bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of MRI and CT parameters to analyze the correlation between disc and facet joint degeneration in the lumbar three-joint complex
Authors: Song Quanwei , Liu Xuqiang , Chen De-jian , Lai Qi , Tang Benyu , Zhang Bin , Dai Min , Wan Zongmiao 
Published: October 2019

Abstract
Lumbar 3-joint complex degeneration is a multifactorial, pathological process. Previous studies included insufficient quantitative analyses to prove the relationship between disc degeneration and facet joint osteoarthritis (OA). We assessed the correlation between intervertebral disc and lumbar facet joint degeneration using computed tomography (CT) and magnetic resonance imaging (MRI) parameters.
A total of 152 participants who underwent conventional MRI and CT in the clinostat position were included in this study. The presence of lumbar disc degeneration was identified using the Pfirrmann grading system, and the presence of lumbar facet joint degeneration was identified using the Weishaupt grading system. Facet tropism was defined as a divergence more than 7° between the facet joint angles of both sides at the same segment. The intervertebral disc heights were also measured.
Most facet joint OA probably appeared at the segment with intervertebral disc degeneration of more than grade III. Facet joint OA was significantly exacerbated with the progression of disc degeneration grade. The intervertebral height significantly decreased with the progression of facet joint degeneration grades, except for grades 0 and 1.
Our current study found that each individual joint degeneration influences the other 2 in the lumbar 3-joint complex. Facet tropism was significantly associated with lumbar disc degeneration. Narrowing of the intervertebral disc height probably aggravates the facet joint degeneration further at the same level.
Traumatic spleen rupture diagnosed during postmortem dissection
Authors: Fomin Dmitrij , Chmieliauskas Sigitas , Petrauskas Vidas , Sumkovskaja Alina , Ginciene Karolina , Laima Sigitas , Jurolaic Eleonora , Stasiuniene Jurgita 
Published: October 2019

Abstract
Spleen is typically injured in blunt abdominal trauma. Spleen injuries make 42% of all blunt abdominal injuries. The aim of this study was to perform a retrospective assessment of the cases of acute and subacute isolated traumatic spleen ruptures.
A retrospective study performed on 50 patients, whose cause of death was isolated spleen rupture and bleeding into the abdominal cavity.
An acute spleen rupture was diagnosed in 47 cases, whereas the rest 3 cases demonstrated a subacute rupture. In cases of acute spleen rupture, the mean weight of spleen was 309.6 g, whereas in 3 cases of subacute rupture the mean weight of the organ achieved 710 g. The mean weight of spleen in the control group with no spleen rupture was 144.7 g.
Recording of the cases of isolated acute and subacute traumatic spleen ruptures and morphological assessment of them are important in forensic pathology science and in clinical practice as well.
Incidence and risk factors for epidural morphine induced pruritus in parturients receiving cesarean section
Authors: Tan Xiao , Shen Le , Wang Lin , Labaciren  , Zhang Yuelun , Zhang Xiuhua , Huang Yuguang 
Published: October 2019

Abstract
This study is designed to clarify the incidence of epidural morphine induced pruritus (EMIP) in Chinese Han and Tibetan parturients after cesarean section (CS) and to identify the correlated risk factors.
This is a prospective multicenter observational study. Follow-up evaluations were performed at 3 hours, 6 hours, 12 hours, 24 hours, and 48 hours after morphine administration. The primary outcome was EMIP incidence. Other details were also recorded for risk factor screening.
Totally 284 parturients receiving CS were enrolled and 247 completed the study. The overall incidence of EMIP was 18.6% (46 in 247). The onset of pruritus was 5.6 ± 4.8 hours (mean ± SD) after morphine administration and the duration of pruritus was 14.0 ± 8.8 hours. Logistic regression models was built with 5 variables, history of allergy, serotonin receptor antagonist administration, I.V. fentanyl administration, epidural morphine volume and VAS pain score. Results of showed that 2 of the variables, history of allergy (P < .001) and serotonin receptor antagonist (P < .05), were significantly correlated with incidence of EMIP.
In conclusion, EMIP incidence in our study was 18.6%. Positive medical history of allergy and not using serotonin receptor antagonist were potential risk factors of EMIP development.

