bluuebunny/crossref_metadata_2025_split huggingface dataset:
Torsional Anatomy of the Lower Limb: The Appearance of Anatomy in Hemispastic Position
Authors: Cianca John , Dy Rochelle , Chiou-Tan Faye Y. , John Joslyn , Taber Katherine H. 
Published: October 2018

Objective
The aim of the study was to determine whether there are relevant anatomical variations to the typical injection sites for antispasticity procedures in the lower limb.

Methods
Sonographic images were obtained at traditional injection locations for spasticity in the lower limb. Images were recorded in neutral and contracted postures. Doppler imaging was obtained for sites that contained vasculature. The images were analyzed, and schematics were created that highlighted relevant findings.

Results
The adductor longus in commonly used injection sites was close to vasculature making accidental injection of the latter a higher risk. The sciatic nerve was vulnerable to injections at the proximal biceps femoris injection side if injected too deeply. Hamstring injection sites can be adjusted to the midline to improve accuracy. The proximity of the tibial nerve to the flexor hallucis longus and the deep fibular nerve to the extensor hallucis longus puts these nerves at risk for accidental injection.

Discussion
Contracted posture results in altered positions of lower extremity muscles that could lead to inadvertent neurovascular injection or decreased efficacy with injections. Findings in this study may be helpful for planning and executing injections to reduce spasticity in the lower extremity.

Conclusions
Sonographic imaging allows a better localization of muscles associated with spasticity and can instruct the clinician to alter usual injection pathways. This article documents visual evidence that previous assumptions for injection strategies require updating.
Asymptomatic Endometrial Thickening of 8 mm or Greater on Postcontrast Computed Tomography in Postmenopausal Women Is a Predictor of Endometrial Cancer
Authors: Franconeri Andrea , Fang Jieming , Brook Alexander , Brook Olga R. 
Published: October 2018

Objectives
The aim of this study was to assess the value of opportunistic endometrial thickness measurement on postcontrast computed tomography (CT) as a predictor of endometrial cancer in asymptomatic postmenopausal women.

Methods
For this Health Insurance Portability and Accountability Act–compliant, institutional review board–approved retrospective study with waiver of informed consent, our institution's tumor board database was searched for postmenopausal patients, diagnosed with endometrial cancer between August 2003 and December 2016 and who had a postcontrast pelvic CT within 12 months prior to the cancer diagnosis (while they were asymptomatic)—“cancer group.” Same number of age-matched patients who had postcontrast pelvic CT constituted the noncancer control group. Endometrial thickness was measured on sagittal postcontrast CT images.

Results
After applying exclusion criteria, 22 asymptomatic patients who were diagnosed with endometrial cancer within 1 year after the CT comprised the cancer group, and 22 age-matched patients comprised the control group. Average endometrial thickness was 18.7 ± 14.8 mm (range, 2–70 mm) in the cancer group and 3.6 ± 2.5 mm (range, 1.8–10 mm) in the control group (P < 0.0001). Endometrial thickness 8 mm or greater predicted endometrial cancer with 86% sensitivity and 91% specificity in these asymptomatic patients. Area under the receiver operating characteristic curve for endometrial thickness as a predictor of endometrial cancer was 0.92.

Conclusions
Endometrial thickness 8 mm or greater on sagittal postcontrast CT was shown to have high sensitivity in opportunistic detection of endometrial cancer in asymptomatic postmenopausal women.
Heterogeneous Pulmonary Perfusion on Dual-Energy Computed Tomography: Faulty Postprocessing or New Artifact?
Authors: Borse Riddhi , Homayounieh Fatemeh , Singh Ramandeep , Digumarthy Subba R. 
Published: October 2018

Abstract
Iodine uptake in the lungs and intrathoracic lesions on postcontrast dual-energy computed tomography is used for evaluation of pulmonary embolism–related perfusion defects and pulmonary infarctions. It has been applied in characterization and treatment response assessment of lung and mediastinal abnormalities. We report a new imaging artifact or faulty image postprocessing in a commercially available rapid kV switching technique of dual-energy computed tomography, which can confound its clinical utility for evaluation of iodine uptake.
Navigating the Pulmonary Perfusion Map: Dual-Energy Computed Tomography in Acute Pulmonary Embolism
Authors: Alis Jonathan , Latson Larry A. , Haramati Linda B. , Shmukler Anna 
Published: October 2018

