bluuebunny/crossref_metadata_2025_split huggingface dataset:
COT-06 HBV REACTIVATION DURING AND AFTER THE TREATMENT OF MALIGNANT GLIOMA WITH TEMOZOLOMIDE
Authors: Kanamori Masayuki , Saito Ryuta , Uenohara Hiroshi , Tominaga Teiji 
Published: December 2019

Abstract

BACKGROUND
It has been reported that temozolomide treatment for malignant glioma can lead to the reactivation of Hepatitis B virus (HBV) and fulminant hepatitis. However, the frequency of HBV reactivation and the preventative effect of entecavir remains unclear. In this study, we retrospectively reviewed clinical features of the cases treated by temozolomide for malignant glioma, focusing on the reactivation of HBV and the effect of entecavir.

METHODS
We screened 129 cases with newly diagnosed and recurrent malignant glioma for HBs antigen, HBs antibody and HBc antibody before the administration of temozolomide. HBV-DNA were quantified by real-time PCR in the HBV carrier and the cases with occult HBV infection. HBV- DNA were monitored every 1–3 months by real-time PCR during temozolomide treatment and 12 months after completion of temozolomide. Entecavir were started before temozolomide treatment to the HB carrier, and if HBV-DNA became detectable at follow-up to the cases with occult HBV infection. Results 2 (1.5%) and 20 (15%) of 129 cases were HB carrier and had occult HBV infection, respectively. HBV- DNA in both of HB carrier turned negative after administration of entecavir, but transiently turned positive again during temozolomide treatment. In the cases with occult HBV infection, 4 (20%) patients had HBV reactivation. HBV- DNA turned negative after starting entecavir without liver dysfunction.

CONCLUSION
HBV carrier and the cases with occult HBV infection were not rare in Japan, and HBV reactivation developed frequently during temozolomide treatment. Because pharmacological prevention of HBV reactivation with entecavir was effective, the screening and monitoring is indispensable in the treatment of malignant glioma with temozolomide.
COT-12 CLINICAL MANAGEMENT AND TIMING OF SURGICAL TREATMENT FOR ASYMPTOMATIC GLIOMA
Authors: Matsuda Ryosuke , Morimoto Takayuki , Takeshima Yasuhiro , Tamura Kentaro , Yamada Shuichi , Nishimura Fumihiko , Nakagawa Ichiro , Motoyama Yasushi , Park Young-Su , Nakamura Mitsutoshi , Nakase Hiroyuki 
Published: December 2019

Abstract

BACKGROUND
In Japan, there are many cases where intracranial diseases are found accidentally due to the widespread use of MRI and brain check-up. Unruptured cerebral aneurysms and asymptomatic cerebral infarctions are often diagnosed, but asymptomatic glioma is rarely diagnosed. We analyzed the asymptomatic gliomas retrospectively among grade 2 or higher gliomas that had undergone diagnostic imaging or surgical treatment in our institution.

MATERIAL AND METHODS
Of 166 adults with grade 2 or higher grade glioma treated in our institution between 2007 and 2018, 15 cases were asymptomatic. Twelve cases were males and 3 were females, with an average age of 55.1 years (34–79 years). There were 7 cases found in brain check-up, 6 cases in the follow-up of other intracranial diseases, and 2 cases in migraine. Twelve patients, except 3 patients, have undergone surgical treatment, and the average time from an initial imaging to surgical treatment was 51.1 weeks (2 to 329 weeks). Eight patients were treated after radiological follow-up and 4 cases are treated within 2 months after the tumor was discovered. The pathological diagnosis was grade 2: 5 cases, grade 3: 2 cases, and grade 4: 5 cases. Three patients without surgical treatment were diagnosed as grade 2 on MRI. Six patients died during follow-up. The median survival time from the first surgical treatment for grade 3 and 4 glioma was 17 months.

