bluuebunny/crossref_metadata_2025_split huggingface dataset:
Convergent strabismus fixus after bilateral abducens nerve palsies due to aneurysms
Authors: Oku Hidehiro , Nishikawa Yuko , Kida Teruyo , Tonari Masahiro , Sugasawa Jun , Ikeda Tsunehiko 
Published: December 2018

Abstract

Rationale:
Convergent strabismus fixus is an ocular motor abnormality in which the eye is fixed in adduction. This condition is mostly associated with high myopia and is caused by a displacement of the extraocular muscles. We report a nonmyopic woman with convergent strabismus fixus due to aneurysms.

Patient concerns:
A 79-year-old woman complained of progressive worsening of esotropia about 50 years prior to her visit. Neuroimaging showed that the eye was not dislocated, and the extraocular muscles were not displaced. However, aneurysms were found bilaterally from the intracavernous carotid arteries and the location was on both abducens nerves.

Diagnoses:
Chronic bilateral abducens nerve palsies due to aneurysms.

Interventions:
Endovascular treatment was successfully performed for the aneurysms.

Outcomes:
Convergent strabismus fixus still remained.

Lessons:
Chronic abducens nerve palsies may develop to nonmyopic convergent strabismus fixus without displacement of extraocular muscles, and mass lesions in the brain including aneurysms should be ruled out when orbital MRI cannot explain the condition.
The efficacy of thoracic paravertebral block for thoracoscopic surgery
Authors: Hu Zhi , Liu Dan , Wang Zhi-Zhen , Wang Biao , Dai Tianyang 
Published: December 2018

Abstract

Background:
The efficacy of thoracic paravertebral block for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of thoracic paravertebral block on thoracoscopic surgery.

Methods:
We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2018 for randomized controlled trials (RCTs) assessing the effect of thoracic paravertebral block on thoracoscopic surgery. This meta-analysis is performed using the random-effect model.

Results:
Six RCTs involving 300 patients are included in the meta-analysis. Overall, compared with control group for thoracoscopic surgery, thoracic paravertebral block results in significantly reduced pain scores within 6 hours (Std. MD = −2.15; 95% CI = −3.67 to −0.62; P = .006), postoperative anesthesia consumption during 48 hours (Std. MD = −1.81; 95% CI = −3.05 to −0.58; P = .004), and hospital stay (Std. MD = −1.19; 95% CI = −2.13 to −0.26; P = .01), but has no important impact on pain scores at 24 hours (Std. MD = −1.10; 95% CI = −2.77–0.57; P = .20), and 48 hours (Std. MD = −1.25; 95% CI = −2.86–0.36; P = .13).

Conclusions:
Thoracic paravertebral block can substantially enhance pain management for thoracoscopic surgery.
Association of allergic rhinitis with obstructive sleep apnea
Authors: Cao Yuan , Wu Shuang , Zhang Liyu , Yang Ying , Cao Sancheng , Li Qiao 
Published: December 2018

AbstractBackground:The co-existence of allergic rhinitis (AR) and obstructive sleep apnea (OSA) is a common phenomenon in clinical practice. AR has long been considered a risk factor for OSA. However, the relationship is not completely clear. Therefore, we conducted a meta-analysis to evaluate the prevalence of AR in sleep-disordered breathing (SDB) /OSA and their relationship.Methods:A comprehensive literature search was performed in PubMed/Medline, Google Scholar, Wiley Online Library, EMBASE, and Web of Science. Data were analyzed and pooled to estimate effect size (ES) /odds ratio (OR) with 95% confidence intervals (95%CI). Heterogeneity was quantified and evaluated by chi-squared-based Q-test and I2 test, withP < .05 andI2 > 50% indicating evidence of heterogeneity.Results:44 studies contained 6086 participants were included in this meta-analysis. For adults, the prevalence of AR was 22.8 (95% CI, 15.0–30.6) % in SDB and 35.2 (95% CI, 25.6–44.7) % in OSA. In children with SDB and OSA, the prevalence of AR was 40.8 (95% CI, 24.3–57.2) %, and 45.2 (95% CI, 25.4–65.0) % respectively. The odds ratios of prevalence of the SDB pediatric patients with AR was 2.12 (95%CI, 1.75, 2.57;P < .0001) times higher than that of non-SDB pediatric patients. There were no significant differences between OSA adults with or without AR in BMI (Body Mass Index), neck circumference, apnea hypopnea index (AHI) and epworth sleep scale score (ESS).Conclusion:The prevalence of AR in OSA/SDB is considerably high and children with SDB suffering from a higher incidence of AR than non-SDB. OSA adults accompanied with AR do not have any influences on sleep parameters.
Intracranial hemorrhage after carotid artery stenting in both anterior and posterior circulation
Authors: Wang Pian , Wang Yan , Zhang Qingbin 
Published: December 2018

