bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Doppler imaging technique for assessing angiogenesis in breast tumors: correlation with immunohistochemically analyzed microvessels density
Authors: Kim Sewha , Lee Hye Jin , Ko Kyung Hee , Park Ah Young , Koh Jieun , Jung Hae Kyoung 
Published: April 2018

Background Microvessel density (MVD) is associated with grade and prognosis in breast tumors. However, conventional color Doppler flow (CDF) imaging has been limited to represent MVD of breast tumors. Purpose To evaluate whether a new Doppler imaging technique (AngioPLUS) can represent MVD of breast tumors. Material and Methods The institutional review board approved this retrospective study, and patients’ informed consent was waived. CDF and AngioPLUS were available in pathologically confirmed 55 breast tumors of 53 women. For each lesion, vascular flow patterns (distribution and amount) of both Doppler images were retrospectively reviewed, and MVD was measured using immunohistochemical analysis of the biopsied tissue sections. MVD was subcategorized as low or high group with reference to the median. The associations between the Doppler features and MVD were evaluated using Fisher’s exact test and Student’s t test. Results Of the 55 masses, 28 (50.9%) were benign and 27 (49.1%) were malignant. Vascular flow distribution and amount of both Doppler imaging were different between the benign and malignant lesions (CDF, P = 0.020 and P = 0.010; AngioPLUS, P = 0.002 and P = 0.005). MVD had no significant relationships with CDF features, but vascular flow distribution on AngioPLUS showed significant differences between the lesions with low and high MVD ( P = 0.020); Combined distribution was more frequent in the high MVD lesions than in the low MVD lesions (17/28, 60.7% vs. 6/27, 22.2%). Conclusion Our data confirmed the correlation between a new Doppler imaging technique, AngioPLUS, and MVD. We suggest that AngioPLUS can be used for assessing MVD in breast tumors.
Relationship between kurtosis and bi-exponential characterization of high b-value diffusion-weighted imaging: application to prostate cancer
Authors: Karunamuni Roshan A , Kuperman Joshua , Seibert Tyler M , Schenker Natalie , Rakow-Penner Rebecca , Sundar VS , Teruel Jose R , Goa Pal E , Karow David S , Dale Anders M , White Nathan S 
Published: April 2018

Background High b-value diffusion-weighted imaging has application in the detection of cancerous tissue across multiple body sites. Diffusional kurtosis and bi-exponential modeling are two popular model-based techniques, whose performance in relation to each other has yet to be fully explored. Purpose To determine the relationship between excess kurtosis and signal fractions derived from bi-exponential modeling in the detection of suspicious prostate lesions. Material and Methods This retrospective study analyzed patients with normal prostate tissue (n = 12) or suspicious lesions (n = 13, one lesion per patient), as determined by a radiologist whose clinical care included a high b-value diffusion series. The observed signal intensity was modeled using a bi-exponential decay, from which the signal fraction of the slow-moving component was derived ( SFs). In addition, the excess kurtosis was calculated using the signal fractions and ADCs of the two exponentials ( KCOMP). As a comparison, the kurtosis was also calculated using the cumulant expansion for the diffusion signal ( KCE). Results Both K and KCE were found to increase with SFs within the range of SFs commonly found within the prostate. Voxel-wise receiver operating characteristic performance of SFs, KCE, and KCOMP in discriminating between suspicious lesions and normal prostate tissue was 0.86 (95% confidence interval [CI] = 0.85 – 0.87), 0.69 (95% CI = 0.68–0.70), and 0.86 (95% CI = 0.86–0.87), respectively. Conclusion In a two-component diffusion environment, KCOMP is a scaled value of SFs and is thus able to discriminate suspicious lesions with equal precision . KCE provides a computationally inexpensive approximation of kurtosis but does not provide the same discriminatory abilities as SFs and KCOMP.
Cho/Cr ratio at MR spectroscopy as a biomarker for cellular proliferation activity and prognosis in glioma: correlation with the expression of minichromosome maintenance protein 2
Authors: Gao Wenjing , Wang Xiao , Li Fuyan , Shi Wenqi , Li Hongxia , Zeng Qingshi 
Published: April 2018

