bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous closure of an iatrogenic coronary artery fistula during recanalization of a chronic total occlusion lesion
Authors: Yu Xue , Wang Xinyue , Zhang Ruisheng , Xu Feng , Ji Fusui 
Published: January 2019

AbstractRationale:Coronary perforation leading to fistula directed to the right ventricle is a rare complication of percutaneous coronary intervention (PCI). The reported outcomes vary from a stable state to rapid deterioration.Patient concerns:An 86-year-old man was diagnosed with non-ST elevation myocardial infarction, and arranged to PCI procedure for the chronic total occluded right coronary artery (RCA) after coronary angiography. The guide wire went through the occluded lesion and got to the distal part of the suspected “post lateral artery”, which later proved to be in the right ventricle (RV). After dilating with a 2.0 mm balloon, large amount of contrast medium leaked out from the lesion; therefore, we suspected a perforation into the pericardium.Intervention:Protamine was intravenously injected to convert the effect of heparin and the 2.0 mm balloon in diameter was dilated for about 1 h to obstruct the ejected blood flow shunting into the pericardium, but the leakage persisted. Nevertheless, the patient remained stable, and we were unable to detect an effusion in the pericardium.Diagnosis:By analyzing the angiogram and echocardiogram, we found that the contrast did not leak into the pericardium, but into the right ventricle (RV) chamber. An iatrogenic coronary artery fistula (ICAF) from the RCA to the RV was confirmed. We thus terminated the procedure.Outcomes:Coronary computed tomography (CT) angiography was performed 2 days after the PCI and no abnormal shunt was found. There was no abnormal Doppler signal in the RV, either. The patient was soon discharged, and there have been no complaints of discomfort during the 10-month follow-up.Lessons:ICAFs from coronary to the RV always have favorable outcomes. Even like the one in this case that caused medium leakage could seal spontaneously without any additional management. Echocardiography or coronary CT angiography could be chosen as imaging options to follow-up ICAFs.
Periprosthetic metastasis following total hip arthroplasty in a patient with lung carcinoma
Authors: Zhan Haibo , Gao Tian , Yu Xiaolong , Zhang Bin , Zeng Jin , Dai Min 
Published: January 2019

Abstract

Rationale:
Periprosthetic osteolysis secondary to septic loosening and aseptic loosening is a well-described phenomenon associated with artificial hip arthroplasty. Periprosthetic bone loss as a result of metastatic infiltration is an uncommon cause of early, progressive loosening of joint replacement prosthesis and is rarely described in the literature.

Patient concerns:
The present study describes a 70-year-old male patient who was diagnosed with pulmonary squamous cell carcinoma 5 years after total hip arthroplasty (THA) and developed a metastasis from squamous cell carcinoma in the periprosthetic neosynovial tissue 1 year after formal chemotherapy. The main complaint was hip pain with limited activity for about 3 months.

Diagnoses:
Expansive bone destruction and periprosthetic osteolysis at the right femoral trochanter were identified through X-ray and 99mTc bone scan. The diagnosis of pulmonary squamous cell carcinoma metastasis was finally confirmed on the basis of postoperative pathological examination.

Interventions:
The patient underwent open surgery with proximal femoral prosthesis revision and tumor prosthesis resection to completely remove the tumor tissue and relieve pain.

Outcomes:
The patient was completely relieved of pain at discharge 2 weeks after surgery and experienced no complications. However, the patient died of respiratory failure due to disease progression 3 months after surgery.

Lessons:
We believe that clinicians should maintain a high index of suspicion and consider metastatic disease in differential diagnosis of cases of aseptic loosening, particularly if the patient has a history of malignant disease and the osteolytic lesion involves the outer cortex. In addition, patients with a known history of malignancy should be screened with a pre-operative bone scan to rule out any metastatic infiltration and regularly followed up at short intervals to detect any early bone loss.
Elective nodal irradiation provides a superior therapeutic modality for lymph node positivity esophageal squamous cell carcinoma patients receiving definitive radiotherapy versus involved-field irradiation
Authors: Li Qiaofang , Zhu Shuchai , Li Shuguang , Deng Wenzhao 
Published: January 2019

