bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of an Ultrasound-Assisted Longitudinal Axis Lateral Crest Approach to Radiofrequency Ablation of the Sacroiliac Joint
Authors: Burnham Taylor Robert , Smith Ashley , McCormick Zachary L. , Teramoto Masaru , Burnham Robert 
Published: February 2021

Objective
The aim of the study was to evaluate the effectiveness and procedural characteristics of a novel, ultrasound/fluoroscopically guided technique (longitudinal axis sacroiliac joint radiofrequency ablation) for sacroiliac joint denervation.

Design
A single-arm cohort with historical cohort comparison was used in this study.

Methods
Thirty-seven participants underwent longitudinal axis sacroiliac joint radiofrequency ablation after 50% or more pain reduction after diagnostic dual-block criterion. Outcomes were the proportion of participants with 50% or more pain reduction and mean Pain Disability Quality of Life Questionnaire change. Subanalysis included longitudinal axis sacroiliac joint radiofrequency ablation procedural and fluoroscopy times compared with participants previously treated with palisade radiofrequency ablation technique.

Results
Primary outcome worst case analysis demonstrated a responder rate of 64.9% (95% confidence interval = 48.8%–78.2%) and 59.5% (95% confidence interval = 43.5%–73.7%) at 3 and 6 mos. There was significant decrease in mean Pain Disability Quality of Life Questionnaire at 3 (45.6 ± 9.5 to 21.4 ± 16.0, P < 0.001) and 6 mos (45.6 ± 9.5 to 23.0 ± 16.5, P < 0.001). Longitudinal axis sacroiliac joint radiofrequency ablation required more procedure time than the palisade technique (38.2 ± 7.9 vs. 32.1 ± 6.9 mins, P = 0.031) but less fluoroscopy time (35.0 ± 11.8 vs. 57.6 ± 16.8 secs, P < 0.001).

Conclusions
Longitudinal axis sacroiliac joint radiofrequency ablation resulted in improvement in pain, disability, and quality of life at 3 and 6 mos. Compared with the palisade technique, longitudinal axis sacroiliac joint radiofrequency ablation required greater procedure time but less fluoroscopy time.
Thinking Outside the Black Box: Current Perceptions on Breast Implant Safety and Utility
Authors: Yesantharao Pooja S. , Lee Erica , Khavanin Nima , Persing Sarah , Jenny Hillary , Abousy Mya , Broderick Kristen P. , Sacks Justin M. 
Published: February 2021

Background:
There is growing public concern surrounding breast implant safety. In fact, the U.S. Food and Drug Administration recently proposed changes to breast implant labeling, which include a boxed warning. Given such efforts to increase transparency on breast implant safety, this study assessed laywomen’s perceptions of breast implant safety, and the impact of proposed changes to breast implant labeling on laywomen’s decision-making regarding breast implants.

Methods:
This was a cross-sectional investigation of women recruited through Amazon Mechanical Turk. Discrete choice modeling was used to query opinions on breast implants after viewing proposed labeling changes. Chi-square and analysis of variance were used for subgroup analyses, and McNemar analyses were used to assess changes in participants’ responses.

Results:
The authors received 500 survey responses. At baseline, 353 participants (70.6 percent) considered breast implants to be at least somewhat safe. After viewing the proposed boxed warning, 252 participants (50.4 percent) responded that they would be less likely to receive implants. In fact, a significantly greater proportion of participants considered breast implants to be either unsafe or very unsafe after viewing suggested changes to implant labeling than at baseline (58.4 percent versus 28.8 percent; p = 0.001). By the end of the survey, willingness to consider alternative options for breast augmentation/reconstruction increased significantly from baseline.

Conclusions:
Improved labeling can enhance laywomen’s understanding of breast implant safety and can impact decision-making. However, greater scrutiny of breast implants should not prevent women who need implants from receiving them. Transparency and objectivity in the surgeon-patient dialogue can ensure the appropriate use of medical devices such as breast implants.
The Effect of Functional Nasal Surgery on Olfactory Function
Authors: Pfaff Miles J. , Bertrand Anthony A. , Lipman Kelsey J. , Shah Aloukika , Nolan Ian , Krishna Vikram , Patel Harsh , Roostaeian Jason , Lee Justine C. 
Published: February 2021

Background:
Functional and aesthetic nasal operations are some of the most common plastic surgery procedures performed in the United States. The purpose of the study was to evaluate the effects of septoplasty, septorhinoplasty, and rhinoplasty procedures on postoperative olfactory function and their relationship to nasal airflow and quality of life.