Background Magnetic resonance (MR) spectroscopy (1H-MRS) has been demonstrated to be useful in grading glioma, but the utility in assessing cellular proliferation activity and prognosis correlated with the expression of minichromosome maintenance protein 2 (MCM2) has not been reported. Purpose To explore the correlation between proton MR spectroscopy parameters (including choline [Cho]/creatine [Cr], N-acetyl aspartate [NAA]/Cr, and Cho/NAA ratios) and the expression of MCM2 and to further evaluate whether 1H-MRS can predict cell proliferative activity and provide prognostic information in high-grade gliomas (HGGs). Material and Methods Forty-three patients with histopathologically confirmed gliomas were involved in this study. All patients underwent 1H-MRS examination before surgery. Proliferative activity of gliomas was evaluated by MCM2 labeling index (LI). Pearson correlation analysis and empiric receiver operating characteristic (ROC) curves were performed. The Kaplan–Meier method and Cox regression were used for survival analysis. Results Significant correlation was observed between the Cho/Cr ratio and MCM2 LI ( r = 0.522, P < 0.01); however, there was no correlation between MCM2 LI and the Cho/NAA or NAA/Cr ratios ( r = 0.295, P = 0.55 and r = −0.042, P = 0.788, respectively). According to ROC analysis, MCM2 LI of 50% and Cho/Cr ratio of 2.68 represented the optimized cut-off values, respectively, to distinguish longer or shorter survival than 15 months in HGGs patients. Multivariate analysis revealed that both the Cho/Cr ratio and MCM2 expression were independent prognostic markers. Conclusion Cho/Cr ratio has a potential in predicting the expression of MCM2 and can evaluate cell proliferative activity noninvasively. Both the Cho/Cr ratio and MCM2 expression are independent prognostic markers in patients with HGGs.
Significance of incidental intra-articular and peri-articular FDG avid foci on PET/CT
Authors: Cohen-Levy Wayne B , Pretell-Mazzini Juan , Singer Adam D , Subhawong Ty , Greif Dylan N , Jose Jean 
Published: April 2018

Background Positron emission tomography/computed tomography (PET/CT) is a useful imaging adjunct in patients with sarcoma. Intra-articular and peri-articular 18F-fluoro-2-deoxy-D-glucose (FDG) avid lesions are often discovered incidentally. Purpose To describe the etiology, appearance, and standardized uptake values (SUV) of incidentally detected FDG avid intra-articular and peri-articular foci in patients with sarcoma. Material and Methods The institutional sarcoma database between November 2011 and November 2016 was retrospectively reviewed. Patients were included if a PET/CT scan was performed and an FDG avid intra-articular or peri-articular focus was found that was distinct from the primary sarcoma. Results The majority of FDG avid foci represented benign, non-physiologic conditions such as osteoarthritis, enthesopathy, bursitis, and post-surgical changes. Six patients each had radiographic features consistent with tenosynovial giant cell tumor (TSGCT) and metastatic disease, respectively. Lower SUV, bilateral findings, and the absence of metastatic disease elsewhere were associated with benign etiologies. There was a statistically significant difference between the mean SUV measured in patients with TSGCT and those with benign, non-physiologic conditions ( P < 0.001). The difference between the benign, non-physiologic cohort and the cohort with widespread metastatic disease did not reach statistical significance ( P = 0.07). Conclusions In patients with soft-tissue or osseous sarcomas, isolated FDG avid intra-articular or peri-articular foci without additional metastatic lesions likely represent benign processes. Isolated intra-articular or peri-articular foci with significantly elevated SUV measurements were favored to represent TSGCT in this series.
Low-dose CT of postoperative pelvic fractures: a comparison with radiography
Authors: Eriksson Thomas , Berg Per , Olerud Claes , Shalabi Adel , Hänni Mari 
Published: April 2018

Background Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose. Purpose To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture. Material and Methods Twenty-one patients were examined with LDCT and CR 0–9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated. Results LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001). Conclusion LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.
Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty
Authors: Zhong Guangjun , Liang Zhu , Kan Jiang , Muheremu Aikeremujiang 
Published: April 2018

Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. Results The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group. Conclusions Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.
Content and acceptability of an Occupational Therapy intervention in HomEcare Re-ablement Services (OTHERS)
Authors: Whitehead Phillip J , Drummond Avril ER , Parry Ruth H , Walker Marion F 
Published: April 2018

Introduction Despite clear compatibilities between the tenets of occupational therapy and re-ablement, there is limited research on occupational therapy in homecare reablement services. This article describes an occupational therapy intervention that was delivered as part of a feasibility randomised controlled trial (Occupational Therapy intervention in HomEcare Re-ablement Services), and evaluates whether the intervention was acceptable to participants. Method There were three phases: (1) a bespoke pro forma was completed, recording the activities undertaken after each therapy visit; (2) an acceptability questionnaire was sent to every intervention participant and (3) semi-structured interviews were completed with key informants who received the intervention. Results The principal activities undertaken were assessment, case management, goal-setting, advice and support, and practising activities in relation to bathing/showering or kitchen activities. Participants particularly valued the advice and support provided. However, there were difficulties due to fluctuations in circumstances and with activities of daily living outside the home within the 6 week timescale. Conclusion An intervention focusing on activities of daily living within the home was acceptable for participants and consistent with their goals; however, they also had goals beyond personal activities of daily living and the timescale of the re-ablement episode. Further research should focus on extended activities of daily living, beyond this time-limited period.
Radiological features of body packers: An experience from a regional accident and emergency department in close proximity to the Hong Kong International Airport
Authors: Tsang Ho Kai Patrick , Wong Cheuk Kei Kathy , Wong Oi Fung , Chan Wing Lun William , Ma Hing Man , Lit Chau Hung Albert 
Published: April 2018

