bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroendokrine Tumoren im Gastrointestinaltrakt
Authors: Breitling Lutz Philipp , Rinke Anja , Gress Thomas Mathias 
Published: October 2019

AbstractNeuroendocrine neoplasms (NEN) are increasingly diagnosed tumors with great clinical and prognostic heterogeneity. One of the peculiarities of NEN is the presence of a clinical hormone syndrome in about 30 % of cases. Somatostatin receptor imaging plays an important role in the diagnosis of spreading and in the planning of therapy. NEN patients should be co-supervised by specialized centers and if possible treated as part of studies. In the case of NEN with no or only circumscribed metastases, complete resection in curative intention is generally the highest therapeutic goal. Small neuroendocrine tumors (NET) G1 of the stomach, duodenum and rectum can be curatively endoscopically resected. In the case of a metastatic, non-curative disease, an antiproliferative therapy with the aim of growth control takes place. In patients with functionally active tumors, an antisecretory or symptomatic therapy is used to control the hormone syndrome. The treatment of metastatic NET is often multimodal and must be established by an experienced interdisciplinary team. The prognosis of NEN is mainly determined by the stage at the time of diagnosis, tumor differentiation, grading and localization of the primary tumor.
The Phenomenon of the Apparent (Double) Femoral Head in Infant Hip Sonography According to Graf-Description, Incidence and Clinical Relevance
Authors: Struwe Charlotte , Bornemann Rahel , Walter Sebastian Gottfried , Koob Sebastian , Placzek Richard 
Published: October 2019

Abstract
Purpose Hip screening sonography according to Graf in rare cases yields the appearance of a double femoral head, aptly named the Double-Head-Sign. The goal of this retrospective study is to offer a definition of this rare sign, evaluate its incidence of occurrence and compare the sonographic findings with the clinical findings.
Materials and Methods This Double-Head-Sign is caused by the overlap of the trochanter major with the actual head of the femur in cases of coxa vara. This was observed in 13 of 2800 neonates we screened as part of our sonographical neonatal hip screening.
Results 13 neonates presented themselves with ultrasound findings in accordance with our description, yielding an incidence of 0,46% in our patient cohort. In correlation, these neonates also exhibited increased external and decreased internal rotation of the hip. Two had an underlying condition (achondroplasia).
Conclusion In these rare cases, clinical examination of hip rotation in 90° hip flexion has proved helpful and further interdisciplinary examination of such infants to distinguish a possible underlying primary condition is recommended
Poplitealarterien-Entrapment-Syndrom: 3 untypische Fälle mit 3 verschiedenen Diagnosewegen
Authors: Siegl Gregor , Cohnert Tina , Brodmann Marianne , Aschauer Manuela , Oswald Wolfgang , Tiesenhausen Kurt 
Published: October 2019