Trial registration: ChiCTR-OPC-17012345
A retrospective cohort study of the prevalence of anxiety and agitation in schizophrenic smokers and the unmet needs of smoking cessation programs
Authors: Hassanzadah Mehgan , Bitar Adib H , Khanfar Nile M , Khasawneh Fadi T , Lutfy Kabirullah , Shankar Gollapudi S 
Published: October 2019

Abstract
Achieving abstinence in schizophrenic smokers using a combination of medications and cognitive behavioral therapy is feasible; however, abstinence rates are significantly lower compared to the general population and studies are scanty. Additionally, maintaining sustained abstinence and preventing relapse is a major limiting factor and represents key tasks in managing tobacco dependence in schizophrenic patients. Several theories have been postulated to explain the higher tendency of tobacco use among schizophrenic individuals. Schizophrenic patients may use nicotine as a “self-medication” strategy to improve negative symptoms of schizophrenia. However, studies suggest that although nicotine may act as an anxiolytic acutely, chronic use of nicotine may lead to increased anxiety with the possibility of increased catecholamines, which is confirmed with the prevalence of tachycardia and hypertension in smokers in general. On this basis, the main objective of our present study was to assess anxiety in schizophrenic smoking and nonsmoking patients by comparing the number of anxiety and agitation episodes and evaluating the amount of antianxiety/antiagitation medication used by each group. A separate objective was to document the unmet needs of smoking cessation programs in treating schizophrenic patients. Consequently, in the present retrospective cohort study, it was observed that schizophrenic smokers tend to have higher anxiety episodes and utilize as-needed medications at a higher frequency compared to nonsmokers for the relief of anxiety and agitation symptoms. Further research is warranted to examine these results on a larger scale.
Comparison between an electronic version of the foot and ankle outcome score and the standard paper version
Authors: Park Jae Yong , Kim Bom Soo , Lee Hyun June , Kim Yu Mi , Kim Hyong Nyun , Kang Hwa Jun , Cho Jae Ho , Choi SeongJu , Choi Youngrak 
Published: October 2019

Abstract
To prove the equivalence of the Korean version of the Foot and Ankle Outcome Score (FAOS) in the printed (PFAOS) vs the electronic (EFAOS) form in a multicenter randomized study.
Overall, 227 patients with ages ranging from 20 to 79 years from 16 dedicated foot and ankle centers were included. Patients were randomized into either a ‘paper first’ group (P-F group, n = 113) or an ‘electronic device (tablet computer) first’ group (E-F group, n = 114). The first evaluation either by paper (P-F group) or tablet (E-F group) was followed by a second evaluation the following day. The difference between the PFAOS and EFAOS results in each group was calculated and analyzed. To evaluate the benefit of each methodology, the time consumed per evaluation was compared and patients were asked which methodology they preferred and which was the easiest to use.
There were no significant differences in age or sex between the groups. An intraclass correlation coefficient (ICC) value of 0.934 (95% confidence interval [CI]: 0.912–0.950, P < .001) was confirmed in PFAOS and EFAOS, showing a significant correlation between the 2 methodologies. EFAOS was completed in a shorter amount of time than PFAOS. The majority of patients agreed that EFAOS was easier to complete than PFAOS.
The paper or electronic forms of the Korean adaptation of FAOS were considered equivalent. The shorter time of completion and the preference for the electronic version over paper by patients deems the electronic FAOS a promising option to consider in future.
Spontaneous rupture of the eyeball due to choroidal metastasis of gastric carcinoma
Authors: Wu Shuang-Qing , Li Qiu-Shi , Zhang Yu , Zhu Li-Wei 
Published: October 2019

Abstract

Rationale:
Although metastatic tumor is the most common intraocular malignancy, choroidal metastasis from gastric cancer is relatively rare. We present the exact course of a spontaneous rupture of the eyeball with choroidal metastasis from gastric carcinoma (GC) and the applied surgical interventions.

Patient concerns:
A 59-year-old male presented with pain and vision loss on his left eye for 6 months. He was diagnosed with GC, for which he received systemic chemotherapy for a year.

