bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early detection of hepatocellular carcinoma in patients with diabetes mellitus
Authors: Nouso Kazuhiro , Furubayashi Yoshie , Shiota Shohei , Miyake Nozomi , Oonishi Ayano , Wakuta Akiko , Kariyama Kazuya , Hiraoka Atsushi , Tsuji Kunihiko , Itobayashi Ei , Shimada Noritomo , Ishikawa Toru , Tada Toshifumi , Toyoda Hidenori , Kumada Takashi 
Published: January 2020

ObjectivesDiabetes mellitus is a risk factor for non-B, non-C hepatocellular carcinoma (NBNC-HCC); however, the number of diabetes mellitus patients is too large to examine tumor occurrence with periodic imaging modalities. Thus, the aim of this study was to develop a novel strategy for early detection of NBNC-HCC in diabetes mellitus patients.Patients and methodsNinety-three diabetes mellitus patients who had a single NBNC-HCC tumor less than 2 cm in diameter were selected from 6789 HCC patients. As controls, 172 tumor-free diabetes mellitus patients were enrolled. Characteristics were compared between groups. Furthermore, the efficacy of FIB4A, a new integrated score with FIB4 and alpha-fetoprotein, was analyzed as a marker for the early diagnosis of NBNC-HCC.ResultsAge, percentage of males, alcohol consumption, total bilirubin, transaminases, γ-glutamyl transpeptidase, FIB4 index, alpha-fetoprotein, and des-gamma-carboxy-prothrombin were higher in NBNC-HCC patients, whereas albumin and platelet counts were higher in the diabetes mellitus control group. Among these factors, the FIB4 index showed the highest odds ratio [OR: 20.0, 95% confidence interval (CI): 9.60–41.7] followed by alpha-fetoprotein (OR: 12.8, 95% CI: 6.53–25.4). A newly developed score, FIB4A, showed the highest area under the receiver operating characteristic curve (0.959) among the factors examined. The sensitivity was 86.2% at a Youden index cutoff (3.5) and it increased to 95.4%, while keeping high specificity (70.9%) when a cutoff of 2.5 was used.ConclusionFIB4A is a potential marker for early detection of NBNC-HCC in patients with diabetes mellitus. However, further studies are needed to confirm these findings.
Incidence rates and clinical characteristics of primary gastrointestinal non-Hodgkin lymphoma: a population study
Authors: Dizengof Vitaly , Levi Itai , Etzion Ohad , Fich Alexander , Blum Avital , Chertok Ilana R. Azulay , Ben-Yakov Gil , Rouvio Ory , Greenbaum Uri 
Published: January 2020

Background & Aims:After the rise of lymphoma incidence in the 1990’s, there is a paucity of epidemiologic studies describing the characteristics of primary gastrointestinal non-Hodgkin’s lymphoma (PGIL). This epidemiologic survey aims to identify recent trends in PGIL.Methods:A retrospective, population-based study describing adult patients with PGIL in the Israeli Negev region between 1998 and 2013.Results:131 patients were diagnosed with PGIL, representing an annual incidence rate of 22.42/100,000, compared to 35.87/100,000 in the overall Israeli population. Both incidence rates did not significantly change during the study period. The median age was 66 years, and the most common presentation was in the stomach (49.6%) and oral cavity (18.3%). Histologically, diffuse large B cell lymphoma (DLBCL) was predominant (55.0%). Most patients (66.4%) had early stage disease. Only T-cell lymphoma showed a male predominance (14.7% versus 5.4%,P=0.008). Fifty patients (44.2%) hadH. pyloritesting, and 35 (70.0%) were positive. Of these, 91.4% received eradication treatment, and 57.1% were negative thereafter.Most patients received CHOP or RCHOP protocols (16.0% and 48.1%, respectively). Complete response was achieved in 53.4%. Median follow-up was 48 months, and 62 patients (47.3%) died during the study period. Liver involvement had a worse prognosis, (33.0% 5-year survival) compared to upper and lower GI disease(70.5% and 46.8% respectively,P=0.003 for the comparison between liver and other locations). T-cell lymphoma had worse survival (11 months vs. not reached,P=0.003).Conclusions:This study demonstrates the incidence, and clinical characteristics of PGIL in the Negev region. It is important to identify disease characteristics, thus facilitating better disease detection and prognostication.
Role of intensive dietary and lifestyle interventions in the treatment of lean nonalcoholic fatty liver disease patients
Authors: Hamurcu Varol Pinar , Kaya Eda , Alphan Emel , Yilmaz Yusuf 
Published: January 2020