Abstract

Rational:
Intracranial hemorrhage (ICH) after carotid artery stenting (CAS) is a rare but fatal complication, and it primarily occurs in the corresponding vascular distribution area. Herein, a case of ICH after CAS in both anterior and posterior circulation has been described.

Patient concerns:
A 62-year-old female was referred to the hospital for left-side limb weakness and right nasal hemianopia for 1 month.

Diagnosis:
Cerebral MRI following hospitalization revealed cerebral infarction in the right posterior cortical watershed area. Computed tomography angiography (CTA) showed severe stenosis in the right internal carotid artery.

Interventions:
We performed CAS to treat the right internal carotid artery stenosis without any complications.

Outcomes:
After CAS, cerebral hemorrhage occurred under strict control of blood pressure in both anterior and posterior circulation. After 69 days of treatment, the patient was discharged from the hospital.

Lessons:
Hypertension is still one of the causes of ICH after CAS. The control of perioperative BP in patients with severe carotid stenosis is yet a major concern.
Nonsmall cell lung cancer with rare exon 7 p.A289V mutation in the EGFR gene responds to Icotinib treatment
Authors: Dai Limeng , Su Xuejiao , Lu Lin , Lv Donglai 
Published: December 2018

Abstract

Rationale:
Mutation p.A289V involving extracellular region of epidermal growth factor receptor (EGFR) exon 7 has not yet been reported in nonsmall cell lung cancer (NSCLC). Studies have shown p.A289V mutation responding to tyrosine kinase inhibitors (TKIs) in glioblastoma cell lines suggesting the point mutation as a potential therapeutic target. However, sufficient evidence of the effect of TKI treatment on the p.A289V mutation involved in NSCLC is not available.

Patient concerns:
An 80-year-old nonsmoker male with lung mass was suffering from severe bone pain.

Diagnosis:
Needle biopsy and positron emitted tomography/computed tomography were performed. The patient was diagnosed with advanced NSCLC adenocarcinoma with bone and lymphatic metastasis. Next-generation sequencing of circulating tumor DNA was performed, which identified a p.A289V mutation in the EGFR gene of the patient.

Interventions:
Our patient refused to receive chemotherapy and tried Icotinib treatment.

Outcomes:
Our patient had a partial response to Icotinib after treatment for 5 months during the therapeutic trial by TKIs. The patient showed adverse symptoms of mild diarrhea and rash (Common Terminology Criteria for Adverse Events grade 1) during the treatment.

Lessons:
In this case, Icotinib prevented completion of the signal transduction cascade of p.A289V mutant in NSCLC. Our finding may expand the EGFR mutation spectrum for TKI treatment in NSCLC. However, the finding needs to be confirmed at a larger scale with NSCLC in Chinese and other populations.
Posterolateral decompression, bone graft fusion, posterior instrumentation, and local continuous chemotherapy in the surgical treatment of thoracic spinal tuberculosis
Authors: Yin Xin Hua , Yan Liang , Yang Ming , Zhang Ke , He Bao Rong , Liu Zhong Kai , Hao Ding Jun 
Published: December 2018