Diagnoses:
Preoperative B-scan, color fundus photography, computed tomography, and magnetic resonance imaging showed a choroidal tumor in his left eye. The spontaneous rupture of the corneoscleral limbus from 2 to 5 o’clock, combined secondary glaucoma, exudative retinal detachment and choroidal detachment were found.

Interventions:
The ruptured corneoscleral limbus was sutured and the orbit was lavaged with 0.4% cisplatin during the enucleation.

Outcomes:
Histopathology confirmed high homology of the choroidal metastasis and GC. He survived for 2 months after surgery, without pain or orbital neoplasms.

Lessons:
Choroidal metastasis from GC rapidly progressed to spontaneous rupture of the eyeball. Careful eyeball enucleation followed by orbital lavage with chemotherapeutics may reduce metastasis risk beyond the eyeball. Additional therapeutic interventions should be considered in patients resistant to single systemic chemotherapy.
Infectious keratitis secondary to canaliculitis with concretions
Authors: Chou Yu-Pu , Yeh Po-Han , Tsai Yueh-Ju , Yen Chieh-Hung , Hsiao Ching-Hsi 
Published: October 2019

Abstract

Rationale:
Canaliculitis is a frequently overlooked and misdiagnosed disease. Concurrent corneal ulceration with canaliculitis is uncommon. We report such a case.

Patient concerns:
An 87-year-old woman complained of swelling and pain of the right eye after acute angle closure glaucoma attack. Slit-lamp examination was compatible with the features of infectious keratitis, and the cultures from corneal scrapings grew Streptococcus anginosus later. Hourly topical vancomycin (25 mg/ml) was instilled, then the corneal ulceration improved initially but became stationary after 1-week treatment.

Diagnosis:
Discharge from the upper punctum was noted subsequently and canalicular concretions were found through curettage. The cultures from canalicular discharge and concretions also revealed the presence of S. anginosus. Thus, infectious keratitis secondary to canaliculitis was diagnosed.

Interventions:
Canaliculotomy was performed to remove the large concretion and vancomycin was injected locally.

Outcomes:
The corneal ulceration resolved after canaliculitis was appropriately treated.

Lessons:
Canaliculitis could be a reservoir for organisms that may make compromised corneas liable to infections. Only the appropriate diagnosis and aggressive treatment of canaliculitis leads to the eradication of associated corneal infections.
Surgical treatment of pulmonary artery sling and tracheal stenosis with or without tracheoplasty
Authors: Li Dongxu , Zhou Xu , Li Mengsi , Liu Xiaojing 
Published: October 2019

Abstract

Background:
Pulmonary artery sling (PAS) is rare, often with tracheal stenosis. And the postoperative mortality is high. For now, there is no consensus on the tracheoplasty for the patients with PAS and tracheal stenosis.

Methods:
Studies involving surgical repair of PAS and tracheal stenosis with and without tracheoplasty were identified by searching the PubMed, EMBASE, and the Cochrane Library databases until June 5, 2019. The assessed variables included ventilation time, early and late mortality, and symptom at follow-up. A random-effect/fixed-effect model was used to summarize the estimates of the mean difference (MD)/risk ratio (RR) with 95% confidence interval (CI).

Results:
This study will be submitted to a peer-reviewed journal for publication.

Conclusion:
This study will assess the safety and efficacy of tracheoplasty for patients with PAS and tracheal stenosis, and provide more evidence-based guidance in clinical practice.

PROSPERO registration number:
CRD42019139788.
Risk factors for axillary lymph node metastases in clinical stage T1-2N0M0 breast cancer patients
Authors: Zhang Yuanxin , Li Ji , Fan Yuan , Li Xiaomin , Qiu Juanjuan , Zhu Mou , Li Hongjiang 
Published: October 2019

