bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fistelprophylaxe mit muskelsparendem, myofaszialem Pectoralis-major-Lappen bei Salvage-Laryngektomie
Authors: Dejaco Daniel , Rauchenwald Tina , Steinbichler Teresa , Wolfram Dolores , Morandi Evi , Appenroth Elisabeth , Djedovic Gabriel , Pierer Gerhard , Riechelmann Herbert 
Published: February 2020

Zusammenfassung
Hintergrund Bei Rezidiv-Plattenepithelkarzinom des Hypopharynx/Larynx nach Bestrahlung stellt die Salvage-Laryngektomie (Salvage-LE) die beste kurative Therapieoption dar. Vorbestrahlung begünstigt die Entstehung pharyngokutaner Fisteln (pk-Fisteln). Transfer von unbestrahltem Gewebe in das OP-Gebiet reduziert die Fistelrate. Hierfür wird oft ein myokutaner Pectoralis-major-Lappen (PML) verwendet. Wir beschreiben einen muskelsparenden, myofaszialen PML (ms-PML) und dessen funktionelle und ästhetische Resultate.
Methoden Über je eine 8 cm lange subklavikuläre und submammäre horizontale Inzision wird ein am R. pectoralis der A. thoracoacromialis gestielter kraniokaudaler Streifen des M. pectoralis major unter Schonung der Pars clavicularis präpariert und supraklavikulär auf den Pharynx aufgebracht. R0-Resektionsraten, Gesamtüberleben (GS), Komplikationen, stationäre Verweildauern und funktionelle und ästhetische Resultate wurden erhoben.
Ergebnisse Bei 25 Patienten wurde eine Salvage-LE mit ms-PML durchgeführt. Die R0-Resektionsrate betrug 100 %, das mediane GS 1,3 (Beobachtungszeitraum: 2,8) Jahre, die Komplikationsrate 16 % (4 komplette Lappennekrosen, 3 pk-Fisteln) und die mediane stationäre Verweildauer 20 (11–78) Tage. Gute funktionelle Ergebnisse wurden beobachtet: Einschränkungen der oralen Nahrungsaufnahme traten bei 2, Einschränkungen der Stimmrehabilitation bei 3 Patienten auf. Wundheilungsstörungen ohne Lappennekrosen wurden nicht beobachtet. Die ästhetischen Resultate waren ansprechend.
Schlussfolgerung Der ms-PML ist ein wenig invasives und sicheres Verfahren zur Fistelprophylaxe bei Salvage-LE mit günstigem funktionellem und ästhetischem Ergebnis.
Unfavorable Hormonal and Psychologic Profile in Adult Women with a
History of Premature Adrenarche and Pubarche, Compared to Women with Polycystic
Ovary Syndrome
Authors: Livadas Sarantis , Bothou Christina , Kanaka-Gantenbein Christina , Chiotis Dimitrios , Angelopoulos Nicholas , Macut Djuro , Chrousos George P. 
Published: February 2020

AbstractIf circulating adrenal androgens levels rise before the age of 8 years in girls,
this phenomenon is termed premature adrenarche (PA), while the concomitant
appearance of pubic hair is called premature pubarche (PP). Girls with PA-PP
display an unfavorable hormonal profile compared to their normal peers and have
an increased risk of developing polycystic ovary syndrome (PCOS) features
peripubertally. However, the sequelae of premature adrenarche remains unclear.
We assessed metabolic, hormonal, psychologic profiles, and ovarian morphology in
21 women of mean age (±SD) 21.3±3.3 years, BMI:
23.6±4.4 kg/m2 with PA-PP, 45 women with
PCOS and 26 controls, matched for age and BMI. PA-PP women displayed a favorable
lipid profile compared to PCOS and controls. Insulin resistance index (HOMA-IR),
however, were similar in PA-PP and PCOS women (2.09±1.42,
2.08±0.83) and higher than controls (1.13±0.49, p
<0.05). Circulating androstenedione levels did not differ between PA-PP
and PCOS women (0.11±0.05 vs. 0.12±0.03), but was higher than
that of controls (0.02±0.0 nmol/l, p <0,05).
Ovarian volume was increased in PA-PP and PCOS (11.14±3.3 vs.
10.99±4.61) compared to controls
(6.74±1.83 cm3). PA-PP women had a higher score
of state/trait anxiety and depressive and eating disorder symptoms than
controls, with a pattern that matched that of PCOS women. Only 14% of
the PA-PP group fulfilled the Rotterdam PCOS criteria. Some women with a history
of PA-PP displayed hormonal and psychologic profile similar to PCOS, and
accordingly a regular monitoring of these girls during adulthood is advised.
Vestibular Nerve Atrophy After Vestibular Neuritis – Results from a Prospective High-Resolution MRI Study
Authors: Freund Wolfgang , Weber Frank , Schneider Daniel , Mayer Ulrich , Scheithauer Marc , Beer Meinrad 
Published: February 2020