Background/aim
Although weight loss is recommended for the treatment of nonalcoholic fatty liver disease (NAFLD) in overweight and obese individuals, this treatment modality remains questionable in lean individuals. In this study, we investigated the effects of medical nutrition therapy (MNT) and intensive lifestyle interventions (ILIs) for NAFLD in lean versus obese patients.

Methods
In total, 35 patients (14 lean and 21 obese) were included in the study. All patients underwent transient elastography examinations, and controlled attenuation parameter (CAP) of >238 dB/m was indicative of hepatic steatosis. After 8 weeks of dietitian follow-up with MNT and ILI, the patients were compared with the baseline.

Results
Significant weight loss was recorded in both lean (5.4%) and obese patients (5.7%) with NAFLD. The mean BMI decreased from 23.9 (20.5–24.8) to 22.4 (19.5–24.2) kg/m2 (P = 0.001) in lean patients and from 34.0 (30.0–42.0) to 31.6 (26.9–42.5) kg/m2 (P < 0.001) in obese patients. The alanine aminotransferase level significantly decreased from 56 (15–163) to 28 (13–98) U/L (P = 0.010) in lean patients and from 27 (13–81) to 22 (13–46) U/L (P = 0.018) in obese patients. The median CAP decreased from 299 (246–360) to 236 (169–318) dB/m (P = 0.002) in lean patients and from 325 (258–400) to 253 (202–383) dB/m (P < 0.001) in obese patients. Moreover, remission of hepatic steatosis was detected in eight lean patients (57.1%) and eight obese patients (38.1%).

Conclusion
These results indicate that 5% body weight loss in effective in both obese and lean patients resulting in a similar NAFLD remission.
Combined use of rosuvastatin and ezetimibe improves hepatic steatosis in patients with dyslipidemia
Authors: Lee Won Dong , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Han Kwang-Hyub , Kim Seung Up 
Published: January 2020

Background and aims
Rosuvastatin plus ezetimibe are beneficial for the management of dyslipidemia. We investigated whether rosuvastatin plus ezetimibe improves hepatic steatosis in patients with dyslipidemia.

Methods
Between January and August 2018, 114 patients with dyslipidemia treated for 6 months with rosuvastatin plus ezetimibe were analyzed in this retrospective cohort study. The degree of hepatic steatosis was assessed using the hepatic steatosis index (HSI). Hepatic steatosis improvement and presence of fatty liver were defined as a ≥5% reduction in HSI score and HSI ≥36, respectively.

Results
The mean age of the study population (50 males and 64 females) was 57.4 years. At baseline, the mean BMI total cholesterol level, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, triglyceride level, and HSI were 25.1 kg/m2, 207.4 mg/dL, 126.1 mg/dL, 52.9 mg/dL, 146.4 mg/dL, and 36.1, respectively. During the 6-month treatment, hepatic steatosis burden was constant (mean HSI = 36.3 and 36.4 at 3 and 6 months, respectively). On multivariate analyses, ultrasonographic fatty liver and HSI ≥36 were selected as independent predictors of hepatic steatosis improvement. However, when 53 (46.5%) patients with fatty liver (HSI ≥ 36) were selected, hepatic steatosis burden was significantly improved (mean HSI = 40.8, 39.3, and 39.7 at baseline, 3 months, and 6 months, respectively).

Conclusions
The use of rosuvastatin plus ezetimibe for the management of dyslipidemia did not improve hepatic steatosis burden in all patients with dyslipidemia, but it improved hepatic steatosis burden in the subgroup with fatty liver.
Outcome of radioiodine therapy in thyroid cancer patients with recent contrasted computed tomography
Authors: Rodriguez Justin D. , Kirk Deepa , Benefield Thad , Maygarden Susan J. , Pou Karla , Kim Lawrence T. , Hackman Trevor G. , Khandani Amir H. 
Published: January 2020

Objective
To document the outcome of radioiodine therapy (RIT) in differentiated thyroid cancer (DTC) patients with recent contrasted computed tomography (CCT).