Abstract
Axillary lymph node metastasis (ALNM) is commonly the earliest detectable clinical manifestation of breast cancer when distant metastasis emerges. This study aimed to explore the influencing factors of ALNM and develop models that can predict its occurrence preoperatively.
Cases of sonographically visible clinical stage T1-2N0M0 breast cancers treated with breast and axillary surgery at West China Hospital were retrospectively reviewed. Univariate and multivariate logistic regression analyses were performed to evaluate associations between ALNM and variables. Decision tree analyses were performed to construct predictive models using the C5.0 packages.
Of the 1671 tumors, 541 (32.9%) showed axillary lymph node positivity on final surgical histopathologic analysis. In multivariate logistic regression analysis, tumor size (P < .001), infiltration of subcutaneous adipose tissue (P < .001), infiltration of the interstitial adipose tissue (P = .031), and tumor quadrant locations (P < .001) were significantly correlated with ALNM. Furthermore, the accuracy in the decision tree model was 69.52%, and the false-negative rate (FNR) was 74.18%. By using the error-cost matrix algorithm, the FNR significantly decreased to 14.75%, particularly for nodes 5, 8, and 13 (FNR: 11.4%, 9.09%, and 14.29% in the training set and 18.1%,14.71%, and 20% in the test set, respectively).
In summary, our study demonstrated that tumor lesion boundary, tumor size, and tumor quadrant locations were the most important factors affecting ALNM in cT1-2N0M0 stage breast cancer. The decision tree built using these variables reached a slightly higher FNR than sentinel lymph node dissection in predicting ALNM in some selected patients.
Cholesterol membrane content has a ubiquitous evolutionary function in immune cell activation: the role of HDL
Authors: Bonacina Fabrizia , Pirillo Angela , Catapano Alberico L. , Norata Giuseppe D. 
Published: October 2019

Purpose of review
Cellular cholesterol content influences the structure and function of lipid rafts, plasma membrane microdomains essential for cell signaling and activation. HDL modulate cellular cholesterol efflux, thus limiting cholesterol accumulation and controlling immune cell activation. Aim of this review is to discuss the link between HDL and cellular cholesterol metabolism in immune cells and the therapeutic potential of targeting cholesterol removal from cell membranes.

Recent findings
The inverse relationship between HDL-cholesterol (HDL-C) levels and the risk of cardiovascular disease has been recently challenged by observations linking elevated levels of HDL-C with increased risk of all-cause mortality, infections and autoimmune diseases, paralleled by the failure of clinical trials with HDL-C-raising therapies. These findings suggest that improving HDL function might be more important than merely raising HDL-C levels. New approaches aimed at increasing the ability of HDL to remove cellular cholesterol have been assessed for their effect on immune cells, and the results have suggested that this could be a new effective approach.

Summary
Cholesterol removal from plasma membrane by different means affects the activity of immune cells, suggesting that approaches aimed at increasing the ability of HDL to mobilize cholesterol from cells would represent the next step in HDL biology.
Vascularized composite allotransplantation versus solid organ transplantation: innate-adaptive immune interphase
Authors: Kadono Kentaro , Gruszynski Mark , Azari Kodi , Kupiec-Weglinski Jerzy W. 
Published: October 2019

Purpose of review
Vascularized composite allotransplantation (VCA), a life-enhancing treatment for patients with complex tissue defects, trauma or illness, expounds upon the foundation of solid organ transplantation (SOT), the gold standard in end-stage organ failure. As innate and adaptive immunity remain the fundamental concern, this review highlights divergent immunobiology responses in VCA and SOT recipients.

Recent findings
Host innate immune activation drives peritransplant tissue ischemia–reperfusion injury (IRI). Despite the direct relationship between ischemia–reperfusion (IR)-stress and cell-mediated acute rejection, the mechanism of how IRI may affect VCA loss needs investigation. With skin grafts being highly immunogenic, the incidence of cell-mediated rejection is higher in VCA than SOT; whereas ex-vivo perfusion may exert cytoprotection against IRI in VCA and SOT. New treatment concepts, such as topical immunosuppression or cell-based tolerogenic therapies, may avoid systemic immunosuppression in VCA. Although antibody-mediated rejection is relatively rare in VCA and its disease seems to be distinct from that in SOT, little is known as to whether and how IRI may influence humoral immune rejection cascade in VCA or SOT.

Summary
Further understanding of the innate-adaptive immune crosstalk should contribute to much needed development of novel therapies to improve VCA outcomes, based on strategies established in SOT.
When rubber meets the road: how innate features of adaptive immune cells play critical roles in transplant alloimmunity
Authors: Morris Anna B. , Ford Mandy L. 
Published: October 2019

Purpose of review
Studies on adaptive cells have largely focused on features that are specific to adaptive immunity. However, adaptive cells utilize innate cell features to modulate their responses, and this area of T and B-cell biology is understudied. This review will highlight recent work done to understand how innate features of adaptive immune cells modulate alloimmunity.