Methods:
A systematic review and meta-analysis was performed evaluating olfactory function following nasal surgery. Preoperative and postoperative values for olfaction, nasal airflow, and quality of life/nasal symptoms were analyzed. The effect size was calculated from each study and used for meta-analysis. As studies evaluated patients at different points in the postoperative period, the latest time point reported by each study was used in the meta-analysis. The 95 percent confidence interval of the effect size was calculated for each study. Study quality was assessed using the Jadad and Methodological Index for Nonrandomized Studies instruments. All included studies were Level of Evidence II.

Results:
There were 25 included studies. Following nasal surgery, patients experienced significant improvements in olfaction (p < 0.001), nasal airflow (p < 0.001), and quality of life/nasal symptoms (p < 0.001). Patients often experienced a transient decrease in olfaction immediately after surgery, followed by improvement postoperatively. Preoperative olfactory dysfunction rates were low and postoperative dysfunction was equally low. Olfaction improvement was directly correlated with improvement in nasal airflow and quality of life.

Conclusions:
Functional and aesthetic nasal operations appear to significantly improve olfaction, which is directly correlated with nasal airflow. Some studies report a transient worsening of these measures in the immediate postoperative period, which subsequently improved at later time points.
Dynamic Maxillary Sinus Changes of Facial Vascularized Composite Allotransplants
Authors: Kauke Martin , Safi Ali-Farid , Palmer William Jackson , Kollar Branislav , Nelms Laurel , Tchiloemba Bianief , Haug Valentin , Pomahac Bohdan 
Published: February 2021

Summary:
Skin is one of the target tissues of rejection in face transplants and, because of its easy accessibility, has become the gold standard in the diagnosis of rejection. The allograft contains deeper tissues where rejection can occur, but samples cannot be obtained because of difficult access. Deep tissue changes were monitored on computed tomographic scans of the midface in six face transplant recipients with the help of image segmentation. The maxillary sinus was identified as a dynamic anatomical compartment. Observed changes in volume of the aeration relative to the opacification (aeration coefficient) of the maxillary sinus were quantified with the help of image segmentation. Changes in the aeration coefficient as a surrogate of mucosal swelling were quantified and related to time, treatment, and skin rejection grade. Lower aeration coefficients were found only in patients with transplanted maxillary sinus mucosa. Pathologic changes were not observed in face transplant recipients with a native maxillary sinus. The data show that the aeration coefficient was significantly lower at the time of biopsy-proven allograft rejection. Neither mechanical, nor infectious, nor medication side effects sufficiently explain the findings presented herein. The authors’ findings are important to consider for clinical management of face transplant patients who receive parts of the sinonasal tract. The authors identify a potential radiologic biomarker of deep tissue allograft rejection. In the future, the proposed methodology might prove useful in monitoring deeper dynamic tissue changes in vascularized composite allografts and might help in designing patient-specific, individualized treatment strategies.
New Developments in the Management of Cutaneous Squamous Cell Carcinoma
Authors: Knackstedt Thomas J. , Knackstedt Rebecca W. , Djohan Michelle , Djohan Raisal , Gastman Brian R. , Crowe David R. 
Published: February 2021

Learning Objectives:
After studying this article, the participant should be able to: 1. List important prognostic features that affect cutaneous squamous cell carcinoma risk. 2. Summarize the changes to the AJCC Cancer Staging Manual, Eighth Edition, staging system for cutaneous squamous cell carcinoma. 3. Evaluate the draining nodal basin with appropriate imaging modalities. 4. Recommend adjuvant radiation therapy in the correct clinical setting for high-risk tumors. 5. Recognize the currently available treatments for advanced cutaneous squamous cell carcinoma.