Zusammenfassung
Einleitung Das Poplitealarterien-Entrapment-Syndrom (PAES) beschreibt einen pathologischen Zustand, bei dem sich durch anatomische Anomalien der Lagebeziehung zwischen zumeist muskulären Weichteilstrukturen des Caput mediale des M. gastrocnemius (CMMG) und der A. poplitea (AP) eine mechanische Kompression und eine daraus folgende Schädigung der Gefäße bis zum Verschluss ergibt.
Patienten In den Jahren 2012 bis 2018 wurden 3 männliche Patienten im Alter zwischen 17 und 48 Jahren wegen eines PAES an unserer Abteilung operiert. Der 1. Patient wurde bereits 2003 mit 23 Jahren einer femoropoplitealen Bypassoperation bei der Diagnose „PAVK II b posttraumatisch“ unterzogen. Nach mehrmaliger Revision fiel 2012 schließlich intraoperativ ein starker, nach lateral ziehender, die Gefäße einengender Sehnenzügel des CMMG auf. Nach Durchtrennung des Sehnenzügels wurde die aneurysmatische Bypassvene ersetzt. Der 2. Patient wurde 2014 mit der Diagnose „PAVK II b bei thrombosiertem Poplitealaneurysma“ nach intraarterieller Lyse mit wandhaftenden Restthromben vorstellig. Intraoperativ zeigte sich proximal des Aneurysmas ein zum CMMG ziehender Sehnenzug, welcher die AP einengte. Beim 3. Patienten trat 2018 eine Fußsohlen- und Wadenclaudicatio rechts mit abgeblasstem und pulslosem Unterschenkel auf. Bildgebend zeigte sich ein Verschluss der Poplitealarterien beidseits. Nach intraarterieller Lyse zeigte die HRMR-Untersuchung des Knies einen atypischen Verlauf der AP von medial das CMMG ventral kreuzend. Die operative Sanierung wurde durch Myotomie und Refixation des Muskels in physiologischer Position vorgenommen. Alle Patienten erhielten eine individuelle medikamentöse Re-Thromboseprophylaxe. Von der Operation der Gegenseite bei simultan bestehendem PAES wurde bei mangelndem Therapiewunsch der Patienten abgesehen.
Schlussfolgerung Das PAES ist selten und wird i. d. R. mit jungen, sportlich aktiven, meist männlichen Patienten mit ausgeprägter Unterschenkelmuskulatur in Verbindung gebracht. Eine späte Diagnose des PAES kann, wie der 1. Fall zeigt, zu schweren Gefäßschäden, unnötigen Rezidiveingriffen und über Jahre protrahiertem Krankheitsverlauf führen. Bei jungen Patienten mit Wadenclaudicatio sollte daher stets auch unabhängig von der körperlichen Konstitution die Differenzialdiagnose PAES erwogen werden.
Therapie primärer Aneurysmen der Extremitätenarterien
Authors: Jung Georg , Leinweber Maria-Elisabeth , Gray Daphne , Derwich Wojciech , Harth Marc , Schmitz-Rixen Thomas 
Published: October 2019

ZusammenfassungPeriphere arterielle Aneurysmen sind seltene Gefäßerkrankungen, bei denen das betroffene Gefäßsegment auf mindestens das 1,5-Fache des nativen Gefäßdurchmessers dilatiert ist. Grundsätzlich können primäre Aneurysmen an sämtlichen Gefäßen auftreten. Die diagnostischen Verfahren umfassen neben der Duplexsonografie die CT- und MR-Angiografie sowie die digitale Subtraktionsangiografie. Von essenzieller Bedeutung ist es, im Rahmen der Diagnostik die Morphologie des Aneurysmas und die Zu- und Abstromverhältnisse möglichst exakt abzubilden. Die häufigste Entität peripherer Aneurysmen sind Poplitealarterienaneurysmen, die eine hohe Koinzidenz mit Aortenaneurysmen haben. Im Rahmen von Bindegewebserkrankungen oder Autoimmunerkrankungen können periphere arterielle Aneurysmen gehäuft auftreten (Ehlers-Danlos-Syndrom, Marfan-Syndrom, Morbus Behçet). Therapeutisch stehen als aktueller Therapiestandard offen chirurgische Verfahren zur Verfügung, aber auch endovaskuläre Therapieansätze sind beschrieben. Aktuell bietet die Literatur aufgrund der Seltenheit der Erkrankungen keine gute Evidenz zum Vergleich beider Verfahren. Für das Poplitealarterienaneurysma zeichnet sich aufgrund von mehreren Registerstudien und Singlecenterstudien ab, dass bei strenger Patientenselektion die endovaskuläre Therapie ein vergleichbares Outcome zur offenen Therapie bieten kann, wenngleich offene Chirurgie therapeutischer Standard bleibt. Für die Therapieplanung arterieller Aneurysmen an den Extremitäten müssen insbesondere individuelle Behandlungskriterien wie die Morphologie des Aneurysmas, die anatomische Lokalisation, besonders in Bezug auf bewegliche Segmente, der Gefäßabstrom und der Allgemeinzustand des Patienten berücksichtigt werden.
Randomized Controlled Trial of Intravenous Dexmedetomidine for Control of Hemodynamics, Surgical Bleeding, and Recovery Profile during Transsphenoidal Pituitary Surgery
Authors: Mathew Preethy J. , Jain Aparna , Wig Jyotsna , Mukherjee Kanchan K. , Gupta Aakriti 
Published: October 2019