Abstract
Pulmonary embolism is the third most common acute cardiovascular disease. Dual-energy computed tomography perfusion imaging is a promising adjunct in the detection of acute PE providing simultaneous functional assessment of pulmonary perfusion alongside the high-resolution morphological information from computed tomography pulmonary angiography. We review the evidence to date and common causes of perfusion defects including artifacts, parenchymal, and vascular causes, and discuss its potential in furthering our understanding of physiology and pathophysiology in acute pulmonary embolism.
Efficacy of the Rotational Traction Method in the Assessment of Glenohumeral Cartilage Surface Area in Computed Tomography Arthrography
Authors: Polat Gökhan , Oğul Hayri , Yalçin Ahmet , Tuncer Kutsi , Kaya Serhat , Pirimoğlu Berhan , Sade Recep , Kantarci Mecit 
Published: October 2018

Objective
We aimed to investigate the efficacy of the rotational traction method in expanding the joint space and enabling the assessment of an extended surface area.

Methods
Sixty patients who underwent computed tomography arthrography were evaluated in the study: 30 with and 30 without the help of rotational traction. The subgroups consisted of patients with adhesive capsulitis, habitual luxation, or labral tears. Areas of obscured joint surface by coalescent cartilages were calculated using computer software, and those belonging to the traction and nontraction groups along with subgroups were compared statistically.

Results
There was a significant difference between the traction and nontraction group regarding the contact surface area (P < 0.001 for both observers). In patients with adhesive capsulitis, the contact surface area was larger compared with the other subgroups (P = 0.002 for observer 1 and P = 0.002 for observer 2). In patients with habitual luxation, the contact surface area was smaller compared with the other subgroups (P = 0.002 for observer 1 and P = 0.001 for observer 2).

Conclusions
Expansion of joint distance is important for assessing the joint cartilage. The rotational traction method provides effective separation of the joint space. For this reason, rotational traction can be used effectively in patients in whom the joint cartilage is to be evaluated.
Effect of Virtual Monoenergetic Images From Spectral Detector Computed Tomography on Coronary Calcium Blooming
Authors: Van Hedent Steven , Große Hokamp Nils , Kessner Rivka , Gilkeson Robert , Ros Pablo R. , Gupta Amit 
Published: October 2018

Objective
The aim of this study was to investigate the quantitative and qualitative effects of virtual monoenergetic images (VMI) by spectral detector computed tomography (SDCT) on calcium blooming in coronary computed tomography angiography.

Methods
Coronary computed tomography angiography using SDCT was performed on 42 patients with coronary artery calcifications. Stenosis grading by diameter and area of calcified plaques and free lumen using VMI from 70 to 140 keV was performed and compared with measurements by conventional images. In addition, interobserver reliability and subjective image quality were assessed by 2 experienced readers.

Results
A total of 61 coronary arteries were evaluated. Stenosis grading by diameter and area showed significant incremental decrease, from 48.86% to 22.82% and from 41.18% to 11.33%, respectively, with increasing VMI (P < 0.05). Interobserver reliability was excellent (intraclass correlation coefficient >0.99). Overall image quality was best at 80 keV.

Conclusions
Calcium blooming significantly decreases at higher monoenergetic levels from SDCT, increasing luminal dimensions and decreasing stenotic grading, with best overall subjective image quality using 80-keV VMI.
Spectral Computed Tomography for the Quantitative Assessment of Patients With Carcinoma of the Gastroesophageal Junction: Initial Differentiation Between a Diagnosis of Squamous Cell Carcinoma and Adenocarcinoma
Authors: Zhou Yue , Hou Ping , Zha Kaiji , Liu Dan , Wang Feng , Zhou Kun , Gao Jianbo 
Published: October 2018

Objective
This study aimed to distinguish between esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) using spectral computed tomography (CT) and to discuss the accuracy according to an optimal threshold of single and combined parameters.