CONCLUSION
Incidence of asymptomatic glioma is very rare. Even for asymptomatic gliomas, the prognosis is not so good due to malignant transformation and disease progression. It is important to explain the natural course of disease and treatment strategy accurately.
COT-14 CLINICAL FEATURES OF PEDIATRIC CENTRAL NERVOUS SYSTEM TUMORS
Authors: Higa Nayuta , Yonezawa Hajime , Uchida Hiroyuki , Oyoshi Tatsuki , Yoshimoto Koji 
Published: December 2019

Abstract

INTRODUCTION
Here,we discuss the presentation,histology,therapy,and outcome of central nervous system tumors in children.

METHODS
Treatment outcome and management was assessed for children diagnosed with central nervous tumors from 2007 to 2017 at Kagoshima University.

RESULTS
Eight-eight patients (56 boys,32 girls) with a mean age of 10.3 years were included in this study. Patient tumor types included: germ cell tumor (n = 26); medulloblastoma (n = 16); pilocytic astrocytoma (n = 8); glioblastoma (n = 8); ependymoma (n = 6,1 with grade 2,5 with grade 3); hemangioblastoma,schwannoma,and ganglioglioma (n = 3 each); SEGA,pilomyxoid astrocytoma,and diffuse astrocytoma (n = 2 each),and anaplastic astrocytoma,PPTID,PNET,PXA,DIA,central neurocytoma,astroblastoma,meningioma,and choroid plexus papilloma (n = 1 each). The most common patient clinical features were headache and vomiting associated with hydrocephalus. The median follow-up period was 61 months. All patients with germ cell tumors underwent adjuvant chemotherapy and radiation therapy (RT); patients with germinoma or immature teratoma were still alive,while patients with embryonal carcinoma,yolk sac tumor,or choriocarcinoma had poor prognosis with a median survival of 16 months. For cases of ependymoma,three patients received ICE chemotherapy and RT,and two patients received RT alone; median survival time was 31 months. For high grade glioma,seven patients received temozolomide and RT,and two patients received temozolomide alone; median survival time was 13 months.

CONCLUSIONS
Patients with germ cell tumors had a relatively good prognosis,while patients with ependymoma or high grade glioma had a poor prognosis. As treatment strategies for ependymoma and high grade glioma are currently limited,it is necessary to evaluate treatment options in consideration of clinical course and quality of life,in addition to histologic and genetic findings.
COT-16 INDICATION OF SYSTEMIC THERAPY FOR ELDER PATIENTS WITH BRAIN TUMORS: A SYSTEMATIC REVIEW AND PERSPECTIVE
Authors: Nakasu Yoko , Mitsuya Koichi , Nakasu Satoshi , Nozaki Kazuhiko 
Published: December 2019

Abstract

BACKGROUND
Little is known about indications and outcome prediction of systemic therapy for elderly patients with brain tumours. Clinical conditions of individuals are heterogenous from healthy to frail or diseased,moreover,are often reversible.

METHOD
We retrieved the literature of brain tumour,systemic therapy,chemotherapy,immunotherapy,in randomized controlled trials (RCTs) and reviews on PubMed database from 2008 to 2018.

RESULTS
1) Definition of elderly by age in years: Depending on each protocol,the definition is arbitrary. Patients older than 60 or 70 years are usually in the elderly group. 2) Systemic evaluation: Performance status (PS) and visceral function are not sufficient to assess elderly patients. Assessment tools specifically developed for the geriatric population are recommended to evaluate individual patients. 3) Effects and toxicity of systemic therapy: Only a few RCT showed no inferiority of outcome in patients older than 60 or 65 years. There are only few evidences about the senile fragility of blood-brain barrier or distribution of drugs in the elderly brain. Molecular subtyping of brain tumours might predict the effects and toxicities of therapies for elderly patients.