Abstract
Background Microscopic transsphenoidal excision of pituitary gland, though considered safe from neurosurgical point of view, produces marked cardiovascular and stress responses despite adequate depth of anesthesia. The aim of this study was to evaluate the effect of dexmedetomidine bolus and infusion in microscopic transsphenoidal pituitary surgery on hemodynamics, bleeding in surgical field, and recovery parameters.
Materials and Methods A prospective randomized double-blind study was conducted in 40 American Society of Anesthesiologists (ASA) I-II patients between 18 and 65 years, who underwent elective transsphenoidal excision of pituitary tumor. Two groups were constituted: one group received dexmedetomidine 1 μg/kg loading dose followed by 0.5 μg/kg/h infusion, the other received placebo bolus and infusion. A standard anesthesia protocol including isoflurane and fentanyl was used in both groups. The hemodynamic profile, intraoperative bleeding, and recovery profile were studied.
Results The heart rate (HR) did not vary significantly from the baseline during surgery and recovery in the dexmedetomidine group. The systolic, diastolic, and mean blood pressures decreased significantly with dexmedetomidine in statistical terms, though they were within the clinically acceptable range and did not require intervention. On comparing the groups, dexmedetomidine group had better perioperative blood pressure profile and decreased isoflurane requirement. Bleeding scores during surgery and recovery were similar in both groups.
Conclusions Intraoperative use of dexmedetomidine in transsphenoidal pituitary surgery provided stable perioperative hemodynamics comprising reduced cardiovascular response to intubation and surgical noxious stimuli along with a similar recovery compared with the control group. Therefore, dexmedetomidine appears as a useful adjunct to control hemodynamics in neurosurgical patients undergoing transsphenoidal surgery.
Pyridoxine Responsive Seizures: Beyond Aldehyde Dehydrogenase 7A1
Authors: Koul Roshan , Alfutaisi Amna , Abdelrahim Rana , Altihilli Khalid 
Published: October 2019

Abstract
Objective Pyridoxine responsive seizures (PDRs) are characterized by early-onset seizures and epileptic encephalopathy (neonates and infants) which respond to pyridoxine. Any type of seizures can be the first presentation of PDRs in these children. The aim of this 20-year retrospective study was to report the profile of 35 children with PDRs.
Materials and Methods Neonatal and infantile seizures responding to pyridoxine were analyzed retrospectively from 1998 to 2018. Depending on the clinical features, laboratory results, and genetic study, they were divided into following four groups: (A) responders with α-aminoadipic semialdehyde dehydrogenase 7A1 (ALDH7A1) mutation, (B) responders with pyridoxal phosphate homeostasis protein (PLPHP) mutation, (C) responders with none of these two known mutations, (D) and responders in combination with antiepileptic medications.
Results Sixteen of 35 children had genetic mutation, 4 with ALDH7A1 mutation, and 12 with PLPHP mutation recently described. Nineteen of 35 children had no genetic positivity.
Conclusion A large number of children with pyridoxine response do not have known genetic confirmation. Over time, new genes, responsible for pyridoxine dependency, may be identified or an unknown metabolic disorder may be seen in these children.
A New Planning Method to Easily Harvest the Superficial Circumflex Iliac Artery Perforator Flap
Authors: Pereira Nicolás , Parada Leonardo , Kufeke Matías , Troncoso Ekaterina , Roa Ricardo 
Published: October 2019