Abstract
To investigate the clinical efficacy of surgical treatment for thoracic spinal tuberculosis with kyphosis deformity via posterolateral debridement, fusion, posterior instrumentation and local continuous chemotherapy. A total of 25 patients with thoracic tuberculosis received surgery by posterolateral decompression, fusion, posterior instrumentation, and postural drainage with local continuous chemotherapy between June 2009 and October 2011. The clinical outcomes was evaluated using statistical analysis about deformity correction, bone fusion, neurologic status, and the visual analog score (VAS) and erythrocyte sedimentation rate (ESR). All of 25 patients were followed up for 39.0 ± 10.7 months (range, 24–60 months) postoperatively. There was no recurrence of tuberculosis, breakage and looseness of internal fixation. Bony fusion was achieved in all cases with 6.7 ± 1.9 months. The values of ESR recovered to normal within 6 months postoperatively. All patients with neurological deficit had significant improvement at the final follow-up. The average preoperative Cobb angles were significantly decreased to 12.2 ± 2.9° (range, 8–17°) postoperatively, and at final follow-up were 12.9 ± 2.7°. Our results showed that single-stage posterolateral debridement fusion, posterior instrumentation and local continuous chemotherapy can be expected to yield satisfactory clinical and radiographic outcomes in patients with thoracic spinal tuberculosis.
The association between IGF1 Gene 3’-UTR polymorphisms and cancer risk
Authors: Xu Gui-Ping , Chen Wei-Xian , Xie Wen-Yue , Wu Li-Fang 
Published: December 2018

Abstract

Background and Objective:
Insulin-like growth factor 1 (IGF1) gene three prime untranslated region (3’-UTR) polymorphisms have been reported to be associated with cancer risk. However, the conclusions of the relevant studies are not consistent. The present meta-analysis evaluates the relationship between IGF1 gene 3’-UTR polymorphisms (rs5742714, rs6214, and rs6220) and cancer risk.

Methods:
Articles regarding the relationship between IGF1 rs5742714, rs6214, and rs6220 polymorphisms and cancer risk were selected by searching the PubMed, Embase, and Web of Science databases before April 30, 2018. Altogether, we obtained 34 case-controlled studies from 20 articles, including 21,568 cases and 31,199 controls. The strength of associations was quantified using odds ratios (ORs) and the corresponding 95% confidence intervals (CIs).

Results:
In the present meta-analysis, no significant associations were detected between rs5742714, rs6214, and rs6220 and overall cancer risk. Thus, in stratified analyses, we found that rs6214 was associated with a significantly reduced risk of breast cancer under the allele, heterozygote, and dominant models (A vs G: OR, 0.94, 95% CI,0.88–1.00, P = .044; GA vs GG: OR, 0.88, 95% CI, 0.80–0.97, P = .012; AA + GA vs GG: OR, 0.89, 95% CI, 0.81–0.97, P = .011), as well as pancreatic cancer under the recessive model (AA vs GA + GG: OR, 0.68, 95% CI,0.53–0.87, P = .003). Also, rs6220 was associated with a significantly increased risk of breast cancer under the homozygote model (GG vs AA: OR, 1.23, 95% CI, 1.02–1.48, P = .031). In addition, rs6220 was found to increase overall cancer risk among Caucasians under the allele model (G vs A: OR, 1.06, 95% CI, 1.00–1.13, P = .043).

Conclusions:
In this meta-analysis, we investigated and reviewed the relationship between IGF1 gene 3’-UTR polymorphisms (rs5742714, rs6214, and rs6220) and cancer risk based on present epidemiological studies. Further studies are needed to draw more precise conclusions in the future.
Therapeutic efficacy of latanoprost on primary open angle glaucoma
Authors: Dai Hai-yan , Wang Jia-ying , Li Yan-qing , Diao Hui-jie , Zhang Li 
Published: December 2018

Abstract

Background:
Latanoprost is quiet new formulation that is approved for the treatment of primary open angle glaucoma (POAG). However, no updated systematic review has addressed its efficacy for POAG. This systematic review of randomized controlled trials (RCTs) aims to assess its efficacy and safety for the treatment of patients with POAG.

Methods:
This study will search the databases of CENTRAL, EMBASE, MEDILINE, CINAHL, AMED and Chinese databases without language restrictions from their inception to the present. It will only include RCTs of latanoprost for POAG. The quality of the included RCTs will be evaluated by the tool of Cochrane risk of bias. The primary outcomes will be measured by the mean IOP reduction from baseline to the endpoint. The secondary outcomes will be assessed by the mean IOP, adjusted mean IOP reduction at each time point, quality of life, and adverse events. The RevMan V.5.3 software will be used to compute the data synthesis carefully if the meta-analysis is allowed. The summary results of the included RCTs will be conducted by using the models of random-effects or fixed-effects based.