Methods
Eighteen patients with DTC and recent thyroidectomy who underwent RIT within 90 days after a CCT were included. Disease status following RIT and whether the expected response to RIT was achieved were documented. Disease status was classified into one of three categories based on the patient’s thyroglobuline level, radioiodine scan (RIS), and other imaging modalities: no evidence of disease (NED), microscopic residual disease (MRD), or gross residual disease (GRD). Expected response to RIT was based on the overall interpretation of the referring physicians of follow up thyroglobuline values, RIS findings and clinical assessment as reflected in progress notes. Follow-up stimulated thyroglobuline and (or) RIS was performed on average 10.8 months after RIT (median 12 months). The last progress note reviewed was on average 33.3 months after RIT (median 31 months).

Results
There were 12 patients with NED, two with MRD and four with GRD. Expected response to RIT was achieved in 17 patients. In one patient, the effectiveness of RIT could not be determined.

Conclusion
RIT in postthyroidectomy setting can be successfully performed within 90 days after CCT. Further research is needed to confirm our findings.
Study of novel deformable image registration in myocardial perfusion single-photon emission computed tomography
Authors: Ito Toshimune , Onoguchi Masahisa , Okuda Koichi , Shibutani Takayuki 
Published: January 2020

Objective
In the present study, deformable image registration (DIR) technology was applied to gated myocardial perfusion single-photon emission computed tomography (G-MPS) reconstructed images in distorting all image phases. We aimed to define a new method of end-diastole compatible image registration and verify the clinical usability for any cardiac volume.

Methods
Projection images were created using the Monte Carlo simulation. All image phases were shifted to fit the end-diastole phase by applying DIR to images that were reconstructed from projection images. Defect ratios were subsequently evaluated using the simulated images of the anterior wall simulated ischemia. Furthermore, receiver operating characteristic (ROC) analysis was performed for the clinical evaluation of DIR and nongated images. To this end, normal volume and small hearts of 33 patients without coronary artery disease and 55 with single vessel disease (coronary stenosis > 70%) were evaluated.

Results
Defect ratio analysis for voxel values of 25–100 were 75.7–21.3 for nongated and 74.7–15.6 for DIR images. For normal cardiac volume, the area under the ROC curve was 0.901 ± 0.088 for nongated and 0.925 ± 0.073 for DIR images (P = 0.078). Finally, for small cardiac volume, the area under the ROC curve was 0.651 ± 0.124 for nongated and 0.815 ± 0.119 for DIR (P < 0.01).

Conclusions
In the present study, we developed a new registration technique by applying DIR to G-MPS images. When optimal DIR conditions were applied, the resolution of G-MPS images was improved. Furthermore, the diagnostic ability was improved in cases of small cardiac volume.
Analysis of the Curative Effect of the Anterior Approach to the Lower Cervical Spine for Cervicothoracic Spinal Tuberculosis
Authors: Li Zhaowei , Li Kunxiang , Tang Baoming , Ren Rong , Zhang Yuan , Li Zeqing , Wang Zengdong , Zhang Xuebin 
Published: January 2020

Background:
The purpose of this study was to explore the clinical effect of the anterior approach to the lower cervical spine for cervicothoracic spinal tuberculosis (CTSTB).

Methods:
A total of 8 patients (6 males and 2 females) with CTSTB diagnosed by imaging examination and γ-interferon test, underwent the first stage lesion removal, bone grafting and internal fixation through the anterior approach to the lower cervical spine, were studied. Then, the clinical efficacy was evaluated using statistical analysis based on the materials about the Cobb angle of kyphosis, visual analog scale (VAS), Frankel grade, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Results:
All patients’ age ranged from 28 to 64 years (mean 46.2 ± 16.3). The mean operation time was 145 minutes (range 90–180 mins), intraoperative blood loss was 425 mL (range 200–1000 mL), and the average bone fusion time was 7.4 months. Postoperative neurological function of Frankel grading was significantly improved compared with that of preoperative. At final follow-up, the kyphosis angle was significantly decreased to 10 ± 2.1°, the mean VAS score was 1.6 ± 0.9 showing significant improvement, ESR and CRP returned to normal. The incidence of complications within 3 months after surgery was 25%, and the incidence of complications directly related to surgery was 12.5% (cerebrospinal fluid leakage).