Summary:
This continuing medical education article reviews the features, management, and prognosis of cutaneous squamous cell carcinoma with an emphasis on high-risk squamous cell carcinoma and data from the past 3 years. This review will discuss the primary tumor management, high-risk features of a squamous cell carcinoma, changes to the American Joint Committee on Cancer staging system, and the utility of sentinel lymph node biopsy, and critically review the evidence regarding adjuvant therapy.
Modified Unilateral Incomplete Cleft Lip Repair with Primary Nasal Overcorrection: A Muscle-Driven Technique
Authors: Denadai Rafael , Chou Pang-Yun , Pascasio Dax Carlo Go , Lo Lun-Jou 
Published: February 2021

Summary:
Millard’s rotation-advancement principle, first-described 60 years ago, continues to guide surgeons in reconstruction of the unilateral cleft lip. Modifications of the rotation-advancement repair are commonly used; however, distinction between the complete and incomplete forms of cleft lip has received less emphasis in surgical procedure descriptions. As a unilateral incomplete cleft lip could present with more tissue overall and a larger lip on the cleft side than a complete form of cleft lip, the authors have adopted a deformity-specific technical approach to treat each particular cleft form. This article highlights the 10 key steps for execution of a modified unilateral incomplete cleft lip repair using the rotation-advancement principle plus the “skin-follows-muscle” model. The intraoperative design and the reconstruction of the skin, muscle, vermilion, intraoral mucosal, and nasal elements are fully detailed in the accompanying videos.
Reversal of Viral Latency and Induction of Gag-Specific T-Cell Responses in HIV-1-Infected Adults Through Cyclic Treatment Interruption of Rosuvastatin: A Proof-of-Concept Study
Authors: Hsieh Szu-Min , Pan Sung-Ching , Huang Yu-Shan , Chang Shan-Chwen 
Published: February 2021

Background:
HIV-1 infection remains incurable through combination antiretroviral therapy. Previous studies have shown statins have immunomodulatory effects, and interruption of statins may cause an immune rebound.

Methods:
In this proof-of-concept study, we longitudinally assessed the impact of immune rebound by cyclic treatment-interruption (CTI) of rosuvastatin on the reversal of HIV latency. The HIV-1-infected persons with stable viral control were considered to be enrolled for CTI of rosuvastatin with a fixed 12-week interval for 72 weeks (3 treatment-interruption cycles). HIV-1 Gag-specific T-cell responses, cell-associated RNA, and proviral DNA were determined.

Results:
From Feb 2017 to Dec 2019, 10 subjects were enrolled. During the 72-week follow-up, their CD4+ T-cell counts did not significantly change, and plasma HIV RNA remained undetectable. Transient but remarkable increases in levels of cell-associated RNA, Gag-specific interferon-γ production from CD4+ T cells and Gag-specific CD8+ cytotoxic capacity were detected shortly after stopping rosuvastatin in every cycle of CTI of rosuvastatin. Furthermore, there was a 2.63-fold reduction (range, 1.41–4.82) in proviral DNA levels (P = 0.005) during the 72-week follow-up. A significant linear association was demonstrated between their nadir CD4+ T-cell counts and the fold decrease in proviral DNA levels (R = 0.81, P = 0.004).

Conclusion:
It may be possible to reverse viral latency in CD4+ T cells, activate Gag-specific T cells, and reduce viral reservoir size through CTI of rosuvastatin in HIV-1-infected subjects with stable combination antiretroviral therapy, especially in those with nadir CD4+ T-cell counts > 350 cells/μL.
Primary Ewing Sarcoma of Seminal Vesicle on PET/CT
Authors: Shen Guohua , Yi Cheng , Pan Lili , Kuang Anren 
Published: February 2021

Abstract
Ewing sarcoma is an aggressive malignancy that most often presents as an undifferentiated primary bone tumor; less commonly, it arises in extraosseous soft tissues of mesenchymal cell origin. Primary extraosseous involvement of seminal vesicle is rarely reported. Herein, we describe FDG PET/CT and MRI findings of a 55-year-old man who presented with a pelvic mass, which was confirmed to be primary Ewing sarcoma/primitive neuroectodermal tumor arising from seminal vesicle by histopathologic findings.
Detection of Nasal Solitary Extramedullary Plasmacytoma on 18F-FDG PET/CT Imaging
Authors: Wu Junhao , Rao Zijuan , Jiang Guohao , Liu Huipan , Zhang Chunyin 
Published: February 2021

Abstract
A 46-year-old man presented with a 3-month history of epistaxis. CT and MRI scan showed a soft tissue mass in the left nasal cavity. An excisional biopsy of the mass revealed extramedullary plasmacytoma. 18F-FDG PET/CT showed intense activity in the region of the left nasal cavity but no other FDG-avid lesions. Additional workups did not reveal any evidence of systematic disease. Based on these findings, the patient was diagnosed as having solitary nasal extramedullary plasmacytoma. He received the local radiation therapy. During the 3-month follow-up, his symptom was relieved.
FDG PET Unveils the Course of Paraneoplastic Cerebellar Degeneration
Authors: Massa Federico , Filippi Laura , Benedetti Luana , Morbelli Silvia , Nobili Flavio 
Published: February 2021