Abstract
Background The superficial circumflex iliac artery perforator flap (SCIP) is a thin, pliable, and versatile flap used mainly for extremities and head and neck reconstruction. Different planning methods have been described, but these are not yet standardized like in other flaps. The aim of this study is to present a fast, effective, and reliable method for SCIP flap planning using computed tomography angiography (CTA).
Patients and Methods Between October 2017 and September 2018, CTA was performed on 40 patients. Preoperative planning of SCIP flaps based on the medial branch was performed analyzing CTA images. The perforating sites of the medial branch on the deep (point D) and superficial fascia (point S) were identified. Distances to those points, from the center of the umbilicus in the “y-axis” and the midline perpendicularly in the “x-axis,” were measured. These measurements were transferred to the patient's skin as a guide for dissection.
Results Eighty areas were studied identifying points D and S in CTA. Forty-three SCIP flaps were performed using this planning method. In 100% of the flaps, points D and S matched perfectly with handheld Doppler and surgical findings.
Conclusion Points D and S method for medial branch based SCIP planning with CTA is an easy to learn, efficient, fast, and reliable technique for preoperative planning, allowing a safe and predictable elevation of the flap.
Predictive Factors for Hamstring Autograft Diameter in Anterior Cruciate Ligament Reconstruction
Authors: Heijboer Willem M.P. , Suijkerbuijk Mathijs A.M. , van Meer Belle L. , Bakker Eric W.P. , Meuffels Duncan E. 
Published: October 2019

AbstractMultiple studies found hamstring tendon (HT) autograft diameter to be a risk factor for anterior cruciate ligament (ACL) reconstruction failure. This study aimed to determine which preoperative measurements are associated with HT autograft diameter in ACL reconstruction by directly comparing patient characteristics and cross-sectional area (CSA) measurement of the semitendinosus and gracilis tendon on magnetic resonance imaging (MRI). Fifty-three patients with a primary ACL reconstruction with a four-stranded HT autograft were included in this study. Preoperatively we recorded length, weight, thigh circumference, gender, age, preinjury Tegner activity score, and CSA of the semitendinosus and gracilis tendon on MRI. Total CSA on MRI, weight, height, gender, and thigh circumference were all significantly correlated with HT autograft diameter (p < 0.05). A multiple linear regression model with CSA measurement of the HTs on MRI, weight, and height showed the most explained variance of HT autograft diameter (adjusted R
2 = 44%). A regression equation was derived for an estimation of the expected intraoperative HT autograft diameter: 1.2508 + 0.0400 × total CSA (mm2) + 0.0100 × weight (kg) + 0.0296 × length (cm). The Bland and Altman analysis indicated a 95% limit of agreement of ± 1.14 mm and an error correlation of r = 0.47. Smaller CSA of the semitendinosus and gracilis tendon on MRI, shorter stature, lower weight, smaller thigh circumference, and female gender are associated with a smaller four-stranded HT autograft diameter in ACL reconstruction. Multiple linear regression analysis indicated that the combination of MRI CSA measurement, weight, and height is the strongest predictor.
Agency and impoliteness in Korean online interactions
Authors: Kim Ariel , Brown Lucien 
Published: October 2019

Abstract(Im)politeness research has often focused either on the importance of social norms or on the intentions of the speaker, with the active role of the listener in assigning social meanings overlooked. This limitation particularly applies to so-called “discernment languages” such as Korean and Japanese. The current paper addresses this gap by offering a small-scale qualitative study of recipient agency in Korean naturally occurring computer-mediated communication (CMC). The data analyzed includes 14 text messages between the recipient (the proprietor of an online food business) and his customer, which were posted on a blog that he owned and operated. We focus on how the recipient agentively evaluates the language usage of the customer, including inconsistent evaluations of her use of non-honorific language, orpanmal. The results suggest that the instability of (im)politeness interpretations cannot be explained solely by social norms or intentions but should also include the socially-mediated agency of the recipient.
Vieni anche te?
Authors: Fiorentino Giuliana 
Published: October 2019

