assays, are often inappropriately used in an attempt to determine an ecologically relevant measurement of activity in soil. As with any potential assay, PNR has inherent biases towards particular functional groups and its use in investigating the ecology of ammonia oxidisers in natural systems should be carefully considered.
The desensitization pathway of GABAAreceptors, one subunit at a time
Authors: Gielen Marc , Barilone Nathalie , Corringer Pierre-Jean 
Published: May 2020

AbstractGABAAreceptors mediate most inhibitory synaptic transmission in the brain of vertebrates. Following GABA binding and fast activation, these receptors undergo a slower desensitization, whose conformational pathway remains largely elusive. To explore the mechanism of desensitization, we used concatemeric α1β2γ2 GABAAreceptors to selectively introduce gain-of-desensitization mutations one subunit at a time. A library of twenty-six mutant combinations was generated and their bi-exponential macroscopic desensitization rates measured. Introducing mutations at the different subunits shows a strongly asymmetric pattern with a key contribution of the γ2 subunit, and combining mutations results in marked synergistic effects indicating a non-concerted mechanism. Kinetic modelling indeed suggests a pathway where subunits move independently, the desensitization of two subunits being required to occlude the pore. Our work thus hints towards a very diverse and labile conformational landscape during desensitization, with potential implications in physiology and pharmacology.