bluuebunny/crossref_metadata_2025_split huggingface dataset:
Solitary colonic metastasis from primary lung adenocarcinoma first presenting as intestinal obstruction
Authors: Choi Sang-ji , Hong Seong Kweon , Chae Gibong , Ryu Young-Joon , Park Sung-Bae , Kim Yang Hee , Moon Suk-Bae , Kim Song-Yi , Kim Hwansoo 
Published: January 2019

Abstract

Rationale:
The brain, liver, adrenal glands, and bone are the most common sites of metastatic disease in patients with lung cancer. Symptomatic gastrointestinal metastases are rare. In the present report, we describe a rare case of a patient with intestinal obstruction due to solitary colonic metastasis from primary lung adenocarcinoma, wherein the intestinal obstruction was the first symptom of lung cancer.

Patient concerns:
A 74-year-old man was admitted to the emergency room with abdominal pain and vomiting, and abdominal computed tomography (CT) indicated obstruction of the ascending colon due to a huge mass.

Diagnosis:
The ascending colon cancer was found to be a metastatic adenocarcinoma based on the results of the pathology report. Chest CT and positron emission tomography-CT were performed to identify the cancer origin site. Moreover, immunohistochemical staining of the tissue specimen for thyroid transcription factor 1, cytokeratin 7 (CK7), and CK20 and CT-guided gun biopsy of the lung mass confirmed the presence of an adenocarcinoma that originated from the lung.

Intervention:
Right hemicolectomy was performed as the primary treatment.

Outcomes:
The patient recovered without any problems due to the surgery itself. However, malignant pleural effusion deteriorated, and no additional palliative chemotherapy was performed.

Lessons:
Patients with malignant bowel obstruction along with lung infiltration should be suspected of not only colon cancer with lung metastasis, but also lung cancer with colon metastasis.
Characteristics and proposed classification system of posterior pilon fractures
Authors: Zhang Jianzheng , Wang Hao , Pen Cheng , Qu Wen-chun , Duan Lida , Ren Jixin , Li Lianhua , Liu Zhi , Sun Tiansheng 
Published: January 2019

Abstract
Posterior pilon fractures involve the medial malleolus (MM). Our purpose was to define the characteristics of posterior pilon fractures, and propose a classification system based on fracture morphology and type of management.
The records of patients with posterior pilon fractures treated from 2011 to 2015 were retrospectively reviewed. The injury mechanism, fracture morphology, surgical approach, and follow-up results were reviewed and analyzed. This study was approved by the Institutional Review Board of PLA Army General Hospital.
Thirty-six patients, 18 males and 18 females (mean age: 48.9 years) were included in the study. Four characteristics were used to define posterior pilon fractures. A simple posterolateral approach or a combined posterolateral and posteromedial approach was used for reduction and fixation in all patients. The mean follow-up time was 28.2 months, and at the end of follow-up, the mean American Orthopedic Foot and Ankle Society Score (AOFAS) was 82.5 points (range: 35–100 points). Based on injury mechanism and fracture morphology, we classified posterior pilon fractures into 3 types that suggest the optimal surgical approach: type I, a single complete fracture fragment; type II, a posterior malleolus fracture with 2 subtypes; type III, a posterior malleolus fracture associated with complete MM fracture with 2 subtypes.
The proposed classification system based on injury mechanism and fracture morphology can guide the surgical approach to maximize outcomes.
Population pharmacokinetics and individualized lobaplatin regimen for the treatment of Chinese small cell lung cancer in the elderly
Authors: Cheng Ying , Wu Lin , Liu Xiaoqing , Zhao Yanqiu , Liu Chunling , Chen Qun , Sun Tao , Zheng Qingshan 
Published: January 2019

Abstract

Background:
Lobaplatin (LBP) is a third-generation platinum compound.

Material and methods:
This prospective study was performed in 7 institutions in 2014–2016. Elderly small cell lung cancer (SCLC) patients (≥65 years old) were divided into 2 groups to receive LBP regimens according to endogenous creatinine clearance rate (Ccr). LBP was administered at 30 and 20 mg/m2 in groups A (Ccr ≥ 80 ml/min) and B (60 ml/min ≤ Ccr < 80 ml/min), respectively. The primary endpoint was plasma LBP concentrations. Secondary endpoints were safety and efficacy parameters, including progression-free survival (PFS) and overall survival (OS).