Abstract
This retrospective study was conducted to evaluate the efficacy and safety of elective nodal irradiation (ENI) and involved-field irradiation (IFI) for esophageal squamous cell carcinoma (ESCC) patients treated with intensity-modulated radiotherapy (IMRT).
From January 2006 to December 2012, 644 patients (ENI = 157, IFI = 487) with stage I to IVa ESCC (AJCC 2010) at our institution were analyzed. Propensity score matching (PSM) was used to identify 471 (ENI = 157, IFI = 314) well-balanced patients for comparison. Overall survival (OS) was the primary outcome of the study.
After PSM, the median OS was 26.8 (95% confidence interval [CI], 17.9–35.7) for the ENI arm versus 21.5 (95% CI: 17.9–25.1) months in the IFI arm. The 1-, 3-, 5-year OS were 77.1%, 42.0%, and 26.1% for the ENI arm versus 73.2%, 32.2%, and 19.0% for the IFI arm (P = .020). ENI was a significant independent predictor of 5-year OS (1.301 [1.052–1.609]; P = .015). Furthermore, patients with stage I/II ESCC or lymph node (LN) positivity in the ENI arm had significantly better 5-year OS than their counterparts in the IFI arm. In addition, for LN positivity patients treated with definitive radiotherapy alone, ENI tended to prolong OS compared with IFI (P = .035). The 2 arms were comparable in toxicities.
Using IMRT, ENI is superior to IFI in improving OS of ESCC patients, with acceptable toxicities that were comparable to those to IFI, especially for LN positivity ESCC patients treated with definitive irradiation alone. These results should be confirmed in a large randomized study comparing these 2 modalities.
Risk factors for bone metastasis in patients with primary lung cancer
Authors: Niu Yujie , Lin Yiting , Pang Hailin , Shen Weiwei , Liu Lili , Zhang Helong 
Published: January 2019

Abstract

Background:
Bone metastases (BM) are prevalent among lung cancer (LC) patients. Although some studies revealed associated factors for BM, each of these papers focused on a few factors. Few studies have identified the potential risk factors through a systematic review.

Methods:
We searched through PubMed, MEDLINE, Web of Science, EMBASE, Cochrane Library and Cochrane Central Register
of Controlled Trials for literature from January 1990 to November 2017. The types of literature included case–control studies, cohort studies, randomized controlled trials and systematic reviews.

Results:
From included 12 studies, we identified that lower blood calcium, T4 stage, N3 stage, P-stage III, nonsquamous, bone sialoprotein expression, elevated carcino-embryonic antigen levels were risk factors for bone metastasis in lung cancer patients.

Conclusion:
We identified that T4 stage, N3 stage, and positive bone sialoprotein expression associated with an increased risk of bone metastasis. Further studies are needed to assess these relationships and to establish the risk prediction model of bone metastasis.
Long noncoding RNA X-inactive specific transcript as a prognostic factor in cancer patients
Authors: Chen Jinbo , Yang Xiong , Gong Dongkui , Cui Yu , Hu Jiao , Li Huihuang , Liu Peihua , Li Chao , Cheng Xu , Liu Longfei , Chen Hequn , Zu Xiongbing 
Published: January 2019

Abstract

Background/aims:
Emerging evidence showed the long noncoding RNA X-inactive specific transcript (lncRNA XIST) may play a crucial role in various cancers. However, its prognostic value in cancer patients remains controversial. Therefore, we performed an in-depth meta-analysis to investigate the potential clinical value of lncRNA XIST as a prognostic marker for cancer patients.

Methods:
A comprehensive literature search was performed from PubMed, Embase and the Cochrane Central Search Library by January 2018. Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (95% Cl) were calculated to evaluate the prognosis as well as clinicopathological parameters of XIST, respectively.

Results:
A total of 18 retrospective studies with 1351 cancer patients were included. Current meta-analysis revealed that elevated lncRNA XIST expression was associated with poor overall survival (OS) (HR = 2.14, 95% CI = 1.26–3.64; P = .005) and disease free survival (DFS) (HR = 4.52, 95% CI = 1.42–14.37; P = .011). The clinicopathological parameters analysis demonstrated that increased XIST expression was significantly associated with tumor size (OR = 2.93, 95% CI = 2.24–3.84; P < .001), clinical stage (OR = 2.73, 95% CI = 1.62–4.58; P < .001) and lymph node metastasis (OR = 2.44, 95% CI = 1.74–3.42; P < .001). In addition, subgroup analysis based on cancer type revealed that lncRNA XIST expression correlated with distant metastasis in digestive cancer (OR = 2.90, 95% CI = 1.80–4.68; P < .001).