Methods
In this monoinstitution study, 61 patients, 35 of whom had ESCC and 26 had EAC confirmed by surgery or esophagoscopy, were recruited from August 2016 to March 2017. Enrolled patients underwent dual-phase chest CT enhancement. The spectral CT parameters (NIC, NICD, NICratio, Z
eff, Z
eff-C, K
40–70 keV, K
80–100 keV, and K
110–140 keV) were measured during arterial phase (AP) and venous phase (VP). Binary logistic regression was used to calculate combined predictive probability. Thresholds of quantitative parameters and diagnostic accuracy were calculated using receiver operating characteristic curve.

Results
Compared with ESCC, higher NICAP, NICVP, NICD, Z
eff AP, Z
eff VP, Z
eff-C AP, and Z
eff-C VP were observed for EAC, whereas NICratio was lower for EAC. Higher K
40–70 keV, K
80–100 keV, and K
110–140 keV were exhibited in EAC than in ESCC. Area under the curve (AUC) of NICAP, K
40–70 keV AP, and Zeff AP were 0.720, 0.730, and 0.706, respectively. The area under the curve of new combined predictive value of NICAP and λ40–0 keV AP was 0.804. The sensitivity and specificity were 77.80% and 80.60%, respectively, when the threshold of new predictive value was 0.60.

Conclusion
The diagnostic accuracy obtained by using NICAP and K
40–70 keV AP combined is better than that obtained using a single parameter in differentiation between a diagnosis of squamous cell carcinoma and adenocarcinoma.
Complementary Molecular and Metabolic Characterization of Meningiomas With DOTATATE and FDG-PET
Authors: Dressen Michael S. , Muthukrishnan Ashok , Tragon Tyson R. , Lieberman Frank S. , Mountz James M. 
Published: October 2018

Abstract

68Ga-DOTATATE imaging for meningiomas is gaining clinical use for selecting patients that may benefit from targeted therapy (eg, 177Lu-DOTATATE). We present an image of a 67-year-old man with an intracranial WHO grade III anaplastic meningioma. He underwent tumor resection followed by intensity-modulated radiation therapy but experienced a recurrence 25 months later. He received an 18F-(FDG) and 68Ga-DOTATATE PET/MR to evaluate for the presence of somatostatin receptor expression and guide subsequent treatment. The scans showed both concordant and discordant regions of uptake, indicating that high somatostatin receptor (SSTR2) expression may not coincide with areas of increased metabolic rate.
Visual and Semiquantitative Accuracy in Clinical Baseline 123I-Ioflupane SPECT/CT Imaging
Authors: Werner Rudolf A. , Marcus Charles , Sheikhbahaei Sara , Solnes Lilja B. , Leal Jeffrey P. , Du Yong , Rowe Steven P. , Higuchi Takahiro , Buck Andreas K. , Lapa Constantin , Javadi Mehrbod S. 
Published: October 2018

Purpose
We aimed to (a) elucidate the concordance of visual assessment of an initial 123I-ioflupane scan by a human interpreter with comparison to results using a fully automatic semiquantitative method and (b) to assess the accuracy compared to follow-up (f/u) diagnosis established by movement disorder specialists.

Methods
An initial 123I-ioflupane scan was performed in 382 patients with clinically uncertain Parkinsonian syndrome. An experienced reader performed a visual evaluation of all scans independently. The findings of the visual read were compared with semiquantitative evaluation. In addition, available f/u clinical diagnosis (serving as a reference standard) was compared with results of the human read and the software.

Results
When comparing the semiquantitative method with the visual assessment, discordance could be found in 25 (6.5%) of 382 of the cases for the experienced reader (ĸ = 0.868). The human observer indicated region of interest misalignment as the main reason for discordance. With neurology f/u serving as reference, the results of the reader revealed a slightly higher accuracy rate (87.7%, ĸ = 0.75) compared to semiquantification (86.2%, ĸ = 0.719, P < 0.001, respectively). No significant difference in the diagnostic performance of the visual read versus software-based assessment was found.

