bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal Cancer in Inflammatory Bowel Disease
Authors: Higgins Peter , Stidham Ryan 
Published: April 2018

AbstractPatients with inflammatory bowel disease (IBD) are at significantly increased risk of colorectal cancer (CRC), principally resulting from the pro-neoplastic effects of chronic intestinal inflammation. Epidemiologic studies continue to highlight the increased risk of CRC in IBD. However, the incidence has declined over the past 30 years, attributed to both successful CRC-surveillance programs and improved control of mucosal inflammation. Risk factors that further increase the risk of IBD-related CRC include disease duration, extent and severity, the presence of inflammatory pseudopolyps, coexistent primary sclerosing cholangitis, and a family history of CRC. All major professional societies agree that IBD-CRC surveillance should occur more frequently than in the general population. Yet, guidelines and consensus statements differ on the surveillance schedule and preferred method of surveillance. Improved sensitivity to previously “invisible” flat dysplastic lesions using high definition and chromoendoscopy methods has resulted in many guidelines abandoning requirements for random untargeted biopsies of the colon. While colonic dysplasia remains a worrisome finding, and several clinical scenarios remain best addressed by total proctocolectomy due to concerns of synchronous undetected lesions and the unpredictable tempo of progression to malignancy, better detection techniques have also increased opportunities for endoscopic resection of dysplastic lesions that can be clearly delineated. Finally, the expanding armamentarium of medical options in IBD, including anti-tumor necrosis factor and anti-adhesion biologic therapies, have substantially improved our ability to control severe inflammation and likely reduce the risk of CRC over time.
Emerging Systemic Therapies for Colorectal Cancer
Authors: Krauss John , Veenstra Christine 
Published: April 2018

AbstractDespite advances over the past 20 years in colorectal cancer (CRC) screening, diagnosis, and treatment, survival outcomes remain suboptimal. Five-year survival for patients with locally advanced CRC is 69%; 5-year survival drops to 12% for patients with metastatic disease. Novel, effective systemic therapies are needed to improve long-term outcomes. In this review, we describe currently available systemic therapies for the treatment of locally advanced and metastatic CRC and discuss emerging therapies, including encouraging advances in identifying novel targeted agents and exciting responses to immunotherapeutic agents.
Development of Preclinical Models to Understand and Treat Colorectal Cancer
Authors: Sebolt-Leopold Judith 
Published: April 2018

AbstractThe establishment and validation of preclinical models that faithfully recapitulate the pathogenesis and treatment response of human colorectal cancer (CRC) is critical to expedient therapeutic advances in the clinical management of this disease. Integral to the application of precision medicine for patients diagnosed with metastatic CRC is the need to understand the molecular determinants of response for a given therapy. Preclinical models of CRC have proven invaluable in answering many of our basic questions relating to the molecular aberrations that drive colorectal tumor progression. This review will address the comparative merits and limitations of the broad spectrum of in vitro and in vivo models available for study of colorectal tumors and their response to experimental therapies.
Factors Affecting Postoperative Lung Expansion in Patients with Pyogenic Empyema
Authors: Ahn Hyo , Kim Yeong , I. Hoseok , Song Seunghwan , Eom Jung , Mok Jeongha , Cho Jeong 
Published: April 2018

Background In patients with parapneumonic empyema, decortication is usually preferred to ensure functional lung re-expansion. However, there could be patients exhibiting incomplete postoperative lung expansion and inadequate drainage despite decortication. Therefore, we evaluated factors affecting postoperative lung expansion in patients undergoing decortication.
Methods A total of 221 patients with pyogenic empyema who underwent video-assisted thoracoscopic surgery (VATS) between January and October 2016 in our hospital were reviewed in terms of surgical success. The following factors were evaluated: age; the time between identification of a localized effusion and surgical referral; chest tube drainage durations; any underlying morbidity preoperative blood culture data; and the thickness of the visceral pleura.
Results Several factors that significantly prolonged the postoperative time to lung expansion were evident in patients with diabetes mellitus (DM) and bacteremia; postoperative chest tube drainage was significantly longer in those with DM (p = 0.009) and bacteremia (p = 0.01); and postoperative hospitalization time was significantly longer in patients with bacteremia (p = 0.01). The thickness of the visceral pleura was strongly correlated with postoperative chest tube drainage duration and postoperative hospitalization time (Pearson correlation coefficient, r = 0.245, p = 0.00).
Conclusions In patients with DM, bacteremia, or thickened pleura, the time to lung expansion after operation was longer. Therefore, stricter pre- and post-operative control of blood-sugar levels and adequate antibiotics are required to facilitate postoperative lung re-expansion. In patients with thickened pleurae, prolonged chest tube placement is unavoidable.
Heparin-Induced Thrombocytopenia in Infants after Heart Surgery
Authors: Abdillah Juma , Hu Qinghua , Chen Xuliang , Chen Xing , Zhou Wu , Luo Wanjun , Huang Lingjin 
Published: April 2018