Results:
One-hundred patients were enrolled. Median PFS and OS in groups A and B were 155 vs170 days and 306 vs 272 days, respectively. The rates of grade III/IV AEs in groups A and B were 60.8% (n = 31) and 51.0% (n = 25), respectively. In population pharmacokinetics, the area under the curve (AUC) value for group B was 39% lower than that of group A. With LBP administration based on body surface area (BSA), AUC differences between individuals were small.

Conclusion:
With Ccr ≥ 60 ml/min, BSA based administration is necessary. Meanwhile, LBP-based regimens are reliable in treating elderly patients with SCLC.
Acupotomy for the treatment of lumbar spinal stenosis
Authors: Kwon Chan-Young , Yoon Sang-hoon , Lee Boram , Leem Jungtae 
Published: January 2019

Abstract

Introduction:
This systematic review protocol describes the methods that will be used to evaluate the efficacy and safety of acupotomy for the treatment of lumbar spinal stenosis.

Methods and analysis:
The following electronic databases will be searched until December 2018 without language or publication status restrictions: five English databases, that is Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Allied and Complementary Medicine Database (AMED), and Cumulative Index to Nursing and Allied Health Literature (CINAHL); three Korean databases, that is Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), and Korea Citation Index (KCI); and three Chinese databases, that is China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP. Any clinical, randomized controlled trials using acupotomy for lumbar spinal stenosis treatment will be included. Changes in the degrees of pain and function will be assessed as primary outcomes. The total effective rate, changes in quality of life, adverse events, and amount of rescue medication used will be evaluated as secondary outcomes. Two independent researchers will perform study selection, data extraction, and risk of bias assessment. If applicable, a meta-analysis will be performed using RevMan version 5.3, with the results expressed as risk ratios or mean differences with 95% confidence intervals. According to a heterogeneity test or the number of studies included, fixed effects or random effects model will be used. The risk of bias tool from the Cochrane group will be used to evaluate the methodological quality of the included studies.

Ethics and dissemination:
Ethical approval is not required because individual patient data will not be included in this study. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentations.

PROSPERO registration number:
CRD42018116567.
Marfan syndrome with type 2 diabetes mellitus
Authors: Zhou Yingyi , Du Xuan , Chen Chao , Shi Bimin , Chen Ke 
Published: January 2019

Abstract

Rationale:
Marfan syndrome (MFS) is a genetic disorder of the connective tissue. MFS has an incidence of about 2 to 3 persons per 10,000 population. MFS is characterized majorly by the involvement of the eyes, skeletal muscles, and cardiovascular system. There are limited case reports of co-existence of MFS and type 2 diabetes mellitus (T2DM).

Patient concerns:
A 16-year-old male patient who got admitted to our hospital with complaints of loss of vision from left eye for the last 3 days.

Diagnosis of MFS along with luxation of left eye lens, and T2DM were made according to the patient's symptoms, signs, biochemical results, and ultrasonography.

Interventions:
The patient received “vitrectomy (posterior approach (left eye)) + cataract extraction (left eye) + intraocular lens implantation (left eye) surgery” for luxation of left eye lens. The patient received “Bentall Operation” for MFS, and was prescribed warfarin 5 mg qod and spironolactone 20 mg bid during the follow-up period. The patient received continuous subcutaneous insulin infusion (CSII) during hospitalization, and then changed to insulin glargine preparation during the follow-up period.

Outcomes:
The vision was restored after the eye surgery and the patient also recovered well after the Bentall Operation. Additionally, there were no obvious complications during hospitalization and the follow-up period. Blood glucose levels were within normal range.

Lessons:
There is a need to improve the recognition of MFS among school and community doctors. Early detection, diagnosis, and treatment of this rare disease can improve the quality of patient's life.
A novel self-expanding biflanged metal stent vs tubular metal stent for EUS-guided transmural drainage of pancreatic pseudocyst
Authors: Yao Yao , Zhang Dingguo , Guo Jiefang , Qi Ke , Li Feng , Zhu Jianwei , Wang Dong , Chen Jie , Xu Can , Wang Luowei , Wang Kaixuan , Jin Zhendong , Li Zhaoshen 
Published: January 2019