Conclusions
In comparison with a fully automatic semiquantitative method in 123I-ioflupane interpretation, human assessment obtained an almost perfect agreement rate. However, compared to clinical established diagnosis serving as a reference, visual read seemed to be slightly more accurate as a solely software-based quantitative assessment.
Pericardial Solitary Fibrous Tumor on FDG PET/CT
Authors: Shao Dan , Wang Shu-Xia 
Published: October 2018

Abstract
Solitary fibrous tumor, which can occur in all parts of the body and is more frequently found in the visceral pleura, is a rare mesenchymal tissue-originating spindle cell tumor derived from CD34-positive dendriticmesenchymal cells, but it rarely occurs in the pericardium. We reported the FDG PET/CT findings of a pathologically confirmed benign pericardial solitary fibrous tumor in a 51-year-old woman.
Intense Choline Activity in Renal Cell Carcinoma Without Obvious 18F-FDG Uptake
Authors: Xia Xiaotian , Hu Fan , Qin Chunxia , Liu Fang , Lan Xiaoli 
Published: October 2018

Abstract
A 64-year-old man presented pain over the right kidney region for 1 year. Contrast-enhanced MRI showed a sharply demarcated soft-tissue mass in the lower part of the right kidney. This lesion had no obvious uptake of 18F-FDG on PET/CT imaging, and an unexpected hypermetabolic irregularly shaped nodule was noted in the upper lobe of the right lung. 11C-choline PET was further performed to reveal the pathological property of the kidney lesion, and high uptake was noticed. The patient received surgery for the 2 lesions, and the final pathological diagnoses were chromophobe renal cell carcinoma and synchronous lung adenocarcinoma.
Dual-Phase 18F-FP-CIT PET in Corticobasal Syndrome
Authors: Min Je Hong , Park Dong Gyu , Yoon Jung Han , An Young Sil 
Published: October 2018

Abstract
Corticobasal syndrome is the most common phenotype of corticobasal degeneration (CBD). 18F-FP-CIT PET and MRI are not helpful in distinguishing CBD from idiopathic Parkinson disease. Dual-phase 18F-FP-CIT PET is a recently developed imaging that shows regional cerebral perfusion in the early phase and dopamine transporter density in the late phase. We investigated the usefulness of dual-phase 18F-FP-CIT PET imaging in 3 patients with corticobasal syndrome. This image highlights that the early phases of 18F-FP-CIT PET may reflect regional cerebral perfusion with a pattern very similar to that of regional glucose metabolism in CBD.
Head and Neck Cancer Soft Tissue Radiation Necrosis—Diagnostic Challenge
Authors: Pucar Darko , Groves Michael W. , Biddinger Paul , Figueroa Ramon , Williams Hadyn T. 
Published: October 2018

Abstract
A 53-year-old man with T4aN2cM0 tongue base squamous cell carcinoma received definitive chemoradiation. FDG PET/CT at 6 weeks showed partial metabolic response with soft tissue air indicating radiation necrosis at primary site and complete response in the neck. At 9 weeks, contrasted CT showed worsening but nonenhancing ulceration, area biopsied demonstrating a minute carcinoma focus with treatment effect. At 12 weeks, PET/CT showed increased primary site uptake interpreted as disease progression; however, no viable tumor was found at salvage surgery. Because nonenhancing ulceration predicts pure radiation necrosis with no viable tumor, contrasted CT may guide treatment selection in challenging cases.
Hypercoagulability in End-stage Liver Disease: Review of Epidemiology, Etiology, and Management
Authors: Verbeek Thomas A. , Stine Jonathan G. , Saner Fuat H. , Bezinover Dmitri 
Published: October 2018

Abstract
In this review, we analyze the epidemiology of thromboses related to end-stage liver disease (ESLD), discuss causes of hypercoagulability, describe susceptible populations, and critically evaluate proposed prophylaxis and treatment of thromboses. Classically, ESLD has been regarded as a model for coagulopathy, and patients were deemed to be at high risk for bleeding complications. Patients with ESLD are not auto-anticoagulated, and they do not have a lower risk of portal vein thrombosis, intracardiac thrombus formation, pulmonary embolism or hepatic artery thrombosis. Though the cause of hypercoagulability is multifactorial, endothelial dysfunction likely plays a central role for all patients with ESLD. Some subpopulations, such as patients with nonalcoholic steatohepatitis and autoimmune conditions, are at increased risk of thrombotic events as are patients of Hispanic ethnicity. The science behind prophylaxis of different types of clotting and treatment of thromboses is developing rapidly. A number of medications, including low molecular weight heparin, unfractionated heparin, aspirin, vitamin K antagonists, and direct oral anticoagulants can be used, but clear guidelines are lacking. Acute intraoperative clotting can be associated with high mortality. Routine use of transesophageal echocardiography can be helpful in early recognition and treatment of intraoperative thrombosis. Heparin should be reserved for cases of intracardiac thrombus/pulmonary embolism without hemodynamic instability. In unstable patients, low dose of recombinant tissue plasminogen activator can be used. In this new era of heightened awareness of thrombotic events in ESLD patients, prospective randomized trials are urgently needed to best guide clinical practice.
The architecture of cell differentiation in choanoflagellates and sponge choanocytes
Authors: Laundon Davis , Larson Ben , McDonald Kent , King Nicole , Burkhardt Pawel 
Published: October 2018