Conclusion:
The current meta-analysis results indicated lncRNA XIST expression level could serve as a prognostic predictor and biomarker in multiple cancers.
Clinical and radiological outcomes of a cervical cage with integrated fixation
Authors: Lonjon Nicolas , Favreul Emmanuel , Huppert Jean , Lioret Eric , Delhaye Manuel , Mraidi Ramzi 
Published: January 2019

Abstract
Cervical cages with integrated fixation have been increasingly used in anterior cervical discectomy and fusion (ACDF) to avoid complications associated with anterior cervical plates. The purpose of this paper is to provide 2-year follow-up results of a prospective study after implantation of a cervical cage with an integrated fixation system.
This was a prospective multicenter outcome study of 90 patients who underwent ACDF with a cage with integrated fixation. Fusion was evaluated from computed tomography images (CT-images) by an independent laboratory at 2-year follow-up (FU). Clinical and radiological findings were recorded preoperatively and at FU visits and complications were reported.
At 24 months, the fusion rate was 93.4%. All average clinical outcomes were significantly improved at 2 years FU compared to baseline: neck disability index (NDI) 18.9% vs 44.4%, visual analog scale (VAS) for arm pain 18.2 mm vs 61.9 mm, VAS for neck pain 23.9 mm vs 55.6 mm. Short form-36 (SF-36) scores were significantly improved. One case of dysphagia, which resolved within 12 months, and 1 reoperation for symptomatic pseudarthrosis were reported. Subsidence with no clinical consequence or reoperation was reported for 5/125 of the implanted cages (4%). There was also 1 case of per-operative vertebral body fracture that did not require additional surgery. Superior and inferior adjacent discs showed no significant change of motion at 2-year FU compared to baseline. Disc height index (DHI) and lordosis were enhanced and these improvements were maintained at 1 year.
The ACDF using cages with an integrated fixation system demonstrated reliable clinical and radiological outcomes and a high interbody fusion rate. This rate is comparable to the rate reported in recent series using other implants with integrated fixation, but the present device had a lower complication rate.
Surgical treatment for primary premature ejaculation with an inner condom technique
Authors: Wang Hai , Bai Ming , Zhang Hai-Lin , Zeng Ang 
Published: January 2019

Abstract
To explore a novel surgical treatment for primary premature ejaculation using an inner condom technique.
A total of 20 males with premature ejaculation, who admitted our andrology clinic from June 2016 to July 2017, were enrolled. By surgery, an inner condom made of acellular dermal matrix (ADM) was transferred to the subcutaneous pocket of the penis. The prolongation of intravaginal ejaculatory latency time (IELT) after the surgery was examined. The perioperative complications were also studied.
The surgical intervention significantly increased the average IELT in patients, from 0.67 to 2.37 min (P = .009). No serious perioperative complications and adverse psychosexual effects were seen. Patients could resume sexual activity 6 weeks after the surgery.
The novel inner condom using ADM is an effective and safe surgical treatment for males with premature ejaculation. The efficacy of this new treatment modality warrants further investigation in independent cohorts.
Nail bed solitary neurofibroma
Authors: Pertea Mihaela , Grosu Oxana-Mădălina , Terinte Cristina , Poroch Vladimir , Velenciuc Natalia , Lunca Sorinel 
Published: January 2019

Abstract

Rationale:
Nail bed solitary neurofibroma is an extremely rare tumor, with only 9 cases recorded in the literature so far.

Patient concern:
We present the case of a 42-year-old female patient, with a history of a slowly growing tumor in the nail bed of the left index and no clinical features of type I neurofibromatosis.

Diagnosis:
Nail bed solitary neurofibroma.

Intervention:
The tumor was surgically removed and the pathology examination established the diagnosis of neurofibroma.

Outcomes:
The postoperative outcome was good, with no recurrence 12 months after surgery.

Lessons:
We present the rarity of this type of tumor localized in the nail bed, taking into consideration the only 9 cases recorded in the literature. Nail bed solitary neurofibroma should be also included in the differential diagnosis of a nail bed tumor.
Madelung disease
Authors: Gao Hui , Xin Zhi-Ying , Yin Xin , Zhang Yu , Jin Qing-Long , Wen Xiao-Yu 
Published: January 2019

Abstract

Rationale:
Madelung disease (MD), a rarely reported disease, also known as benign symmetric lipomatosis, a disorder resulting from alcoholic abuse. It's largely under-recognized and under-reported, possibly because of unawareness of the condition by physicians.

Patient concerns:
A 45-year-old Chinese man presented with intermittent fatigue and abdominal distension and progressive bilateral breast enlargement. He has been a heavy drinker for ten years before onset of the disease with an average daily alcohol intake of more than 120 g/day.

Diagnosis:
Due to the patient's symptoms, laboratory test results, radiographic findings, he was diagnosed with MD.

Interventions:
We treated him with abstinence from alcohol and supportive therapy.

Outcomes:
The patient is now in stable condition, with improvement in symptoms during follow-up.