Abstract
In paraneoplastic cerebellar degeneration (PCD), the standard diagnostic workup might be inconclusive, especially in seronegative subtypes. Brain 18F-FDG PET is an accurate supportive diagnostic tool in immune-mediated disorders, but findings in PCD are controversial. Semiquantitative analysis of 18F-FDG PET can meaningfully assist visual assessment in different neurological conditions and has been mainly applied to disclose regional hypometabolism. We describe a seronegative PCD associated with small cell lung cancer in which 18F-FDG PET semiquantitative analysis accurately disclosed the longitudinal pathological changes of brain metabolism occurring in the acute and posttreatment remission stages and paralleling clinical impairment and response to treatment.
Reconstruction of Extensive Auricular Defects Using a Retroauricular Artery Perforator–Based Propeller Flap
Authors: Evin Nuh , Evin Seyda Guray , Akdag Osman , Tosun Zekeriya 
Published: February 2021

Background
Various local techniques have been successfully used for the reconstruction of auricular defects. However, most local techniques are not suitable for extensive auricular defects. The aim of this study is to investigate the utility of a retroauricular artery perforator–based propeller flap for the reconstruction of extensive auricular defects by evaluating aesthetic outcomes using objective and quantitative parameters.

Methods
Twenty-one patients with extensive full-thickness and partial-thickness defects were treated with retroauricular artery perforator–based propeller flaps harvested from the mastoid and neck regions. The surgical procedures were performed using single-stage reconstruction in postauricular partial-thickness defects and 2-stage reconstruction in full-thickness auricular defects. Levels of final satisfaction and tissue matching as well as donor scar perception were evaluated by the patients and objective observers.

Results
The original sizes and projections of the auricles were achieved. The color, texture, and thickness of the flaps matched well with the adjacent auricles. The vast majority of the patients and observers were very satisfied with the surgical outcome.

Conclusions
Retroauricular artery perforator–based propeller flaps may preserve the size and projection in both partial- and full-thickness extensive defects of the auricle. With this procedure, there was also excellent matching of the color, texture, and thickness of the flap with the adjacent tissue, as well as acceptable levels of donor scarring, thereby achieving satisfactory aesthetic outcomes.
Incisions for Parotidectomy
Authors: Aggarwal Vaibhav 
Published: February 2021

Abstract
In the last 2 decades, authors have gained considerable interest in modifying the age-old classical parotidectomy incisions to address cosmetic concerns of their patients. The article reviews all the incisions that have been introduced over time after modified facelift and Blair incision for performing parotidectomy. These include retroauricular hairline approach, Arden technique, trichophytic incision, periauricular incision, intraauricular modification of facelift approach, endaural approach, postaural approach, Panda technique, preauricular crutch approach, and mini Blair incision. Although these have been reported to be safe, feasible, and cosmetically better approaches, at present, the absence of well-designed prospective observational and interventional studies do not warrant them to be widely used in clinical practice. This will guide surgeons in making patient curated parotidectomy incisions under special circumstances. Currently, these remain limited to the hands of experienced surgeons in high volume centers.
Analysis of Actual Versus Predicated Intracranial Volume Changes for Distraction Osteogenesis Using Virtual Surgical Planning in Patients With Craniosynostosis
Authors: Kamel George N. , Carbulido Mary Kristine , McKee Ryan M. , Segal Rachel M. , Ewing Emily , Brandel Michael G. , Lance Samuel H. , Gosman Amanda A. 
Published: February 2021

Introduction
The primary outcome metric in patients with craniosynostosis are changes in intracranial volumes (ICVs). In patients who undergo distraction osteogenesis (DO) to treat craniosynostosis, changes are also dependent on the length of distraction. Virtual surgical planning (VSP) has been used to predict anticipated changes in ICV during cranial vault reconstruction. The purpose of this study is to analyze the actual versus predicted ICV changes using VSP in patients who undergo DO for craniosynostosis management.