Results:
The results of this study will be published at the peer-reviewed journals. It will provide evidence to determine the efficacy and safety of latanoprost for POAG.

Conclusion:
The results of this study will provide helpful evidence for both clinicians and patients, and for the health policy makers to refer for the policy or guideline making.

Systematic review registration:
PROSPERO CRD42018115416.
Endoscopic submucosal dissection of early gastric cancer with mixed-type histology
Authors: Bang Chang Seok , Choi Jae Ho , Yang Young Joo , Lee Jae Jun , Baik Gwang Ho 
Published: December 2018

Abstract

Background:
Endoscopic submucosal dissection (ESD) is a primary treatment for the early gastric cancer (EGC) who have a negligible risk of lymph node metastasis satisfying specific criteria. These criteria are histologically categorized by EGC with differentiated-type histology (EGC-DH) and undifferentiated-type histology (EGC-UH). However, gastric cancer is histologically heterogenous and there has been no specific criteria for EGC with mixed-type histology (EGC-MH). Moreover, therapeutic outcomes of ESD for EGC-MH have not been clearly described.

Methods:
We will search the core databases (MEDLINE (through PubMed), the Cochrane Library, and Embase) from their inception to November 2018 using pre-established searching strategy by 2 independent evaluators. The P.I.C.O. is as follows; Patients: who have EGC-MH, Intervention: ESD, Comparison: none, Outcome: at least one among the rate of complete resection, curative resection, en bloc resection, recurrence or procedure-related adverse event that enabled an evaluation of feasibility of ESD. All types of study design will be sought and publications in English with full-text will be included. The risk of bias will be assessed using the ROBINS-I tool. Descriptive data synthesis is planned and quantitative synthesis will be used if the included studies are sufficiently homogenous (pooled therapeutic outcomes data with 95% confidence intervals). Publication bias will be assessed with quantitative analyses if more than 10 articles are enrolled.

Results:
The results will provide evidence for validity of current ESD criteria in addition to the technical feasibility of ESD for EGC-MH.

Conclusion:
This study will provide evidence of ESD for EGC-MH.
Transthoracic radiofrequency ablation for hepatic tumor located beneath the diaphragm under one-lung ventilation
Authors: Park Sung Wook , Kim Youngsoon , Kang Hee Yong , You Ann Hee , Jeon Jong Mi , Woo Hyunho , Choi Jeong-Hyun 
Published: December 2018

Abstract

Rationale:
Radiofrequency ablation (RFA) has become the reliable, effective, and less invasive treatment for small primary or metastatic hepatic tumors. Hepatic tumors that located immediately beneath the diaphragm are difficult to treat with percutaneous RFA due to poor visualization by percutaneous ultrasonography and the close location of the heart or lung. A transthoracic approach has been proposed to be an alternative for hepatic tumors located beneath the diaphragm that are difficult to access by conventional percutaneous or laparoscopic approaches. There has been no report regarding the anesthetic management of the transthoracic RFA for hepatic tumor.

Patient concerns:
A 69-year-old female had undergone segmentectomy due to hepatocellular carcinoma 4 years ago.

Diagnoses:
Newly developed hepatic tumor located in the liver dome and beneath the diaphragm was diagnosed by follow-up imaging study.

Interventions:
Because the tumor could not be identified by transabdominal ultrasonography (US), transthoracic approach for RFA under one-lung ventilation was planned. General anesthesia was induced with propofol and remifentanil via target-controlled infusion system and rocuronium was administered. Orotracheal intubation with double-lumen endotracheal tube was performed and position of the tube in the trachea was confirmed by bronchoscope. The RFA electrode was introduced percutaneously into the right pleural cavity, guided by visualization through the thoracoscope and inserted into the tumor after visualizing the tumor by US. Radiofrequency waves can be successfully administered through the needle.

Outcomes:
We performed successfully RFA of the hepatic tumor through one-lung ventilation and transthoracic approach. At 5 days postoperatively, she was discharged in a stable condition without any complication.