Purpose Sudden unilateral peripheral vestibular deficit is mostly termed vestibular neuritis (VN), even if its cause or the exact location of the lesion remains unclear. Thus, therapy is mostly symptomatic. We aimed to prove if there is peripheral atrophy after VN with persistent canal paresis.
Methods After approval by the ethics committee and according to the declaration of Helsinki and with informed consent, ten patients with persistent canal paresis after VN and ten age-matched healthy controls were included. High-resolution measurement (in-plane resolution 0.2 mm) of the internal auditory canal (IAC) using a 3 D CISS sequence at 3 Tesla was performed. The course of the pertaining nerves was reconstructed in the 3 D dataset and the measurement was performed at 60 % of the length of the IAC. The cross-sectional areas of the superior (SVN) and inferior vestibular nerve (IVN) were taken independently by two blinded readers.
Results The interrater difference regarding the area was 22 %. We found significant atrophy of the SVN with a 24 % smaller area (p = 0.026) and found a smaller ratio of SVN/IVN on the symptomatic side (p = 0.017). Concerning single subject data, only 5 patients showed extensive atrophy of the NVS, while 5 patients did not. The time since symptom onset did not significantly influence the atrophy.
Conclusion MRI measuring of the area of the NVS after VN could detect atrophy after VN. However, only 5 patients exhibited marked atrophy, while the other 5 patients did not. With the background of stringent inclusion criteria (more than 6 months of symptom duration and proven persistent canal paresis), one has to wonder if there might be different etiologies behind the apparently identical symptoms.
Key Points:
Citation Format
Repeat Surgery in Chronic Aortic Dissection: A New Technique without Touching the Native Aorta
Authors: Martinelli Gian Luca , Cotroneo Attilio , Tolva Valerio , Armienti Felice , Bobbio Mario , Musica Gabriele , Visetti Enrico , Tesler Ugo Filippo 
Published: February 2020

Abstract
Background Repeat surgery of the chronically dissected aorta following repair of a Type-A acute aortic dissection (AAD) still represents a challenge. The proposed surgical options are as follows: (1) staged procedure with elephant trunk (ET) technique, (2) traditional frozen elephant trunk (FET) intervention, and (3) beating heart cerebral vessel debranching followed by thoracic endovascular aortic repair (TEVAR). However, a marked enlargement of the proximal descending thoracic aorta might make it difficult to perform FET/ET intervention. Furthermore, because in conventional surgery for AAD, a prosthetic graft replacement is generally limited to the ascending aorta, and in repeat surgery, this short Dacron graft rarely provides enough room to allow a beating heart cerebral vessel debranching and obtaining a reliable landing zone for the implantation of a firmly anchored stent graft.
Methods We retrospectively reviewed all the five consecutive patients treated in our institution, between 2014 and 2017, for chronic aortic dissection after successful surgical treatment of acute Type-A aortic dissection with graft replacement limited to the ascending aorta. The five patients underwent repair utilizing a modified FET technique with total aortic arch and upper descending aorta exclusion without touching the native dissected aorta.
Results No early- or midterm mortality was observed. Mean time interval between the initial and the reoperative procedure was 26 months (range, 3–80 months). No patient had a minor/major neurologic event. Mean circulatory arrest time was 16 minutes (range, 11–25 minutes). Mean follow-up time was 22 months (range, 9–42 months).
Conclusions We report our initial experience with a modified FET technique realized by anastomosing the stent graft with the previously implanted ascending aortic graft in Hishimaru's zone 0 and by rerouting all cerebral vessels without “touching” the native chronically dissected aorta. A larger number of patients and a longer follow-up will be required to confirm these initial encouraging results.
Medial-Sided Injuries in the Multiple Ligament Knee Injury
Authors: Moatshe Gilbert , Vap Alexander R. , Getgood Alan , LaPrade Robert F. , Engebretsen Lars 
Published: February 2020