Background: Body packing is a frequently used method for drug trafficking. Local information about the clinical and radiological features of body packing is lacking. Objectives: To evaluate the radiological features of body packers presenting to a hospital near to the Hong Kong International Airport and to compare the radiological features of solid form versus liquid cocaine. Methods: This was a retrospective cohort study. Medical notes of 269 suspected body packers, presenting to the Accident and Emergency Department of North Lantau Hospital under the detention by the law enforcement personnel from 1st January 2015 to 28th February 2017, were reviewed. The radiological features of body packing were retrospectively evaluated. Results: Sixty-nine cases were confirmed body packers radiographically. Majority of them (81%, 56/69) were cocaine packers. Powder form cocaine (67%, 49/69) was the most popular drug packed, followed by liquid cocaine (15%, 10/69). There was a trend of increasing incidence of liquid cocaine packers. The classical ‘double condom’, ‘tic tac’ and ‘halo’ signs were present in 94%, 72.5% and 42% of cases with radiologically confirmed body packing respectively. The ‘rosette’ sign was only identified in 1 case. Three new radiological signs, the ‘bag of eggs’, ‘lucent triangle’ and ‘black crescent’ sign, were suggested to aid identification of drug packets. The classical ‘tic tac’ sign was absent in all liquid cocaine packing cases (p<0.05). The liquid cocaine packets appeared irregular with indistinct border in majority of cases (p<0.05). The solid form packets were mostly opaque to faeces while liquid cocaine had variable density (p<0.05). Most solid form packets had homogeneous content which was in contrast to the heterogeneous content in liquid cocaine (p<0.05). Conclusion: Failure in detecting drug body packing may result in medicolegal consequences. Emergency physicians need to be aware of subtle radiological signs of liquid cocaine packets in the plain abdominal radiography.
Expression and Functions of Formyl Peptide Receptor 1 in Drug-Resistant Bladder Cancer
Authors: Jiang Xue , Lei Ting , Zhang Man 
Published: April 2018

Objective: To explore the correlation of formyl peptide receptor 1 expression with drug resistance and the functions of formyl peptide receptor 1 in drug-resistant bladder cancer. Methods: Expression of formyl peptide receptor 1 in T24 and T24/DDP cisplatin-resistant bladder cancer cell lines was tested by quantitative real-time Polymerase Chain Reaction and Western blotting. After incubation of T24/DDP with N-formyl-Met-Leu-Phe, the phosphor proteins were tested by Western blot analysis. We characterized the functions of formyl peptide receptor 1 in T24/DDP cells by assessing proliferation, migration, and changes of cell cycles. Results: Formyl peptide receptor 1 was expressed in both T24 and T24/DDP, and it was overexpressed in T24/DDP compared with T24. Formyl peptide receptor 1 activation promoted the expression of the messenger RNA of resistance-related proteins, such as multidrug resistance-associated protein 1 (MRP1) and lung resistance-related protein (LRP). The expression of 4 signal pathway proteins were upregulated: signal transducer and activator of transcription 3, Janus kinase 2, extracellular regulated protein kinases, and protein kinase B, while the expression of phosphatidylinositol 3-kinase was observed to be downregulated in drug-resistant bladder cancer cells. Formyl peptide receptor 1 activation also improved the expression of phospho-signal transducer and activator of transcription 3 and phospho-extracellular regulated protein kinases 1/2 and promoted the proliferation and migration of T24/DDP cells. In addition, formyl peptide receptor 1 inhibition led to the change in the cell cycle in T24/DDP. Conclusions: The overexpression of formyl peptide receptor 1 may be related to drug-resistant bladder cancer and promotes the deterioration of drug-resistant bladder cancer.
Incidence and mitigation of gastrointestinal events in patients with relapsing–remitting multiple sclerosis receiving delayed-release dimethyl fumarate: a German phase IV study (TOLERATE)
Authors: Gold Ralf , Schlegel Eugen , Elias-Hamp Birte , Albert Christian , Schmidt Stephan , Tackenberg Björn , Xiao James , Schaak Tom , Salmen Hans Christian 
Published: April 2018