CONCLUSION
Feasibility of modern systemic therapies are not well studied for elderly patients with brain tumours. Clinical condition varies in individual elderly patients. We need prospective studies of systemic therapy in elderly patients based on an eligibility with not only chronologic age but comprehensive geriatric assessments.
COT-17 EFFECT OF BEVACIZUMAB AGAINST CYSTIC COMPONENT OF PRIMARY/METASTATIC BRAIN TUMORS
Authors: Yamasaki Fumiyuki , Takano Motoki , Yonezawa Ushio , Taguchi Akira , Onishi Shumpei , Kurisu Kaoru , Sugiyama Kazuhiko 
Published: December 2019

Abstract

BACKGROUND
Bevacizumab (BEV) improves the symptom via reducing the peritumoral edema and sometimes via reducing the size of brain tumor. However,the effect of BEV against cystic part of brain tumor has not been documented yet. In this report,we investigated the effect of BEV on cystic component of brain tumors.

MATERIALS AND METHODS
Our institutional review board approved this retrospective study. Between 2008 and 2018,139 patients with primary or metastatic brain tumor were treated with BEV in our Hospital. We defined cystic lesions as high intense lesion of size 1 cm or bigger on T2WI,and excluded necrotizing cysts and cystic changes in surgical resection cavity. The symptoms and images before and after administration of bevacizumab were evaluated. Changes in cyst size of brain tumor was evaluated as follows: CR (complete response=disappearance),PR (reduction by 50% or more),MR (reduction by 25–50%),SD (size change less than 25%),PD (increase by 25% or more). The effect of bevacizumab on tumor itself was determined according to RANO criteria.

RESULTS
Of the 139 patients,21 (15.1%) brain tumors had cystic component. The best response of cyst to BEV were as follows: CR 6,PR 7,MR 4,SD 4. The group of patients with progressively increasing cysts prior to BEV administration had significant cyst size reduction compared to stable cyst size groups at best response timing (mean 76.3% vs. 32.8%,P&lt;0.01). Patients with cyst showed significant improvement of symptoms after the treatment with BEV compared to patients without cyst (P&lt;0.01). However,response rate against tumor itself was not different between patients with or without cyst. Overall survival of glioblastoma patients after starting BEV was not different between tumor with cyst and without cyst.

CONCLUSION
BEV may be effective for patients who are symptomatic due to cystic enlargement.
Use of Ultraviolet Irradiation in Addition to Commonly Used Hospital Disinfectants or Cleaners Further Reduces the Bioburden on High-Touch Surfaces
Authors: Zeber John E , Coppin John D , Villamaria Frank C , Williams Marjory D , Copeland Laurel A , Chatterjee Piyali , Choi Hosoon , Jinadatha Chetan 
Published: December 2019

Abstract

Background
The reduction in microbial bioburden achieved by terminal disinfection in a hospital may vary considerably by type of disinfectant or cleaner and by environmental service (EVS) personnel. This study estimated whether supplemental ultraviolet (UV) irradiation after disinfection or cleaning reduced bioburden and whether the supplemental effect persisted after adjusting for disinfectant or cleaner type and EVS personnel.

Methods
Environmental samples for aerobic bacterial colonies (ABC) and methicillin-resistant Staphylococcus aureus (MRSA) were obtained from 5 high-touch surfaces in patient rooms at 3 time points: before manual cleaning, after manual cleaning using 1 of 3 disinfectants or 1 cleaner, and after UV irradiation.

Results
For ABC, the model-estimated mean (95% uncertainty interval) counts were 56% (48%–63%) lower for postmanual + UV compared with manual clean alone, and for MRSA they were 93% (62%–99%) lower for postmanual + UV vs manual clean alone.