Background Heparin-induced thrombocytopenia (HIT) in infants is a rare disorder, and the diagnosis and management of HIT still remains challenging. Argatroban is a synthetic direct thrombin inhibitor (DTI) that is widely used for treating HIT. However, little is known about the efficacy of the activated clotting time (ACT) test in monitoring DTI treatment as an alternative to the routinely used activated partial thromboplastin time (aPTT).
Methods Between July 2013 and January 2015, four infants were diagnosed with HIT after surgical correction of congenital anomalies. In all cases, heparin was used during cardiopulmonary bypass (CPB). Diagnosis of HIT was based on the “4 Ts” pretest clinical scoring system, and platelet factor 4 (PF4) antibody was detected using enzyme-linked immunosorbent assay. Argatroban was used in treating HIT. When argatroban was infused, anticoagulation tests (aPTT, prothrombin time [PT], thrombin time [TT], and fibrinogen) were performed every 4 to 12 hours. ACT was used in addition to monitor the anticoagulation effect of argatroban. The target ACT was 1.5 to 3.0 times the baseline. ACT was measured every 2 to 4 hours and remeasured 1 hour after each dosage adjustment.
Results Thrombocytopenia (defined as a 50% decrease in platelet count) occurred during the 3rd to 6th day postoperatively. After the diagnosis of HIT, argatroban was started immediately, and platelet counts stabilized and gradually increased. Anticoagulation effect of argatroban was successful monitored by ACT and aPTT. Poor correlation between the ACT test and aPTT test (R = 0.270, p = 0.092) was noted in one patient. ACT values increased rapidly after 3 to 7 days on argatroban treatment. In most cases, low dosage of argatroban was given ranging from 0.04 to 5.00 μg/kg/min.
Conclusion Argatroban may be an effective medicine in treating HIT in infants, in a reduced dosage. The great fluctuation in argatroban dosage during the course of HIT treatment necessitates close monitoring. ACT test may be reliable and convenient for monitoring HIT treatment and may contribute to positive clinical outcomes in infants. The efficacy of argatroban and the use of ACT monitoring in the management of HIT infants needs further study.
Alternative Choices for Anterolateral Thigh Flaps Lacking Suitable Perforators: A Systematic Review
Authors: Namgoong Sik , Yoon Young , Yoo Ki , Han Seung , Kim Woo , Dhong Eun 
Published: April 2018

Background The anterolateral thigh (ALT) flap has become a predominant option in the field of reconstruction. However, some difficulties in harvesting flap exist due to the anatomical variability of the perforators. Reports have provided solutions for unreliable perforators. Although numerous cases that showed successful conversion to tensor fasciae latae (TFL) flap or anteromedial thigh (AMT) flap have been reported in the literature, none fully addresses the reliability of the perforators that have been described to date. Therefore, we conducted a systematic literature review to compare the reliability of the TFL flap with that of the AMT flap when an ALT flap perforator is not suitable.
Methods A systematic review of the MEDLINE, PubMed, and Cochrane Library electronic databases was performed to compare the characteristics of TFL and AMT flap perforators.
Results A total of 13 articles were included for review. The mean number of TFL perforators varied from 1.41 to 3.17 per thigh. The mean number of AMT perforators was between 0.59 and 1.3 per thigh. The cumulative assessment of the clinical and anatomical studies showed 456 perforators in 180 TFL flaps (mean, 2.53) and 145 perforators in 162 AMT flaps (mean, 0.90). The mean pedicle length of the TFL and AMT flaps ranged from 7.0 to 9.59 cm and from 7.4 to 11.0 cm, respectively. The mean perforator diameter was similar in both flaps.
Conclusion Currently available literature suggests that the TFL flap may be a more reliable alternative when adequate perforators are not found for ALT flap harvest.
Does Cigarette Smoking Harm Microsurgical Free Flap Reconstruction?
Authors: Heidekrueger Paul , Haas Elisabeth , Coenen Michaela , Giunta Riccardo , Ninkovic Milomir , Broer P. , Ehrl Denis 
Published: April 2018

Background Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions.
Methods Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center. The cases were divided into “smoker” (S) and “nonsmoker” (NS) groups according to their cigarette smoking status. The data were retrospectively screened for patients' demographics, perioperative details, surgical complications, free flap types, recipient sites, flap survival, and overall outcomes.
Results Both groups were comparable regarding comorbidities including hypertension, peripheral artery disease, diabetes, American Society of Anesthesiologists scores, types of performed free flaps, and recipient sites. While patients in the NS group were significantly older and had a higher prevalence of obesity (p < 0.05), there were no significant differences regarding the rate of major or minor complications during our 3-month follow-up period (p > 0.05).
Conclusion While minor and major complications were increased regarding virtually all examined parameters, cigarette smoking did not have significant effects on the overall outcomes of microsurgical free flap reconstructions.
Check the Record: Remote CT Scans for Breast Flap Perforator Mapping
Authors: Sergesketter Amanda , Pyfer Bryan , Phillips Brett , Zhao Ruya , Hollenbeck Scott 
Published: April 2018