Abstract
In this paper we return to the question of the use of te, the Italian personal pronoun, as
subject instead of complement. According to scientific literature, the diffusion of te in substitution of
tu as the subject of the clause is attributed to the spoken variety of language.
We aim at verifying this hypothesis and to further document the use of te as subject using
existing corpora of both written and spoken language.
The research considers old and new issues (for example the diffusion of the coordinative phrase io e
te instead of io e tu, on which see Blasco Ferrer, 1992)
and intends to represent the phenomenon in quantitative and qualitative terms.
In the conclusions it is stated that the phenomenon, even better represented in the spoken versus the written,
seems diachronically stable, and sensitive to diatopic factors. The most significant results of the current research consist in
having evaluated the presence of the phenomenon separately in the different constructs in which it occurs, and in having
identified other contexts of attestation.
Pd@MC-PVA composite electrocatalyst for ethanol electrochemical oxidation
Authors: Zhang Guoqing , Jin Binbin , Zhao Yongqing 
Published: October 2019

Abstract
By a simple and effective intermittent microwave heating (IMH) method, Pd anchored on mesoporous carbon (MC) and Poly (vinyl alcohol), (PVA) (Pd@MC-PVA) composite was successful synthesized for ethanol electrochemical oxidation. Both cyclic voltammetric and chronoamperametric measurements indicate that the performance of Pd@MC-PVA was significant improved for ethanol oxidation. The activity of Pd@MC-PVA for ethanol oxidation is four times higher than that of Pd@MC with the same Pd loading in alkaline media. The activity enhancement could attribute to a good Pd dispersion and utilization on MC because of strong hydrophilic and excellent conductivity.
The Ottoman Empire: The Mandate That Never Was
Authors: Akın Yiğit 
Published: October 2019

Abstract
A century after the victorious Allied powers distributed their spoils of victory in 1919, the world still lives with the geopolitical consequences of the mandates system established by the League of Nations. The Covenant article authorizing the new imperial dispensation came cloaked in the old civilizationist discourse, entrusting sovereignty over “peoples not yet able to stand by themselves under the strenuous conditions of the modern world” to the “advanced nations” of Belgium, England, France, Japan, and South Africa. In this series of “reflections” on the mandates, ten scholars of Europe, Africa, the Middle East, Asia, and the international order consider the consequences of the new geopolitical order birthed by World War I. How did the reshuffling of imperial power in the immediate postwar period configure long-term struggles over minority rights, decolonization, and the shape of nation-states when the colonial era finally came to a close? How did the alleged beneficiaries—more often the victims—of this “sacred trust” grasp their own fates in a world that simultaneously promised and denied them the possibility of self-determination? From Palestine, to Namibia, to Kurdistan, and beyond, the legacies of the mandatory moment remain pressing questions today.
Fat Graft Enhanced With Adipose-Derived Stem Cells in Aesthetic Breast Augmentation: Clinical, Histological, and Instrumental Evaluation
Authors: Gentile Pietro , Kothari Ashutosh , Casella Donato , Calabrese Claudio 
Published: October 2019

Abstract

Background
Fat graft enhanced with adipose-derived stem cells (FG-e-ASCs) has been utilized in outcomes of radiotherapy after mastectomy, breast soft tissue defects, ulcers, and loss of substance. The authors present their experience utilizing FG-e-ASCs in breast augmentation.

Objectives
The aim of this study was to evaluate the safety and efficacy of a study group (SG) regarding utilization of FG-e-ASCs in breast augmentation for aesthetic improvement, comparing the results with a control group (CG).

Methods
A total of 46 patients affected by breast hypoplasia were treated with FG-e-ASCs, comparing results with those of a CG (n = 30) treated with fat graft not enhanced with adipose-derived stem cells (FG-ne-ASCs). The preoperative evaluation included a complete clinical evaluation, a photographic assessment, magnetic resonance imaging of the soft tissue, ultrasound, and mammography. Postoperative follow-up took place at 1, 3, 7, 12, 24, and 48 weeks and then annually.