Conclusion:
On the basis of familiarity with the anatomical structure and combining with the experience of the surgeon, the anterior approach to the lower cervical spine can be an effective treatment method for CTSTB.
Comparison of Different Intraarticular Injection Substances Followed by Temporomandibular Joint Arthroscopy
Authors: Sakalys Dovydas , Dvylys Dominykas , Simuntis Regimantas , Leketas Marijus 
Published: January 2020

Abstract
Nowadays, temporomandibular joint (TMJ) arthroscopies are often finished with intraarticular injections. There are a couple of different substances that can be injected into the articular cavity following arthroscopy; however, it is still unclear which one can help to reach the best clinical results.
The aim of this systematic review was to compare different substances that can be injected intraarticularly following TMJ arthroscopy to enhance clinical success.
A review protocol was registered in PROSPERO (Registration number: CRD42018114833). An electronic search was performed using PubMed, Cochrane Library, PlosOne, and Science Direct databases using a combination of the terms “temporomandibular” and “arthroscopy” to identify clinical trials published from 2009 until 2019. Mean differences of pain levels were evaluated in random-effect meta-analysis.
In total, 951 records were screened, of which only 3 fulfilled the inclusion criteria and were included into qualitative data synthesis, and only 2 articles were included into quantitative data analysis.
The results showed that subjects who received plasma rich in growth factors intraarticular injections had statistically significantly lower pain levels 18 months postoperatively than patients who received hyaluronic acid injections.
The results of the meta-analysis revealed that intraarticular injections followed by TMJ arthroscopy were more effective than arthroscopy alone in pain management (mean difference = −1.00, 95% confidence interval: −4.76 to 2.77, I
2 = 97% with significant heterogeneity).
The authors conclude that, although the sample is not extensive (only 3 studies), a tendency towards the superiority of plasma rich in growth factors over other treatments is seen in pain management of TMD.
Apert Syndrome Management: Changing Treatment Algorithm
Authors: Raposo-Amaral Cassio Eduardo , Denadai Rafael , Oliveira Yuri Moresco de , Ghizoni Enrico , Raposo-Amaral Cesar Augusto 
Published: January 2020

Background:
The purpose of this study is to review 10 years of surgical experience in the management of Apert syndrome, focusing on an updated algorithm which includes hand reconstruction and posterior vault distraction osteogenesis (PVDO). Additionally, the authors compare PVDO, which is currently used, with fronto-orbital advancement (FOA), which was utilized in a previous algorithm.

Methods:
An observational retrospective study was performed on consecutive patients with Apert syndrome who underwent upper and lower limb reconstruction and craniofacial surgery between 2007 and 2017. A modified Clavien–Dindo surgical complication scale was used to stratify complications between PVDO and FOA. Demographic, surgical, and outcome data was also recorded. The blood transfusion rate between PVDO and FOA was also assessed and compared utilizing the Student t test.

Results:
The present study included 69 patients with Apert syndrome (34 males and 35 females). Craniofacial surgeries were performed on a total of 38 patients. A total of 210 operations were performed on the respective upper and lower limbs of patients included in this study. A total of 18 patients underwent PVDO (n = 9) and FOA (n = 9). Posterior vault distraction osteogenesis required significantly less transfused blood volume than FOA (P < 0.05). Complication rate and length of hospital stay were similar for each procedure.

Conclusion:
An updated algorithm to treat Apert patients was implemented. Posterior vault distraction osteogenesis incorporated into an updated algorithm results in a lower blood transfusion rate.
Relationship Between Primary Acquired Nasolacrimal Duct Obstruction, Paranasal Abnormalities and Nasal Septal Deviation
Authors: Dikici Oğuzhan , Ulutaş Hafize Gökben 
Published: January 2020

Objectives:
This study aimed to investigate the relationship between nasal septal deviation and paranasal abnormalities in the etiology of primary acquired nasolacrimal duct obstruction (PANDO).