Lessons:
Transthoracic RFA can be successfully performed under one-lung ventilation, optimal analgesia, and vigilant monitoring.
Relationships Matter: Progress and Challenges in Research on the Health Effects of Intimate Relationships
Authors: Smith Timothy W. 
Published: December 2018

ABSTRACT
Social connections play an important role in health and disease and provide opportunities for clinical and public health interventions. Marriage and similar intimate relationships play a central role in the potential health benefits of positive social connections. This editorial provides an integrative perspective on three papers in this issue of Psychosomatic Medicine that examine intimate relationships and health and illustrates the application of current areas in relationship science. The importance of integrated conceptual models and statistical techniques to disentangle common third factors and overlapping constructs are highlighted, as well as the need for a multi-method approach that goes beyond self-report questionnaires. This editorial concludes with a summary of biobehavioral and psychological mechanisms and directions for future research.
Correlation Between Pathologic Complete Response in the Breast and Absence of Axillary Lymph Node Metastases After Neoadjuvant Systemic Therapy
Authors: Samiei Sanaz , van Nijnatten Thiemo J. A. , de Munck Linda , Keymeulen Kristien B. M. I. , Simons Janine M. , Kooreman Loes F. S. , Siesling Sabine , Lobbes Marc B. I. , Smidt Marjolein L. 
Published: December 2018

Objective:
The aim was to investigate whether pathologic complete response (pCR) in the breast is correlated with absence of axillary lymph node metastases at final pathology (ypN0) in patients treated with neoadjuvant systemic therapy (NST) for different breast cancer subtypes.

Background:
Pathologic complete response rates have improved on account of more effective systemic treatment regimens. Promising results in feasibility trials with percutaneous image-guided tissue sampling for the identification of breast pCR after NST raise the question whether breast surgery is a redundant procedure. Thereby, the need for axillary surgery should be reconsidered as well.

Methods:
Patients diagnosed with cT1-3N0-1 breast cancer and treated with NST, followed by surgery between 2010 and 2016, were selected from the Netherlands Cancer Registry. Patients were compared according to the pathologic response of the primary tumor with associated pathologic axillary outcome. Multivariable analysis was performed to determine clinicopathological variables correlated with ypN0.

Results:
A total of 4084 patients were included for analyses, of whom 986 (24.1%) achieved breast pCR. In clinically node negative patients (cN0), 97.7% (432/442) with breast pCR had ypN0 compared with 71.6% (882/1232) without breast pCR (P < 0.001). In clinically node positive patients (cN1), 45.0% (245/544) with breast pCR had ypN0 compared with 9.4% (176/1866) without breast pCR (P < 0.001). The odds of ypN0 was decreased in case of clinical T3 stage (OR 0.59, 95% CI 0.40–0.87), cN1 (OR 0.03, 95% CI 0.02–0.04) and ER+HER2- subtype (OR 0.30, 95% CI 0.20–0.44), and increased in case of breast pCR (OR 4.53, 95% CI 3.27–6.28).

Conclusions:
Breast pCR achieved after NST is strongly correlated with ypN0 in cN0 patients, especially in ER+HER2+, ER-HER2+, and triple negative subtypes. These results provide data to proceed with future clinical trials to investigate if axillary surgery can be safely omitted in these selected patients when image-guided tissue sampling identifies a breast pCR.
On-site ribosome remodeling by locally synthesized ribosomal proteins in axons
Authors: Shigeoka Toshiaki , Koppers Max , Wong Hovy Ho-Wai , Lin Julie Qiaojin , Dwivedy Asha , de Freitas Nascimento Janaina , Cagnetta Roberta , van Tartwijk Francesca , Ströhl Florian , Cioni Jean-Michel , Carrington Mark , Kaminski Clemens F. , Harris William A. , Jung Hosung , Holt Christine E. 
Published: December 2018

SUMMARYRibosomes are known to be assembled in the nucleolus, yet recent studies have revealed robust enrichment and translation of mRNAs encoding ribosomal proteins (RPs) in axons, far away from neuronal cell bodies. Using subcellular proteomics and live-imaging, we show that locally synthesized RPs incorporate into axonal ribosomes in a nucleolus-independent fashion. We revealed that axonal RP translation is regulated through a novel sequence motif, CUIC, that forms a RNA-loop structure in the region immediately upstream of the initiation codon. Inhibition of axonal CUIC-regulated RP translation leads to defects in local translation activity and axon branching, demonstrating the physiological relevance of the axonal ribosome remodeling. These results indicate that axonal translation supplies cytoplasmic RPs to maintain/modify local ribosomal function far from the nucleolus.