Results
The patients treated with FG-e-ASCs showed 58% maintenance of the contour restoring and of 3-dimensional (3D) volume after 3 years compared with the patients of the CG treated with FG-ne-ASCs, who showed 29% maintenance. In 67.4% (n = 31) of breast augmentations treated with FG-e-ASCs, we observed a restoration of the breast contour and an increase of 10.3 mm in the 3D volume after 36 months, which was observed in only 20.0% (n = 6) of patients in the CG treated with FG-ne-ASCs. Volumetric persistence in the SG was higher than that in the CG (P &lt; 0.0001 SG vs CG).

Conclusions
Utilization of FG-e-ASCs was safe and effective in this series of cases performed.

Level of Evidence: 4
Surgical correction of postpneumonectomy syndrome with adjustable saline implants and transoesophageal echocardiography
Authors: Encarnacion Carlos O , Deshpande Seema P , Mondal Samhati , Carr Shamus R 
Published: October 2019

Abstract
Postpneumonectomy syndrome can have a significant clinical impact on a patient. It presents as progressive dyspnoea due to compression of the contralateral bronchus and/or pulmonary veins. Herein, we present a patient who over a 2-year period developed progressive dyspnoea on exertion and eventually also at rest, due to compression of her left mainstem bronchus and her left inferior pulmonary vein. Surgical correction with implantable adjustable saline implants was undertaken to ameliorate her symptoms. Concurrent use of intraoperative transoesophageal echocardiography permitted real-time adjustment of the implants. This allowed objective measurement and demonstration of normalization of pulmonary vein velocity, which resulted in complete symptom resolution.
2979The effect of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors on endothelial progenitor cells
Authors: Itzhaki Ben Zadok O , Mager A , Leshem-Lev D , Lev E , Kornowski R , Eisen A 
Published: October 2019

Abstract

Background
Endothelial progenitor cells (EPCs) have an important role in the process of vascular repair by promoting re-endothelialization following endothelial injury. We hypothesized that proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors, which reduce cardiovascular events, will increase the level of EPCs and thus affect the process of vascular repair. Therefore, we sought to investigate the effect of PCSK9 inhibitors on circulating EPCs.

Methods
Study population included patients with known stable CAD who were initiated PCSK9 inhibitors. Blood samples were drawn and evaluated for EPCs at baseline and after treatment (1 month). Circulating EPCs were then assessed quantitatively by the expression of VEGFR-2, CD34 and CD133 using flow cytometry, and functionally by the formation of colony forming units (CFUs).

Results
Our preliminary cohort included 12 patients (median age of 69 years), 31% of whom were female. At baseline, total cholesterol and low density lipoprotein levels were 190 (IQR 180, 227) mg/dL and 123 (IQR 107, 154) mg/dL, respectively. Following 1-month of therapy with a PCSK9 inhibitor and along with a decrease in LDL to a median of 58 (IQR 50, 67) mg/dL, we observed an increase in the expression of CD34(+)/VEGFR-2(+) (1.2% (IQR 0.6, 1.6) to 3.0% (IQR 1.2, 4.5), P=0.07) and CD133(+)/VEGFR-2(+) (0.8% (IQR 0.7, 1.4) to 1.7% (IQR 0.6, 4.0), P=0.5). Proliferation of EPCs was confirmed microscopically (1 CFUs (IQR 1, 1.5) to 1.5 CFUs (IQR 1.5, 2.5), P=0.016) (Figure 1) and by an MTT assay (0.16 (IQR 0.12, 0.19) to 0.19 (IQR 0.17, 0.21), p=0.016).

Conclusions
These preliminary results in patients with CAD demonstrate that treatment with PCSK9 inhibitors is associated with higher levels of EPCs, thus promote endothelial repair. This finding may represent a novel mechanism of action of PCSK9 inhibitors, which might have important future clinical implications.