Conclusions
Although UV supplementation provides incremental benefit in bioburden reduction across all cleaners or disinfectants tested, it provides the greatest benefit when supplementing cleaners or disinfectants with the lowest disinfection properties. UV irradiation provides additional bioburden reduction to manual cleaning or disinfection, even when accounting for variability introduced by different disinfectants and EVS personnel.
Between Art and Commerce: Women, Business Ownership, and the Arts and Crafts Movement*
Authors: Thomas Zoë 
Published: December 2019

Abstract
In art-historical works and social and cultural histories the Arts and Crafts movement is portrayed as an anti-commercial design reform movement that revolved around the workshops of a cadre of elite male ‘craftsmen’. But a confluence of elements during this era — developments in print culture; urbanization; mass consumerism; the women’s movement; reactions against industrialization; widespread interest in medievalism and domestic crafts — created an environment in which many more people became involved in the movement than is traditionally recognized. This research offers the first history of the emergence of women’s ‘artistic’ businesses across England, c.1870–1939. The article argues that the persistent focus on institutional hierarchies in histories of skilled work has led to a failure to consider the importance of rhetorical self-fashioning and the built environment in the construction of new cultural roles. Engrained disciplinary divides have also led to discrete bodies of scholarship on the history of artistic culture, ‘professional society’ and business ownership, which belie the interwoven nature of these categories in lived experience. Tracing the gendered strategies implemented by women business owners ultimately reveals their democratization of the movement to incorporate greater reception of domestic consumerism, ‘popular’ culture, and a wider range of incomes and interests.
SPOT REGION OF INTEREST IMAGING: A NOVEL FUNCTIONALITY AIMED AT X-RAY DOSE REDUCTION IN NEUROINTERVENTIONAL PROCEDURES
Authors: Borota Ljubisa , Patz Andreas 
Published: December 2019

Abstract
Aim of the study: The aim of this study was to describe a new functionality aimed at X-ray dose reduction, referred to as spot region of interest (Spot ROI) and to compare it with existing dose-saving functionalities, spot fluoroscopy (Spot F), and conventional collimation (CC). Material and methods: Dose area product, air kerma, and peak skin dose were measured for Spot ROI, Spot F, and CC in three different fields of view (FOVs) 20 × 20 cm, 15 × 15 cm, and 11 × 11 cm using an anthropomorphic head phantom RS-230T. The exposure sequence was 5 min of pulsed fluoroscopy (7.5 pulses per s) followed by 7× digital subtraction angiography (DSA) runs with 30 frames per DSA acquisition (3 fps × 10 s). The collimation in Spot F and CC was adjusted such that the size of the anatomical area exposed was as large as the Spot ROI area in each FOV. Results: The results for all FOVs were the following: for the fluoroscopy, all measured parameters for Spot ROI and Spot F were lower than corresponding values for CC. For DSA and DSA plus fluoroscopy, all measured parameters for Spot ROI were lower than corresponding parameters for Spot F and CC. Conclusion: Spot ROI is a promising dose-saving technology that can be applied in fluoroscopy and acquisition. The biggest benefit of Spot ROI is its ability to keep the entire FOV information always visible.
DEVELOPMENT OF A NEW SECONDARY STANDARD FOR H*(10)
Authors: Bairlein K , Behnke B , Hupe O 
Published: December 2019

Abstract
A secondary standard for ambient dose equivalent, H*(10), is necessary for the dissemination of the unit Sievert (Sv), but there is no such standard commercially available currently. Furthermore, the measurement of H*(10) instead of calculating H*(10) from air kerma and conversion coefficients is needed for unknown radiation fields. We developed a prototype of a new secondary standard for H*(10) based on a spherical 1 l ionization chamber for air kerma. This chamber was modified with copper wires at the inner surface to adjust the response of the chamber according to H*(10). Additionally, a Makrolon shell and an aluminium coating were added to optimize the response at energies below 50 keV. The prototype fulfils the requirements given in ISO 4037-2 in the energy range from 12 keV to 7 MeV. In combination with an electrometer, it can be used as area dosemeter, suitable for pulsed fields and for low energy radiation.
Iatrogenic Nerve Palsy Occurs With Anterior and Posterior Approaches for Humeral Shaft Fixation
Authors: Streufert Benjamin D. , Eaford India , Sellers Thomas R. , Christensen Joseph T. , Maxson Benjamin , Infante Anthony , Shah Anjan R. , Watson David T. , Sanders Roy W. , Mir Hassan R. 
Published: December 2019