Methods:
A total of 37 (8 men, 29 women) patients (48 eyes with PANDO) between the ages 20 and 77 years (mean age, 52.8 ± 13.1 years) were included in the study. In the axial sections of paranasal sinus computed tomography, the transverse diameters at the most upper part and the most distal part of the nasolacrimal canal were separately measured. In addition, the relationships between PANDO and nasal septal deviation, inferior turbinate hypertrophy, agger nasi cells, paradoxical middle turbinate, concha bullosa, and the angle between the bony inferior turbinate and medial wall of the maxillary sinus were investigated.

Results:
A statistically significant relationship was found between PANDO and the axial location of septal deviation classification, axial angle of septal deviation classification, paradoxical middle turbinate, angle between the bony inferior turbinate and medial wall of the maxillary sinus and inferior meatus measure.

Conclusion:
The authors concluded that the location and angle of the nasal septal deviation in the axial plane, width of the angle between the bony inferior turbinate and medial wall of the maxillary sinus, inferior meatus measure, and paradoxical middle turbinate may be effective factors in the etiology of PANDO.
Cervical Spine Injuries in Pediatric Maxillofacial Trauma: An Under-Recognized Problem
Authors: Goodenough Christopher J. , Moffitt Joseph K. , Wainwright D’Arcy J. , Cantor Andrew D. , Nguyen Phuong D. , Teichgraeber John F. , Greives Matthew R. 
Published: January 2020

Abstract
Pediatric cervical spine injuries (CSI) are uncommon events, but can be devastating injuries. Facial fractures have been associated with injuries to the cervical spine in children, but may be deemed isolated facial fractures and bypass the standard trauma pathway. The objective of this study is to describe the mechanisms, associated injuries and outcomes of pediatric cervical spine injuries in patients with known maxillofacial trauma at a level 1 trauma center. An analysis was performed of all patients under the age of 18 with maxillofacial trauma admissions to a single level 1 trauma center, from 2006 to 2015. Patients were stratified based on the presence or absence of a cervical spine injury. Data was abstracted to include demographic, mechanism and clinical outcomes data. There were 1274 patients who were admitted with maxillofacial trauma during the study period. Of these, 72 (5.7%) experienced a cervical spine injury. Factors associated with cervical spine injuries include older age and penetrating mechanism. Cervical spine injuries were associated with concomitant traumatic brain injuries and skull fractures. Patients with spine injuries were more like to experience a longer length of stay and death. On multivariate analysis, only increased age predicted CSI. Our database demonstrated a 5.7% incidence of pediatric cervical spine injuries in patients with maxillofacial trauma. This incidence is higher than previously published reports of smaller cohorts. Clinicians must take care to stabilize the cervical spine in any patient with facial fractures, especially during work up and diagnostic maneuvers performed before spinal injuries are ruled out.
Single-Stage Reconstruction of Full-Thickness Nasal Alar Defect Using Bilobed and Turnover Flaps
Authors: Habib Bedwani Nader , Rizkalla Maged 
Published: January 2020

Abstract
Skin cancer of the nose remains a common challenge for the reconstructive surgeon with full-thickness defects being particularly problematic. Reconstruction of the internal nasal lining poses the greatest difficulty with local tissue often having unsatisfactory vascularity or surface area. We describe the reconstruction of a full thickness nasal alar defect in a patient after failed full-thickness skin graft using a single stage procedure combining a bilobed flap with a turnover flap. The patient achieved excellent initial and long-term cosmesis and functionality and was very satisfied with the results. We demonstrate that selected full-thickness nasal alar defects may be reconstructed in a single procedure using a carefully placed turnover flap for the internal nasal lining and bilobed flap for outer skin cover.
Endoscopic Removal of Huge Cholesterol Granuloma in the Maxillary Sinus Confused With Odontogenic Keratocyst
Authors: Kim Dong-Jo , Kim Sung-Dong , Kim Sang-Hoon , Cho Kyu-Sup 
Published: January 2020

AbstractCholesterol granuloma is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. Furthermore, a huge and aggressive cholesterol granuloma involving the maxillary sinus, hard palate, buccal space, and maxillary alveolus is extremely rare and has not been reported previously. This article reports a case of huge cholesterol granuloma in the maxillary sinus confused with an expansile odontogenic keratocyst, which was treated successfully via transnasal endoscopic approach.