Methods
All patients with craniosynostosis treated with DO at a single institution, Rady Children's Hospital, between December 2013 and May 2019 were identified. Inclusion criteria are as follows: VSP planning with predicted postoperative ICV values and preoperative and postdistraction CT scans to quantify ICV. Postoperative ICV and VSP-estimated ICV were adjusted for age-related ICV growth. The primary outcome measure calculated was age-adjusted percent volume change per millimeter distraction (PVCPD), and results were analyzed using paired Wilcoxon signed rank tests.

Results
Twenty-seven patients underwent DO for cranial vault remodeling. Nineteen patients were nonsyndromic, and 8 patients were syndromic. The median postoperative PVCPD was 0.30%/mm, and the median VSP-estimated PVCPD was 0.36% per millimeter (P < 0.001). A subanalysis of nonsyndromic patients showed a median postoperative PVCPD of 0.29%/mm in nonsyndromic patients that differed significantly from the VSP estimate of 0.34%/mm (P = 0.003). There was also a significant difference in syndromic patients' observed PVCPD of 0.41%/mm versus VSP estimate of 0.79%/mm (P = 0.012).

Conclusions
Virtual surgical planning overestimates the change in ICV attributable to DO in both syndromic and nonsyndromic patients.
Modified Stair-Step Flap With Turnover Flap for Drooling Correction After Lower Lip Composite Defect Reconstruction
Authors: Chen Chih-Cheng , Wang Szu-Han , Lin Shih-Lung 
Published: February 2021

Background
Oral commissure and buccal complex defects are commonly seen after cancer ablation. Free flap reconstruction can offer adequate soft tissue volume and outer skin lining. However, oral incompetence often occurs when an oral commissure has defects, particularly when the patient receives postoperative radiotherapy. The purpose of this article was to describe our method of the modified stair-step technique and improve the oral competence.

Methods
This study involves 22 patients who had partial lower lip and/or upper lip defects and underwent flap reconstruction and/or postoperative radiotherapy resulting in oral incontinence. Fourteen patients had been treated with an anterolateral thigh flap, 7 patients had been treated with a radial forearm flap, and 1 patient had been treated with a fibular osteocutaneous flap. Our modified stair-step commissuroplasty was done in all cases, and a debulking procedure was done in each second operation.

Results
Acceptable oral continence and contour were achieved in 19 patients. Some patients still had drooling after their second operation, but it was considerably less than before.

Conclusions
This technique is an easy procedure for revision of lower lip deformities after oral commissure reconstruction.
Cephalocranial Disproportionate Fossa Volume and Normal Skull Base Angle in Pfeiffer Syndrome
Authors: Lu Xiaona , Forte Antonio Jorge , Allam Omar , Park Kitae Eric , Alperovich Michael , Steinbacher Derek M. , Tonello Cristiano , Alonso Nivaldo , Persing John A. 
Published: February 2021

Background:
Pfeiffer syndrome is a rare syndromic craniosynostosis disorder, with a wide range of clinical manifestations. This study aims to investigate the structural abnormalities of cranial fossa and skull base development in Pfeiffer patients, to provide an anatomic basis for surgical interventions.

Method:
Thirty preoperative CT scans of Pfeiffer syndrome patients were compared to 35 normal controls. Subgroup comparisons, related to differing suture synostosis, were performed.

Results:
Overall, the volume of anterior and middle cranial fossae in Pfeiffer patients were increased by 31% (P < 0.001) and 19% (P = 0.004), versus controls. Volume of the posterior fossa in Pfeiffer patients was reduced by 14% (P = 0.026). When only associated with bicoronal synostosis, Pfeiffer syndrome patients developed enlarged anterior (68%, P = 0.001) and middle (40%, P = 0.031) fossae. However, sagittal synostosis cases only developed an enlarged anterior fossa (47%, P < 0.001). The patients with solely bilateral squamosal synostosis, developed simultaneous reduced anterior, middle and posterior cranial fossae volume (all P ≤ 0.002). The overall skull base angulation, measured on both intracranial and subcranial surfaces, grew normally.

Conclusion:
Enlarged anterior cranial fossae in Pfeiffer syndrome children is evident, except for the squamosal synostosis cases which developed reduced volume in all fossae. Volume of the middle cranial fossa is influenced by associated cranial vault suture synostosis, specifically, sagittal synostosis cases develop normal middle fossa volume, while the bicoronal cases develop increased middle fossa volume. Posterior cranial fossa development is restricted by shortened posterior cranial base length. Surgical intervention in Pfeiffer syndrome patients optimally should be indexed to different suture synostosis.