AbstractMultiligament knee injuries (MLKI) are complex and challenging to treat. The posteromedial corner (PMC) structures are commonly torn in MLKI. A thorough and systematic evaluation is imperative to avoid a missed diagnosis and for planning treatment. With several structures injured, the treatment method (operative vs. nonoperative, repair vs. reconstruction), availability of allografts, timing of surgery, and rehabilitation are some of the factors that have to be considered in the decision-making. Persistent valgus instability because of untreated or not healed medial collateral ligament (MCL) tears will increase graft forces on the cruciate ligament grafts, thus increasing the risk of reconstruction graft failure. In recent years, there has been a growing body of literature on the anatomy and biomechanics of the medial structures that has aided in the development of biomechanically and clinically validated anatomic PMC reconstructions. Despite good healing potential of the MCL, in MLKI, surgical treatment is recommended for grade III PMC injuries to aid early rehabilitation and reduce the risk of surgical failure. Several studies have reported satisfactory outcomes after surgical treatment of MLKI involving the medial side. Early functional rehabilitation is imperative to reduce the risk of arthrofibrosis.
Aseptic Loosening of Porous Metaphyseal Sleeves and Tantalum Cones in Revision Total Knee Arthroplasty: A Systematic Review
Authors: Roach Ryan P. , Clair Andrew J. , Behery Omar A. , Thakkar Savyasachi C. , Iorio Richard , Deshmukh Ajit J. 
Published: February 2020

AbstractBone loss often complicates revision total knee arthroplasty (TKA). Management of metaphyseal defects varies, with no clearly superior technique. Two commonly utilized options for metaphyseal defect management include porous-coated metaphyseal sleeves and tantalum cones. A systematic review was conducted according to the international Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We combined search terms “Total knee arthroplasty” AND/OR “Sleeve,” “Cone” as either keywords or medical subject heading (MeSH) terms in multiple databases according to PRISMA recommendations. All retrieved articles were reviewed and assessed using defined inclusion and exclusion criteria. A total of 27 studies (12 sleeves and 15 cones) of revision TKAs were included. In the 12 studies on sleeve implantation in revision TKAs, 1,617 sleeves were implanted in 1,133 revision TKAs in 1,025 patients. The overall rate of reoperation was 110/1,133 (9.7%) and the total rate of aseptic loosening per sleeve was 13/1,617 (0.8%). In the 15 studies on tantalum cone implantation in revision TKAs, 701 cones were implanted into 620 revision TKAs in 612 patients. The overall rate of reoperation was 116/620 (18.7%), and the overall rate of aseptic loosening per cone was 12/701 (1.7%). Rates of aseptic loosening of the two implants were found to be similar, while the rate of reoperation was nearly double in revision TKAs utilizing tantalum cones. Variability in the selected studies and the likely multifactorial nature of failure do not allow for any definitive conclusions to be made. This review elucidates the necessity for additional literature examining revision TKA implants.
The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes
Authors: Ayik Omer , Demirel Mehmet , Birisik Fevzi , Ersen Ali , Balci Halil I. , Sahinkaya Turker , Batibay Sefa Giray , Ozturk Irfan 
Published: February 2020

AbstractThe present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.
New Biomarkers Used in the Diagnosis of Tuberculosis-Related Pleural Effusions
Authors: Teke Turgut 
Published: February 2020