Lessons:
Doctors, confronted with progressive bilateral breast enlargement in a patient with alcoholic liver disease, should be aware of the underreported MD. Recognition of this syndrome could help doctors establish diagnosis and emphasize the importance of alcohol abstinence as the mainstay of management.
Pregnancy-related acquired hemophilia A initially manifesting as pleural hemorrhage
Authors: Qian Lili , Ge Hangping , Hu Pingping , Zhu Ni , Chen Junfa , Shen Jianping , Zhang Yu 
Published: January 2019

Abstract

Rationale:
Acquired hemophilia A is a rare hemorrhagic disease in which the body produces specific antibodies that attack factor VIII, resulting in bleeding that is mainly mucocutaneous and associated with soft tissue and the gastrointestinal system. Approximately 50% of this disease derives from basic diseases, such as autoimmune diseases, cancer, and pregnancy.

Patient concerns:
We report a 35-year-old postpartum female with acquired hemophilia A who initially presented with pleural hemorrhage.

Diagnoses:
In this patient activated prothrombin time (PT) and activated partial thromboplastin time (APTT) were found, and the factor VIII activity was 12.6%, furthermore Bethesda assay showed a FVIII antibody titer of 7.4 Bethesda units (BUs).

Interventions:
The treatment requires a 2-pronged approach: treatment of the bleeding and elimination of the inhibitor.

Outcomes:
After hemostatic agents were used and inhibitors were eradicated, the patient achieved complete remission without relapse.

Lessons:
It is essential to recognize the development of disease earlier in pregnant woman.
RET fusion in advanced non-small-cell lung cancer and response to cabozantinib
Authors: Wang Yucong , Xu Yinghui , Wang Xu , Sun Chao , Guo Ye , Shao Guoguang , Yang Zhiguang , Qiu Shi , Ma Kewei 
Published: January 2019

Abstract

Rationale:
Lung cancer is a series of gene-driven disease. EGFR, ALK, and ROS1 are 3 major driver genes that play an important role in lung cancer development and precision management. Additionally, rare genetic alterations continue to be discovered and may become novel targets for therapy. The RET gene is one of such rare genetic alteration of non-small cell lung cancer (NSCLC). In this report, we present a RET-positive case that benefited from cabozantinib treatment.

Patient concern:
A 50-year-old male patient was diagnosed with lung adenocarcinoma 2 years ago, at that time he received palliative surgery of pulmonary carcinoma and completed 4 cycles of chemotherapy with gemcitabine and cisplatin. Six months later, he was hospitalized in our cancer center due to the disease recurrence, presenting with pleural metastasis.

Diagnosis:
Gene alteration was examined using the intraoperative specimen by PCR method, and KIF5B/RET gene fusion was detected. Therefore, the patient was diagnosed with late-stage lung adenocarcinoma with RET gene mutation.

Interventions:
The patient received treatment with cabozantinib from June 2017.

Outcomes:
Cabozantinib was administered (140 mg orally, once daily) for approximate 9 months, and his disease achieved stable disease (SD). During that period, there were no severe adverse events (AE), except for a grade II rash (CTCAE 4.0).

Lessons:
We found that the RET fusion gene is a novel driver molecular of lung adenocarcinoma in patients without common mutations in such genes as EGFR, ALK, and ROS1. This case report supports a rationale for the treatment of lung adenocarcinoma patients with a RET fusion and provides alternative treatment options for these types of NSCLC patients.
Multiple infections by EBV, HCMV and Helicobacter pylori are highly frequent in patients with chronic gastritis and gastric cancer from Southwest Mexico
Authors: Del Moral-Hernández Oscar , Castañón-Sánchez Carlos Alberto , Reyes-Navarrete Salomón , Martínez-Carrillo Dinorah N. , Betancourt-Linares Reyes , Jiménez-Wences Hilda , de la Peña Sol , Román-Román Adolfo , Hernández-Sotelo Daniel , Fernández-Tilapa Gloria 
Published: January 2019