Abstract
Although endoscopic ultrasound (EUS)-guided transmural drainage of pancreatic fluid collections with metal stents is generally preferred over plastic stents, its superiority among different types of metal stents has not yet been well studied. We conducted this study to compare clinical outcomes and complications of a novel self-expanding biflanged metal stent (BFMS) and a traditional-shaped tubular metal stent (TMS) in treating pancreatic pseudocyst (PPC).
This was a retrospective analysis on consecutive patients with PPC underwent EUS-guided transmural drainage with either TMS or BFMS in a single tertiary center with expertise in management of complex biliary and pancreatic problems. The technical and functional success rate, reintervention, complications, and recurrence rate were evaluated.
From September 2013 to January 2018, 125 patients (66.4% male, median age 47 years) underwent EUS-guided transmural drainage for PPC. Among them, 49 used TMS and 76 used BFMS. All patients met the inclusion criteria that cyst diameter was >6 cm or the distance between cyst and stomach wall was shorter than 1 cm. There was no difference in technical success (98% vs 97.4%, P = 1.0) or functional success rate (87.8% vs 92.1%, P = .54) using 2 types of metal stents. However, more procedure related complications occurred in TMS than in BFMS group. TMS group had a much higher migration rate than BFMS group (14.6% vs 0, P = .001), even though there was no significant difference in bleeding, infection, or death rate between 2 groups. With similar clinical outcomes, TMS group required more additional plastic stent placement than BFMS group for better drainage.
TMS and BFMS placement can both be considered as methods of endoscopic transmural PPC drainage with equal efficacy, whereas BFMS could be preferred for fewer complications or less need of additional plastic stent placement.
A pathological toe fracture as the first presentation of cervical cancer
Authors: Zhang Jinming , Li Ze , Ma Xiaotong , Feng Helin 
Published: January 2019

Abstract

Rationale:
Cervical cancer is one of the most common gynecologic malignancies worldwide, and it spreads mainly through direct extension. Distinct metastases are less common and usually spread to distant lymph nodes, lungs, and bones. Bone metastases from cervical cancer are most commonly observed in the pelvis and spine. Thus, a pathological toe fracture as the initial presentation of cervical cancer is extremely rare.

Patient concerns:
We report a patient with a toe metastasis that first presented with pain caused by a pathological fracture.

Diagnoses:
The patient underwent surgery to remove the right great toe, and the histopathology revealed squamous carcinoma that originated from the cervix.

Interventions:
The patient then underwent cervical cancer surgery, chemotherapy, and radiotherapy.

Lessons:
A pathological toe fracture as the initial presentation of cervical cancer is extremely rare, but clinicians need to be aware that we should not exclude cancer when patients come to the hospital for pathological fractures.
Triple Premasseteric Branches of Facial Artery
Authors: Nayak Satheesha B. 
Published: January 2019

Abstract
Facial artery is known to show variations in its origin, course, termination, and branching pattern. One of its reported variant branch is called premasseteric branch. During our dissection classes, it was observed that an elderly male cadaver had 3 premasseteic branches arising from the facial artery. The first and second premasseteric branches passed deep to masseter under its anterior border, whereas the third premasseteric branch terminated by anastomosing with the infraorbital artery. This case could be of importance to maxillofacial surgeons, craniofacial surgeons, and plastic surgeons.
Reconstruction of Mohs Defects Located in the Head and Neck
Authors: Egeler Sabine A. , Johnson Anna Rose , Ibrahim Ahmed M.S. , Bucknor Alexandra , Chen Austin , Malyar Masoud , Tobias Adam M. , Lin Samuel J. , Mureau Marc A.M. , Lee Bernard T. 
Published: January 2019

Background:
Defects following Mohs micrographic surgery (MMS) can range in size from small defects requiring linear closure to large defects needing flap coverage. Reconstruction is dependent on defect size and facial aesthetic unit involvement. The aim of this study was to review the types of facial reconstruction per aesthetic unit involvement and describe their outcomes.

Methods:
All data were retrieved for patients ≥18 years who underwent multidisciplinary treatment including dermatological MMS and plastic surgical reconstruction at a single tertiary hospital center (2001–2017). Patient characteristics, tumor pathology, surgical specifics, reconstructive modalities, and surgical outcomes were analyzed.