AbstractTuberculosis-related pleural effusion (TPE) is reported in 12 to 38% of thoracic tuberculosis (TB) cases in the pediatric population. In TPE, the pleural fluid bacilli load is very low, generally resulting in negative acid-fast bacill (AFB) staining and Mycobacterium culture. In the pleural fluid, AFB stain positivity is reported in <20%, and Mycobacterium tuberculosis positive culture in 18 to 38%. In childhood, this ratio is even lower. Also, pleural effusion (PE) mycobacterial culture gives late results (2–8 weeks). Therefore, TPE is diagnosed with pleura biopsy and pleural liquid examination. However, pleura biopsy is a more invasive operation and the diagnosis rates vary. The clinical and laboratory findings are not typical; it is very hard to distinguish between TPE and another cause of exudative PE. This situation makes it essential for research on reliable new biomarkers that can provide fast and accurate diagnosis of TPE. Adenosine deaminase (ADA) activity being above 40 to 50 U/L (despite varying depending on age) strongly suggests TPE. Other new biomarkers featured in TPE diagnosis are interferon-γ, cytokines, and nucleic acid multiplication tests. However, the results of ADA and other potential biomarkers shown to be beneficial in TPE diagnosis should always be interpreted with clinical and microbiological findings because no biomarker can provide information about M. tuberculosis culture and drug resistance. Especially in countries with high resistance against TB drugs, performing pleura biopsy, culture and drug resistance tests are important with regard to diagnosis and therapy planning.
Predictors of Long-Term Neurodevelopmental Outcome of Hypoxic-Ischemic Encephalopathy Treated with Therapeutic Hypothermia
Authors: Goswami Ipsita , Guillot Mireille , Tam Emily W. Y. 
Published: February 2020

AbstractHypoxic-ischemic encephalopathy (HIE) is a manifestation of perinatal asphyxial insult that continues to evolve over days to weeks following the initial injury. Therapeutic hypothermia has demonstrated that a proportion of this secondary brain injury may indeed be preventable. However, therapeutic hypothermia has also altered the prognostic utility of many bedside tools that are commonly used as predictors of long-term neurodevelopmental outcome in HIE. Clinicians are often confronted with uncertainty when assessing the prognosis of infants with HIE. Improved understanding of the implications and limitations of individual investigations may inform clinical decisions and allow for timely intervention. This review summarizes the predictive value of currently available prognostic markers in HIE infants in the therapeutic hypothermia era, including clinical, biochemical, neurophysiological, physiological, and neuroimaging predictors.
ROLE OF MATERNAL ERYTHROCYTE ARGINASE ACTIVITY IN PREGNANCY – A PILOT STUDY
Authors: Shetty Sukanya , Rao Ashalatha V. , Bhandary Roopa 
Published: February 2020

Abstract
Introduction Arginase is an urea cycle enzyme which catalyzes the cleavage of L arginine to L- ornithine and urea. It is expressed in liver, erythrocyte, brain, kidney, mammary gland and intestine. The arginase activity detected in nonhepatic tissues that lacka complete set of urea cycle enzymes is thought to provide ornithine, the biosynthetic precursor of proline, an important constituent of collagen, andthe polyamines, which are important for cell proliferation.
Aim and objectives In the current study arginase level in maternal erythrocytes were determined to ascertain any possible role in pregnancy.
Study design The study group comprised of total 45 subjects including twenty non – pregnant women (mean age 31.0 ± 6.0 years) and twenty five pregnant women (mean age 29.6 ± 6.1 years) of gestational age between 28 – 38 weeks.
Results We found a significant increase in the level of maternal erythrocyte arginase (p 0.05) in pregnant women when compared to non – pregnant women.
Conclusion Our study suggests that the increased maternal erythrocyte arginase activity may have a role in fetal growth and development.
DEVELOPMENT OF GASTRO RETENTIVE FLOATING MATRIX TABLETS OF DILTIAZEM HYDROCHLORIDE
Authors: Charyulu R. Narayana , Patil Amit B. , C.H Lakshmi Deepika , Prabhu Prabhakar , C.S Shastry 
Published: February 2020