Recent findings
Over the past year, research has shown that T-cell-expressed danger-associated molecular patterns, Toll-like receptors, complement receptors, and Fc receptors regulate T-cell alloimmunity in a cell-intrinsic manner. Further, IL-17 and p40 of IL-12 have been implicated in the migration of T cells into allografts. Lastly, innate B cells, specifically B1 cells, have been shown to produce clinically relevant autoantibody associated with poor graft outcome.

Summary
These data provide evidence that innate features are utilized by adaptive immune cells to control adaptive alloimmunity.
The Nasolabial Fold: A Micro–Computed Tomography Study
Authors: Kwon Hyun-Jin , O Jehoon , Cho Tae-Hyeon , Choi You-Jin , Yang Hun-Mu 
Published: October 2019

Background:
The nasolabial fold is known to be a challenging midface feature for aesthetic physicians. However, the steric conformation of the structures related to the nasolabial fold has remained undefined because the composition and topography of this region are highly intricate. Therefore, this study aimed to clarify the three-dimensional structures of the nasolabial fold using micro–computed tomography and verify their detailed composition by means of histologic observation.

Methods:
Twenty-four specimens were collected from the area beside the alae nasi to the area above the oral angle of 12 cadavers (mean age, 80.3 years) bilaterally. Twelve specimens were evaluated by means of phosphotungstic acid contrast staining, and the rest were evaluated by means of histologic staining. All specimens were divided into three regions and analyzed comprehensively.

Results:
The medial region of the nasolabial fold had dense irregular connective tissue intermingled with muscle fibers; the lateral region of the nasolabial fold had numerous fibrous septa with abundant adipose tissue. The levator labii alaeque nasi and the zygomaticus minor were attached to the medial part of the nasolabial fold, and the fascial septa were intermittently tethered to the dermis, lateral to the nasolabial fold. The extension of the adipose tissue within the fascial septa was limited by the lateral border of the muscle attachment.

Conclusions:
Dimensional and distributional alterations of the adipose tissues with senescence could render the nasolabial fold deeper by increasing the depth of the subcutaneous layer, lateral to the fold. Thus, to ameliorate the fold, the adipose tissue, lateral to the fold, or the muscle traction, medial to the fold, should be altered.
Does Breast Implant–Associated ALCL Begin as a Lymphoproliferative Disorder?
Authors: Kadin Marshall E. , Adams William P. , Inghirami Giorgio , Di Napoli Arianna 
Published: October 2019

Summary:
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has been included as a provisional entity in the revised version of the World Health Organization Classification of Tumors of Haematopoietic and Lymphoid Tissue. To increase opportunities to intervene with early diagnosis, treatment, and possible prevention, it is important to consider that BIA-ALCL may evolve from a preexisting lymphoproliferative disorder characterized by (1) an indolent localized (in situ) disease in approximately 80 percent of reported cases; (2) a requirement for external cytokine stimulation for cell survival; (3) CD30+ cells in some clinically benign seromas/capsules; (4) undetected T-cell clonality in some cases; (5) JAK/STAT mutations in only a minority of cases; and (6) cure by capsulectomy and implant removal in most cases. BIA-ALCL resembles CD30+ cutaneous lymphoproliferative disorder: ALK−, CD30+ anaplastic cells with an aberrant T-cell phenotype; overexpression of oncogenes (JUNB, SATB1, pSTAT3, SOCS3) in lymphomatoid papulosis; frequent apoptosis; complete spontaneous regression in lymphomatoid papulosis; and partial spontaneous regression in cutaneous ALCL. Unlike CD30+ cutaneous lymphoproliferative disorder, BIA-ALCL cannot be readily observed over time to study the different steps in progression to ALCL. BIA-ALCL also shares features of lymphomas of mucosa-associated lymphoid tissue, which are clinically indolent, initially localized, antigen driven, and caused by Gram-negative bacteria. Further studies of cytokines, clonality, mutations, and other biomarkers are needed to identify possible premalignant steps in the evolution of benign late seromas to BIA-ALCL.