AbstractThe chronic inflammation and damage to the gastric epithelium induced byHelicobacter pylori(H. pylori) are the main risk factors for gastric cancer development. Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) induce chronic inflammation and have been found in gastric tumors. The objectives this observational study were to determine the frequency of multiple infections byHelicobacter pylori, Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) and to relate the infection by EBV and HCMV withH. pylori vacA/cagAgenotypes in patients with chronic gastritis or gastric cancer. DNA fromH. pylori, EBV and HCMV was detected by PCR in biopsies from 106 Mexican patients with chronic gastritis and 32 from gastric cancer. ThecagAstatus and thevacAgenotypes ofH. pyloriwere determined by PCR. In chronic gastritis and gastric cancer EBV was found in 69.8% and 87.5%, HCMV in 52.8% and 53.1%, andH. pyloriin 48.1% and 40.6%, respectively. In chronic gastritis, 53% ofH. pylori+patients were EBV+and 33% were both EBV+/HCMV+; in gastric cancer, 92.3% ofH. pylori-infected individuals were EBV+and 46.1% were EVB+/HCMV+. All the intestinal- and mixed-type tumors and the 83.3% of diffuse-type tumors were EBV+. No significant differences were found between single infections or coinfections with the diagnosis or the cancer type. TheH. pylorigenotypes were not related to EBV or HCMV infection. The frequency of dual infections byH. pylori, EBV and HCMV is higher in patients from southwest Mexico than other populations. It is likely that these pathogens act synergistically to induce inflammation and gastric cancer.
A computer-aided diagnosis system using artificial intelligence for the diagnosis and characterization of breast masses on ultrasound
Authors: Park Hee Jeong , Kim Sun Mi , La Yun Bo , Jang Mijung , Kim Bohyoung , Jang Ja Yoon , Lee Jong Yoon , Lee Soo Hyun 
Published: January 2019

Abstract
To evaluate the value of the computer-aided diagnosis (CAD) program applied to diagnostic breast ultrasonography (US) based on operator experience.
US images of 100 breast masses from 91 women over 2 months (from May to June 2015) were collected and retrospectively analyzed. Three less experienced and 2 experienced breast imaging radiologists analyzed the US features of the breast masses without and with CAD according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and categories. We then compared the diagnostic performance between the experienced and less experienced radiologists and analyzed the interobserver agreement among the radiologists.
Of the 100 breast masses, 41 (41%) were malignant and 59 (59%) were benign. Compared with the experienced radiologists, the less experienced radiologists had significantly improved negative predictive value (86.7%–94.7% vs 53.3%–76.2%, respectively) and area under receiver operating characteristics curve (0.823–0.839 vs 0.623–0.759, respectively) with CAD assistance (all P < .05). In contrast, experienced radiologists had significantly improved specificity (52.5% and 54.2% vs 66.1% and 66.1%) and positive predictive value (55.6% and 58.5% vs 64.9% and 64.9%, respectively) with CAD assistance (all P < .05). Interobserver variability of US features and final assessment by categories were significantly improved and moderate agreement was seen in the final assessment after CAD combination regardless of the radiologist's experience.
CAD is a useful additional diagnostic tool for breast US in all radiologists, with benefits differing depending on the radiologist's level of experience. In this study, CAD improved the interobserver agreement and showed acceptable agreement in the characterization of breast masses.
Hemodynamic changes after infusion of intravenous lipid emulsion to treat refractory hypotension caused by glyphosate-surfactant herbicide poisoning
Authors: Lee Min-Jeong , Min Young Gi 
Published: January 2019

Abstract

Rationale:
Glyphosate-surfactant herbicides (GlySH) are non-selective herbicides that are extensively used worldwide. A recent case report on GlySH poisoning suggested successful resuscitation upon using intravenous lipid emulsion (ILE) for refractory hypotension. The efficacy of ILE in GlySH poisoning remains unproven due to a lack of randomized controlled trials, and further evidence is required to clarify the mechanism by which ILE may reverse hypotension in GlySH poisoning.

Patient concerns:
A 46-year-old man presented to the emergency department 45 min following ingestion of approximately 200 cc of GlySH. On arrival, his vital signs were as follows: blood pressure, 82/50 mmHg and pulse, 85 beats/min. Hypotension did not respond to fluid resuscitation and norepinephrine infusion; his cardiac output (CO) was 4.5 L/min and systemic vascular resistance (SVR) was 604 dynes·s·cm−5 with blood pressure of 63/35 mmHg.

Diagnosis:
GlySH poisoning presented with refractory hypotension.

Interventions:
A bolus (100 mL) of ILE was infused with subsequent infusion of 400 mL over 4 h.

Outcomes:
A few minutes following the bolus of ILE, his blood pressure increased to 101/54 mmHg with CO of 6.5 L/min and SVR of 701 dynes·s·cm−5. Blood pressure, CO, and stroke volume increased gradually over next 8.5 h. His clinical status improved gradually, and norepinephrine could be tapered on hospital day (HD) 3. The patient was discharged at HD 10 without sequelae.

Lessons:
ILE could be used as a rescue treatment in case of a poor response to conventional fluid and vasopressor therapy. The underlying mechanism of rescue with ILE might be a positive inotropic effect.