AbstractThe objective of the present investigation was to formulate and evaluate hydrodynamically balanced floating matrix controlled drug delivery system of diltiazem hydrochloride. Floating matrix tablets are associated with advantages of increased bioavailability and minimizing the dosing frequency. Diltiazem hydrochloride is a calcium channel blocker, an anti-hypertensive and anti-anginal drug, which undergoes extensive firstpass metabolism and display poor bioavailability. It has an elimination half-life of 3 to 4.5 h and an absorption zone from the upper intestinal tract. Gastric floating of diltiazem hydrochloride tablets results from effervescence produced by the reaction between sodium bicarbonate and hydrochloric acid in stomach. Seven formulations of floating tablets were prepared using direct compression technique with low viscosity polymer such as HPMC K100LV, high viscosity polymers such as HPMC K4M, K15M, and carbopol in different ratios. The evaluation results revealed that all formulations comply with the specification of official pharmacopoeias and/or standard reference with respect to general appearance, content uniformity, hardness, friability and buoyancy. Accelerated stability studies carried out at different temperatures, 27 ± 2 °C, 40 ± 2 °C and 7 ± 2 °C did show no changes in physicochemical properties at the end of 8 weeks indicating all the formulations are stable. Out of all the formulation developed, formulation F6 containing equal ratio of HPMC K4M and K100LV showed optimum floating time and in vitro drug 6 release of 82.19% at the end of 8 h. Thus it is summarized; high viscosity grade polymer HPMC K4M, low viscosity grade polymer HPMC K100LV and carbopol can be successfully used in formulation of sustained release gastro retentive floating drug delivery system.
MATRIX BUTTON PROVISIONALS
Authors: Bhat Vinaya 
Published: February 2020

AbstractFabrication of provisional restorations has been explained using different materials and techniques in the past. Formation of an external matrix before preparation of the abutment, which is later used in combination with a resin material, is one of the techniques. Here, a new material has been used as matrix in direct, indirect and indirect-direct methods to produce esthetic and functional provisional restorations. There is neither wasting of chair side time nor a second visit for the patient.
HUMAN DIROFILARIASIS: AN UNCOMMON CASE OF SUB CUTANEOUS INFECTION WITH DIROFILARIA REPENS WITH A BRIEF REVIEW OF LITERATURE
Authors: H. Sanjeev , M. Rajini , R. Prasad S. 
Published: February 2020

AbstractDirofilaria are a group of arthropod borne filarial nematodes that cause infection in wide range of domestic and wild animals. Dirofilaria repens is a common zoonotic infection in countries like Sri Lanka. Human infection with Dirofilaria repens is not widely recognized in India. Most of the documented cases of human dirofilariasis recorded in India presented with ocular infections, affecting the eyelid, periorbital region and occasionally the sub conjunctivae. Here we report a rare case of sub cutaneous dirofilariasis, which presented as a swelling at an uncommon site.
Exploring the effects of web-based communication tasks on the development and transferability of audience awareness in
L2 writers
Authors: Sasaki Miyuki , Baba Kyoko , Nitta Ryo , Matsuda Paul Kei 
Published: February 2020

Abstract
This article reports on two quasi-experimental studies that investigated the possible development and transfer of
audience awareness in novice EFL writers as they engaged in online writing tasks through a Social Networking Service (SNS).
Japanese students from two universities were asked to write, read, and comment on other students’ writing once a week. The two
studies were arranged sequentially so as to capture in an exploratory but jointly illuminating manner whether and how the
“elusive” (Hyland, 2005) construct of “sense of audience” can develop and transfer
across genres. The results of both studies suggest that the SNS environment can help L2 writers develop audience awareness and
transfer that awareness across genres when two conditions are met: (1) the genre of the SNS tasks should be perceived as similar
to that for which transfer was expected; and (2) the students did not develop a sense of audience in previous writing
instruction.
Anti-scope prefix order and zero-marked obliques
Authors: Baker Brett , Harvey Mark 
Published: February 2020

Abstract
A number of indigenous languages of northern Australia have complex systems of noun class prefixation
incorporating the formal realization of case or topicality, as well as class. The markers of case and topicality occur inside the
marking of class, in an unexpected position according to considerations of scope. In addition, where case is marked, zero marking
is associated with oblique case roles while core roles are associated with substantive marking; again, an unexpected pattern given
universals of case expression. We present evidence for the diachronic development of these noun class prefixation systems from an
older system of demonstratives prefixed for class via a grammaticalization path: demonstrative > topic article > topic
prefix. The class/topic prefixes then developed into class/case-marking prefixes through frequency correlations between topic,
case, animacy and humanness. All stages in our reconstructed pathway are attested by extant languages.