Results:
A total of 418 patients were included. Patients were predominantly White, non-Hispanic (97%) and female (58%) with a mean age of 60 ± 13.9 years. Tumor pathology was predominantly basal cell carcinoma in 73% of all cases followed by squamous cell carcinoma in 14%. The nasal aesthetic unit was mostly affected (50%). Local advancement flaps and different types of grafts were used in 51% and 25% of reconstructions, respectively. Complications were observed in 3% and local cancer recurrence in 4% of the patients. Scar revision was needed in 6% of the patients.

Conclusion:
Reconstruction of facial defects after Mohs micrographic surgery can be challenging due to its technical complexity and aesthetic implications. There were differences in complications in reconstructions performed within the same day versus 1 week, with a majority of complications occurring within same-day Mohs reconstructions. A multidisciplinary structured approach, which incorporates patient-reported outcomes, may be needed to optimize surgical results.
Cone-Beam Computed Tomography Study on Morphologic Characteristics of the Posterior Region in Hard Palate
Authors: Ling Chuangliang , Jiang Qian , Ding Xiaojun 
Published: January 2019

Background:
The goal of this study is to evaluate the morphologic characteristics of the posterior palatine region among the Chinese population, more specifically, the greater palatine grooves, crests, bridges, and torus palatinus structures and make comparisons between different ethnic groups and minorities.

Methods:
A total of 323 cone-beam computed tomography (CBCT) scans were collected for analysis on the presence of grooves, crests, bridges, or torus palatinus (TP). Data were collected through recognizing the grooves, crests, bridges, and TPs and calculating the number of those anatomy structures. The statistics index, including average, standard deviation, were adopted to describe the subjects and Wilcoxon test, Mann–Whitney test, and Chi-squared test were all carried out by SPSS.

Results:
Three different morphologic manifestations of the greater palatine groove (GPG) found in the upper 1st and 2nd molar regions are as follows: no groove, 1 groove, and 2 grooves. The number of crests ranged from 0 to 3. And the incidence of torus palatines was 29%. Moreover, a positive correlation was found between the presence of crests/GPGs and age in the 2nd molar region.

Conclusion:
The results in this study reveal that GPGs in the upper 1st and 2nd molar regions have 3 different morphologic manifestations among Chinese people and the number of crests can vary from 0 to 3 crests. Although the proportion of GPG or crest and the incidence of TP are different from the proportions of other studies, this may be due to the fact that different ethnic groups and sample sizes were used in the course of this study. Information about the anatomy structures of the posterior region in hard palate directly contributed to a decrease in potential complications during palatal implant surgery and periodontal surgery.
Black sea cucumber (Holothuria atra Jaeger, 1833) rescues Pseudomonas aeruginosa-infected Caenorhabditis elegans via reduction of pathogen virulence factors and enhancement of host immunity
Authors: Lee Wan-Ting , Tan Boon-Khai , Eng Su-Anne , Yuen Gan Chee , Chan Kit Lam , Sim Yee Kwang , Sulaiman Shaida Fariza , Shu-Chien Alexander Chong 
Published: January 2019

AbstractA strategy to circumvent the problem of multidrug resistant pathogen is consumption of functional food rich in anti-infectives targeting bacterial virulence or host immunity. The black sea cucumber (Holothuria atra) is a tropical marine sea cucumer species traditionally consumed as remedy for many ailments. There is a paucity of knowledge the anti-infectives capacity of H. atra and the underlying mechanisms involved. The objectives of this study were to utilize the Caenorhabditis elegans-P. aeruginosa infection model to assess the anti-infective properties of H. atra. We first showed the capacity of a H. atra extract and fraction in promoting survival of C. elegans during a customarily lethal P. aeruginosa infection. The same chemical entities also attenuate the production of several P. aeruginosa virulence factors and biofilm. Treatment of infected transgenic lys-7::GFP worms with H. atra fraction restored the repressed expression of lys-7, a defense enzyme, indicating improved host immunity. QTOF-LCMS analysis revealed the presence of aspidospermatidine, an indole alkaloid and inosine. Collectively, our finding shows that H. atra confers survival advantage in C. elegans against P. aeruginosa infection through inhibition of pathogen virulence and eventually, the restitution of host lys-7 expression.
Carriage of a single strain of non-toxigenic Corynebacterium diphtheriae biovar Belfanti (Corynebacterium belfantii) in four patients with cystic fibrosis
Authors: Pivot Diane , Fanton Annlyse , Badell-Ocando Edgar , Benouachkou Marion , Astruc Karine , Huet Frederic , Amoureux Lucie , Neuwirth Catherine , Criscuolo Alexis , Aho Serge , Toubiana Julie , Brisse Sylvain 
Published: January 2019