Background Perforator mapping with computed tomography angiography (CTA) prior to autologous breast reconstruction reduces donor-site morbidity and operative time, but is costly. The aim of this study was to evaluate whether pre-existing CT scans could be used for dominant perforator identification before autologous reconstruction.
Methods We identified all female patients who underwent mastectomy with immediate or delayed breast reconstruction with abdominal free flaps at a single institution between 2006 and 2016. Medical records were reviewed to identify patients with pre-existing CT scans of the abdomen/pelvis. CT images were reviewed by the senior surgeon and ranked on a 1 to 3 scale to indicate utility for preoperative planning. An analysis was performed to assess financial savings and radiation avoidance associated with the use of pre-existing scans.
Results Of 301 identified patients, 44.9% (n = 135) had an available pre-existing CT. A dominant perforator was identified on 92.6% of scans. A higher proportion of dominant perforators was identified using positron emission tomography (PET)/CT scans compared with CT scans with intravenous (IV) contrast and noncontrast CTs (p < 0.0001). Compared with PET/CTs and CTs with IV contrast, the average utility score for noncontrast CTs was lower (p = 0.0001). Dominant perforators were clearly identified in patients who had both a remote CT scan and a preoperative CTA. Perforator mapping using remote CT scans yielded a projected radiation reduction of 13.2 mGy per patient and yielded a projected annual U.S. health care savings of $28,459,638.
Conclusion Our study suggests that pre-existing CT scans represent a viable and economical alternative for perforator mapping before abdominal-based free flap breast reconstruction.
Female Sexual Function in Women with Suspected Deep Infiltrating Endometriosis
Authors: Lima Ryane Vieira , Pereira Ana Maria Gomes , Beraldo Fernando Bray , Gazzo Cláudia , Martins João Alfredo , Lopes Reginaldo Guedes Coelho 
Published: April 2018

Objective To evaluate the quality of the sexual function of women with suspected deep infiltrating endometriosis.
Methods A cross-sectional, observational and prospective study was conducted between May 2015 and August 2016, in which 67 patients with deep infiltrating endometriosis, suspected or diagnosed, were assessed for epidemiological and clinical characteristics, such as pain level through a visual analog scale (VAS), features of deep infiltrating endometriosis lesions and score on the Female Sexual Function Index (FSFI) before the onset of treatment. The statistical analysis was performed using the software STATA version 12.0 (StataCorp LLC, College Station, TX, USA) to compare the variables through multiple regression analysis.
Results The average age of the patients was 39.2 years old; most patients were symptomatic (92.5%); and the predominant location of the deep infiltrating lesions was on the rectosigmoid colon (50%), closely followed by the retrocervical region (48.3%). The median overall score on the FSFI was 23.4; in 67.2% of the cases the score was ≤ 26.5 (cutoff point for sexual dysfunction). Deep dyspareunia (p = 0.000, confidence interval [CI]: 0.64–0.83) and rectosigmoid endometriosis lesions (p = 0.008, CI: 0.72–0.95) showed significant correlation with lower FSFI scores, adjusted by bladder lesion, patients' age and size of lesions. Deep dyspareunia (p = 0.003, CI: 0.49–0.86) also exhibited significant correlation with FSFI pain domain, adjusted by cyclic bowel pain, vaginal lesion and use of gonadotropin-releasing hormone (GnRH) analog. These results reflect the influence of deep dyspareunia on the sexual dysfunction of the analyzed population.
Conclusion Most patients exhibited sexual dysfunction, and deep dyspareunia was the pelvic painful symptom that showed correlation with sexual dysfunction.
Development of Targeted Muscle Reinnervation Model in Hind Limb Amputated Rats
Authors: Garg Rohit , Uygur Safak , Cwykiel Joanna , Siemionow Maria 
Published: April 2018