Background: Gastrointestinal (GI) events are common adverse events (AEs) associated with delayed-release dimethyl fumarate (DMF), an approved treatment for relapsing–remitting multiple sclerosis (RRMS). The objective of the TOLERATE study was to evaluate GI tolerability and GI mitigation via symptomatic therapies in patients initiating DMF in a real-world clinical setting in Germany. Methods: TOLERATE was a multicentre, open-label, single-arm study performed at 25 German sites. Endpoints were frequency, severity, duration (all primary) and mitigation of GI-related events (secondary). Patients were instructed to take DMF according to the prescribing information for up to 12 weeks and to document GI events and intake of GI-symptomatic therapy on numerical rating scales, using eDiaries. Results: A total of 211 patients were included in the safety population (71% female; mean age 40 ± 11 years). Of these, 185 patients (87.7%) reported GI-related events, out of which nearly half received GI-symptomatic therapy (84/185; 45.4%). The most frequently reported GI events were upper abdominal pain, flatulence and nausea. GI-related events peaked during the first 3 weeks of therapy and rapidly decreased thereafter. The severity of GI events over 12 weeks according to the Modified Overall Gastrointestinal Symptom Scale were mild to moderate in the majority of patients reporting GI-related events and taking symptomatic GI medication (53.6%). Only 10% of all patients discontinued study treatment due to AEs in general, while 6.6% discontinued due to GI-related events. The severity of GI-related events decreased over time in patients who received symptomatic treatment with one or more medications (e.g. acid secretion blockers, antidiarrhoeals or antiemetics). Conclusion: Gastrointestinal events associated with delayed-release DMF were mainly mild to moderate in severity. Prevalence of GI events peaked during the first 3 weeks of therapy and rapidly faded thereafter. Although 44.9% of patients experiencing GI events used common GI symptomatic therapies, only 6.6% of patients discontinued DMF because of GI events, suggesting that GI events could be managed well with common symptomatic therapy.
Crowdsourcing sugammadex adverse event rates using an in-app survey: feasibility assessment from an observational study
Authors: Jabaley Craig S. , Wolf Francis A. , Lynde Grant C. , O’Reilly-Shah Vikas N. 
Published: April 2018

Background: Mobile applications (apps) have become a ubiquitous source of clinical decision support. We sought to ascertain the feasibility of using an app platform to obtain a crowdsourced measure of adverse drug reaction reporting rates associated with sugammadex administration and compare it with traditionally-derived estimates. Methods: Using the widely-distributed anesthesia calculator app, ‘Anesthesiologist’, we surveyed anesthesia providers regarding their experience with adverse drug reactions associated with sugammadex administration. Results: Data were analyzed from 2770 participants in 119 countries responding between March 2016 and May 2017, who were estimated to have administered between 1.6–2.9 million doses (588–1040 administrations per participant). A low and high-end reporting rate of adverse events was estimated based on respondents’ reported frequency and duration of sugammadex use. The estimated reporting rate of anaphylaxis due to sugammadex was 0.0055–0.098%, similar in range to previously published estimates. Conclusions: Use of an in-app survey facilitated a global assessment of anesthesia providers and could have useful applications in monitoring adverse events and estimating their rates. Further work is needed to validate this approach for other medications and clinical domains.
Unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee: A meta-analysis
Authors: Jauregui Julio J , Blum Christopher L , Sardesai Neil , Bennett Craig , Henn R Frank , Adib Farshad 
Published: April 2018

Background: Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK’s predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Thus, the purpose of this study was to evaluate functional outcomes and revision rates of UKA in the setting of SONK. Methods: A systematic literature search was performed to evaluate all studies examining patients who underwent UKA for SONK. Screening of the articles was performed using multiple Boolean search strings, methodological index for non-randomized studies criteria, and other selected exclusion criteria. Results: Seven studies were included, with a total of 276 knees (273 patients). The mean age was 68 years (64–74 years), with a mean body mass index of 26 kg/m2 (25–29 kg/m2). The final range of motion was 125° (124–126°). Standardized mean difference (SMD) of clinical improvement pre- and post-outcome was 3.39 ( p < 0.001). The improvement in the visual analog score was 57.03 points, with an SMD of 4.57 ( p < 0.001). Revision rates were determined to be 5.51% (95% confidence interval of 1.96–10.69%). Conclusion: Our meta-analysis demonstrated that in properly selected patients, UKA could be an excellent alternative to TKA for patients with SONK. These data show that UKA has few complications, significant improvements on functional outcomes, and good survivorship at a mean follow-up of 6 years.