ABSTRACTCystic fibrosis (CF) patients are commonly colonized by bacterial pathogens, which can induce persistent lung inflammation and may contribute to clinical deterioration. Colonization of CF patients and cross-transmission by Corynebacterium diphtheriae has not been reported so far. The aim of this article was to investigate the possibility of a cross transmission of C. diphtheriae biovar Belfanti between four patients of a CF center. C. diphtheriae biovar belfanti (now formally called C. belfantii) isolates were collected from four patients in a single CF care center over a 6 years period and analyzed by microbiological methods and whole genome sequencing. Epidemiological links among patients were investigated. Ten isolates were collected from 4 patients. Whole genome sequencing of one isolate from each patient showed that a single strain was shared among them. In addition, one patient had the same strain on two consecutive samplings nine months apart. The strain was non-toxigenic and was susceptible to most antimicrobial agents. Ciprofloxacin resistance was observed in one patient. Transmission of the strain among patients was supported by the occurrence of same-day visits to the CF center. This study demonstrates colonization of CF patients by C. diphtheriae biovar Belfanti (C. belfantii) and shows persistence and transmission of a unique strain during at least six years in a single CF patient care center.Previous meeting presentationsThe information in this work was not previously presented in any meeting.Accession numbersThe genomic sequence data generated in this work were submitted to the European Nucleotide Archive and are available from the International Nucleotide Sequence Database Collaboration (NCBI/ENA/DDBJ) databases under project accession number PRJEB28372 and run data accession numbers ERR2757916 to ERR2757921.
RPA phosphorylation regulates DNA resection
Authors: Soniat Michael M. , Myler Logan R. , Paull Tanya T. , Finkelstein Ilya J. 
Published: January 2019

AbstractGenetic recombination in all kingdoms of life initiates when helicases and nucleases process (resect) the free DNA ends to expose single-stranded (ss) DNA overhangs. Resection termination in bacteria is programmed by a DNA sequence but the mechanisms limiting resection in eukaryotes have remained elusive. Using single-molecule imaging of reconstituted human DNA repair factors, we identify a general mechanism that limits DNA resection. BLM helicase together with EXO1 and DNA2 nucleases catalyze kilobase-length DNA resection on nucleosome-coated DNA. The resulting ssDNA is rapidly bound by RPA, which is in turn phosphorylated as part of the DNA damage response (DDR). Remarkably, phosphorylated RPA (pRPA) inhibits DNA resection via regulation of BLM helicase. pRPA suppresses BLM initiation at DNA ends and promotes the intrinsic helicase strand-switching activity. These findings establish that pRPA is a critical regulator of DNA repair enzymes and provides a feedback loop between the DDR and DNA resection termination.
Molecular and functional heterogeneity of cancer associated fibroblasts in high-grade serous ovarian cancer
Authors: Hussain Ali , Voisin Veronique , Poon Stephanie , Dmytryshyn Julia , Richman Cory , Meens Jalna , Ho Victor W , Tang Kwan Ho , Paterson Joshua , Clarke Blaise , Bernardini Marcus Q , Bader Gary D , Neel Benjamin G , Ailles Laurie E 
Published: January 2019

SUMMARYRecent studies indicate that cancer-associated fibroblasts (CAFs) are phenotypically and functionally heterogeneous. However, little is known about CAF subtypes and the roles they play in cancer progression. Here we identify and characterize two CAF subtypes that coexist within high grade serous ovarian cancers: Fibroblast activation protein (FAP)-high (FH) CAFs resemble the classical myofibroblast-type CAF, whereas FAP-low (FL) CAFs possesses a preadipocyte-like molecular signature. Patients with predominantly FH CAFs have significantly worse outcomes than patients with predominantly FL CAFs. FH CAFs contract collagen gels and aggressively promote proliferation, invasion and therapy resistance of cancer cells, whereas FL CAFs do not. Overexpression of the FL-specific transcription factor TCF21 in FH CAFs decreases their ability to promote gel contraction, invasion, and in vivo tumor growth. Understanding CAF subtypes in more detail could lead to better patient stratification and novel therapeutic strategies.