Objective:To determine if surgical approach impacts the rate of nerve palsy after plate fixation of humerus shaft fractures and whether or not iatrogenic nerve palsy recovers in similar ways to preoperative palsy.Design:Retrospective.Setting:Two trauma centers.Patients:Patients 18+ years of age with nonpathologic, extra-articular humerus shaft fractures (OTA/AO 12A/B/C and 13A2-3) treated with plate fixation.Intervention:Plate fixation of humerus shaft fractures, from 2008 to 2016.Main Outcome Measurement:Rate of iatrogenic nerve palsy by a surgical approach and injury characteristics.Results:Two hundred sixty-one humeral shaft fractures were included. The rate of preoperative palsy was 19%. Radial nerve palsy (RNP) was present in 18%. Iatrogenic RNP occurred in 12.2% and iatrogenic ulnar palsy in 1.2%. Iatrogenic palsy occurred in 15.6% of middle and 15% of distal fractures, with fracture location significantly different in those developing RNP (P= 0.009). Iatrogenic RNP occurred in 7.1% of anterolateral, 11.7% of posterior triceps-splitting, and 17.9% of posterior triceps-sparing approaches (P= 0.11). Follow-up data were available for 139 patients at an average of 12 months. Preoperative RNP resolved less often than iatrogenic RNP, in 74% versus 95% (P= 0.06). Time to resolution was longer for preoperative RNP, at 5.5 versus 4.1 months (P= 0.91). Twenty-two percent with preoperative RNP underwent tendon transfer or wrist fusion, versus 0% after iatrogenic RNP (P= 0.006).Conclusion:Iatrogenic RNP is not uncommon with humeral fracture fixation and occurs at similar rates in anterior and posterior approaches and with midshaft and distal fractures. Iatrogenic RNP had a high rate of recovery. Preoperative RNP more often requires surgery for unresolved palsy.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Chemotherapy in Esthesioneuroblastoma/Olfactory Neuroblastoma
Authors: Cranmer Lee D. , Chau Bonny , Rockhill Jason K. , Ferreira Manuel , Liao Jay J. 
Published: December 2019

Objective:
Chemotherapy has been proposed as an adjunct to primary local therapy in esthesioneuroblastoma (ENB)/olfactory neuroblastoma (ON), but its role has not been precisely defined. Here, we evaluated its role in ENB treatment.

Materials and Methods:
The Surveillance Epidemiology and End Results (SEER) database was queried for ENB/ON (International Classification of Diseases-3 9522). Cases met criteria for inclusion if they were unique, had a primary location in the nasal cavity, and had adequate information for Kadish staging derivation. Univariable and multivariable Cox analyses assessed chemotherapy treatment effect on disease-specific survival (DSS) and overall survival (OS). Multiple imputation addressed missing data. A P<0.05 was designated for statistical significance.

Results:
In adjusted multivariable analyses, chemotherapy treatment was associated with inferior DSS (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.21-2.51; P=0.003) and OS (HR, 1.71; 95% CI, 1.26-2.32; P=0.001). Among the subset with local or regional disease treated with surgery and/or radiation therapy, chemotherapy remained associated with inferior outcomes DSS (HR, 2.78; 95% CI, 1.63-4.74; P<0.001) and OS (HR, 2.18; 95% CI, 1.45-3.27; P<0.001). Chemotherapy treatment misclassification did not explain these findings.