SUMMARYCollar cells are ancient animal cell types which are conserved across the animal kingdom [1] and their closest relatives, the choanoflagellates [2]. However, little is known about their ancestry, their subcellular architecture, or how they differentiate. The choanoflagellateSalpingoeca rosetta[3] expresses genes necessary for animal multicellularity and development [4] and can alternate between unicellular and multicellular states [3,5], making it a powerful model to investigate the origin of animal multicellularity and mechanisms underlying cell differentiation [6,7]. To compare the subcellular architecture of solitary collar cells inS. rosettawith that of multicellular “rosettes” and collar cells in sponges, we reconstructed entire cells in 3D through transmission electron microscopy on serial ultrathin sections. Structural analysis of our 3D reconstructions revealed important differences between single and colonial choanoflagellate cells, with colonial cells exhibiting a more amoeboid morphology consistent with relatively high levels of macropinocytotic activity. Comparison of multiple reconstructed rosette colonies highlighted the variable nature of cell sizes, cell-cell contact networks and colony arrangement. Importantly, we uncovered the presence of elongated cells in some rosette colonies that likely represent a distinct and differentiated cell type. Intercellular bridges within choanoflagellate colonies displayed a variety of morphologies and connected some, but not all, neighbouring cells. Reconstruction of sponge choanocytes revealed both ultrastructural commonalities and differences in comparison to choanoflagellates. Choanocytes and colonial choanoflagellates are typified by high amoeboid cell activity. In both, the number of microvilli and volumetric proportion of the Golgi apparatus are comparable, whereas choanocytes devote less of their cell volume to the nucleus and mitochondria than choanoflagellates and more of their volume to food vacuoles. Together, our comparative reconstructions uncover the architecture of cell differentiation in choanoflagellates and sponge choanocytes and constitute an important step in reconstructing the cell biology of the last common ancestor of the animal kingdom.
Differential Effects of the Menstrual Cycle on Reactive and Proactive Aggression in Borderline Personality Disorder
Authors: Peters Jessica R. , Owens Sarah A. , Schmalenberger Katja M. , Eisenlohr-Moul Tory A. 
Published: October 2018

AbstractBorderline personality disorder (BPD) is characterized by rapidly shifting symptoms, including intense anger and aggressive behavior. Understanding how fluctuations in ovarian hormones across the menstrual cycle may contribute to symptom instability is key for accurate assessment of BPD symptoms and effective interventions. Reactive and proactive aggression, as well as anger in and out, were assessed daily in 15 physically healthy, unmedicated naturally cycling female individuals without dysmenorrhea meeting criteria for BPD across 35 days. Urine LH surge and salivary progesterone were used to confirm ovulation and verify cycle phase. Cyclical worsening of symptoms was evaluated using multilevel models to evaluate symptom differences between cycle phases. Both forms of aggressive behavior demonstrated marked cycle effects, with reactive aggression highest during perimenstrual cycle phases, co-occurring with increases in anger in and out. In contrast, highest levels of proactive aggression were observed during the follicular and ovulatory phases, when emotional symptoms and anger were otherwise at lowest levels. These findings highlight the importance of identifying the function of aggression when considering potential psychological and biological influences. Naturally cycling individuals with BPD may be at elevated risk for perimenstrual worsening of a range of interpersonally reactive symptoms, including reactive aggression, whereas proactive aggression may occur more in phases characterized by less emotional and cognitive vulnerability and greater reward sensitivity. Research on aggression in this population should consider cycle effects. Cycling individuals with BPD attempting to reduce aggressive behavior may benefit from cycle-tracking to increase awareness of these effects and to develop appropriate strategies.