Conclusions:
This analysis does not support chemotherapy to improve either DSS or OS in primary ENB/ON treatment, after controlling for known ENB prognostic factors available from SEER. Other prognostic and treatment selection factors could exist which were not controlled in these analyses. Chemotherapy could beneficially affect outcomes other than DSS or OS. Although the concerns have been expressed regarding chemotherapy treatment misclassification in SEER, their analyses did not identify such misclassification as an explanation for our findings.
TOPOGRAPHIC ANALYSIS OF PHOTORECEPTOR LOSS CORRELATED WITH DISEASE MORPHOLOGY IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Riedl Sophie , Cooney Lewis , Grechenig Christoph , Sadeghipour Amir , Pablik Eleonore , Seaman John W. , Waldstein Sebastian M. , Schmidt-Erfurth Ursula 
Published: December 2019

Purpose:
To quantify morphologic photoreceptor integrity during anti–vascular endothelial growth factor (anti-VEGF) therapy of neovascular age-related macular degeneration and correlate these findings with disease morphology and function.

Methods:
This presents a post hoc analysis on spectral-domain optical coherence tomography data of 185 patients, acquired at baseline, Month 3, and Month 12 in a multicenter, prospective trial. Loss of the ellipsoid zone (EZ) was manually quantified in all optical coherence tomography volumes. Intraretinal cystoid fluid, subretinal fluid (SRF), and pigment epithelial detachments were automatically segmented in the full volumes using validated deep learning methods. Spatiotemporal correlation of fluid markers with EZ integrity as well as bivariate analysis between EZ integrity and best-corrected visual acuity was performed.

Results:
At baseline, EZ integrity was predominantly impaired in the fovea, showing progressive recovery during anti–vascular endothelial growth factor therapy. Topographic analysis at baseline revealed EZ integrity to be more likely intact in areas with SRF and vice versa. Moreover, we observed a correlation between EZ integrity and resolution of SRF. Foveal EZ integrity correlated with best-corrected visual acuity at all timepoints.

Conclusion:
Improvement of EZ integrity during anti-VEGF therapy of neovascular age-related macular degeneration occurred predominantly in the fovea. Photoreceptor integrity correlated with best-corrected visual acuity. Ellipsoid zone integrity was preserved in areas of SRF and showed deterioration upon SRF resolution.
Implantation of Presbyopia-Correcting Intraocular Lenses Staged After Descemet Membrane Endothelial Keratoplasty in Patients With Fuchs Dystrophy
Authors: Price Marianne O. , Pinkus Denisse , Price Francis W. 
Published: December 2019

Purpose:
To assess outcomes of presbyopia-correcting intraocular lens (IOL) implantation after Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial corneal dystrophy.

Methods:
This retrospective single-center study evaluated a consecutive series of patients with Fuchs endothelial corneal dystrophy who received presbyopia-correcting IOLs after DMEK. The main outcomes were corrected distance visual acuity, uncorrected distance visual acuity, uncorrected near visual acuity, and refractive error.

Results:
Fourteen extended depth of focus and 2 bifocal IOLs were implanted in 16 eyes of 8 patients (5 women and 3 men; age, 47–68 years). Fourteen IOLs were spherical and 2 were toric. Postoperatively, the median corrected distance visual acuity was 20/20 (range, 20/15–20/25), the median binocular uncorrected distance visual acuity was 20/25 (range, 20/15–20/25), the median binocular uncorrected near visual acuity was 20/20 (range, 20/20–20/50), and the median manifest spherical equivalent refraction was 0.05 diopters (D) (range, −0.75 to +0.75 D). Implantation of toric extended depth of focus lenses reduced refractive cylinder from 1 and 2.25 D preoperatively to 0 D in both eyes of 1 patient postoperatively. A comparison of biometry measurements taken before and after DMEK showed the median change in average keratometry was 0.26 D with a substantial range of −1.74 to +1.18 D. The median endothelial cell loss was 63 cells/mm2 (3%) after staged phacoemulsification.

Conclusions:
Favorable visual and refractive outcomes were obtained with presbyopia-correcting IOLs in patients with Fuchs dystrophy when the biometry measurements and IOL implantation were staged after DMEK had cleared the guttae and corneal edema.