Background Targeted muscle reinnervation (TMR) is a novel approach to postamputation neuroma pain; however, this has not been explicitly studied. The purpose of this study was to develop a TMR model in hind limb amputated rats.
Methods Ten hind limbs from 5 Sprague Dawley cadaver rats were used. Sciatic nerve, main branches of the sciatic nerve (common peroneal, tibial, sural), motor branches from the sciatic nerve to the biceps femoris and cauda femoris, gluteal nerve and its motor branches to the semimembranosus, and biceps femoris and femoral nerve were dissected to look for consistent nerve anatomy that can be used for TMR in the rat hind limb amputation model. Transfemoral amputation was performed and two types of coaptations were made: common peroneal nerve to motor branch to biceps femoris and tibial nerve to motor branch to semimembranosus.
Results The total surgical time for the dissection, amputation, and coaptation of nerves was ∼90 minutes. A total of 100 nerves were dissected in 10 rat hind limbs. Anatomical dissections were straightforward to perform. Anatomy of the dissected nerves was consistent. Hind limb amputations were performed without damaging the target muscles and nerves. Nerve lengths were sufficient for coaptation without any tension.
Conclusions To the best of our knowledge, this is the first report on TMR model in hind limb amputated rats. This model will allow for mechanical, electromyography (EMG), and histological analysis for future assessment of neuroma prevention.
Update Pharmakotherapie bei Parkinson
Authors: Ceballos-Baumann A. O. , Fietzek U. M. 
Published: April 2018

ZusammenfassungAuch im letzten Jahr wurden zahlreiche pharmakotherapeutische Entwicklungen für die Parkinsonkrankheit vorangebracht. Die in den USA kommerziell erfolgreiche retardierte Darreichungsform von Levodopa IPX066 ist in Europa zwar zugelassen, aber nicht am Markt verfügbar. Eine speziell gefaltete Akkordeon Pille verspricht ebenso eine vereinfachte Galenik bei besserer klinischer Wirkung. Levodopa ist als Inhalativum kurz vor Markteintritt und zeigt in den vorgelegten Studien, dass Off-Phasen erfolgreich verkürzt werden können, allerdings nicht schnellere Hilfe leisten als die verfügbaren Stand-by Medikamente. Neu ist auch, dass L-Dopa über die Haut appliziert werden kann. Safinamid und Opicapon sind über Rezept verfügbar. Für letzteres liegen die Ergebnisse der Zulassungsstudien vor. Die neue AmantadinGalenik hat in den USA aufgrund günstiger Studiendaten die Zulassung zur Behandlung von Dyskinesien erhalten. Auch hat sich das Verständnis um Risikofaktoren zur Entwicklung eines Parkinson deutlich weiterentwickelt. Wir stellen neueste Arbeiten zu dem Glucagon-like-Peptid-Analogon Exenatide und dem ß2-Adrenorezeptor vor.
Genetisch determinierte Dystonien
Authors: Lohmann K. , Paus S. , Lohmann E. , Gasser T. , Ganos C. , Klein C. , Brüggemann N. 
Published: April 2018

ZusammenfassungDystonien sind durch anhaltende oder intermittierende Muskelkontraktionen gekennzeichnet, die zu abnormen, häufig repetitiven Bewegungen verschiedener Körperteile führen. Die Einteilung der Dystonien erfolgt nach klinischen und ätiologischen Kriterien, wobei insbesondere die Genetik durch die Identifikation neuer, mit der Krankheit assoziierter Gene an Bedeutung gewonnen hat.Innerhalb des Krankheitsbildes der Dystonie können folgende Formen voneinander unterschieden werden: bei den isolierten Formen bestehen keine über die Dystonie hinausgehenden Zeichen oder Symptome; kombinierte Dystonien zeichnen sich durch eine Kombination von Dystonie und anderen Bewegungsstörungen wie Parkinsonismus, Chorea und Myoklonien aus und bei den komplexen Dystonien finden sich weitere neurologische und nicht-neurologische Manifestationen. Mutationen in den folgenden Genen sind mittlerweile als etablierte Ursachen für isolierte oder kombinierte erbliche Dystonie identifiziert worden: Tor1A, THAP1, GNAL, ANO3, KMT2B, GCH1, TAF1, PRKRA, ATP1A3, SGCE und ADCY5; > 100 Gene stehen im Zusammenhang mit komplexen Dystonien. Viele, insbesondere auch einige genetisch bedingte Formen der Dystonien, sprechen auf die Therapieoption der tiefen Hirnstimulation gut an. Aktuell arbeiten Forschungsnetzwerke daran, die Diagnostik und Therapie der Dystonien weiter zu verbessern.
Ectopic neurogenesis induced by prenatal antiepileptic drug exposure augments seizure susceptibility in adult mice
Authors: Sakai Atsuhiko , Matsuda Taito , Doi Hiroyoshi , Nagaishi Yukiko , Kato Kiyoko , Nakashima Kinichi 
Published: April 2018

Significance
Recent clinical studies suggest that environmental insults, such as valproic acid (VPA) exposure, in utero can have adverse effects on brain function of the offspring in later life, although the underlying mechanisms of these impairments remain poorly understood. By focusing on the property of neural stem/progenitor cells (NS/PCs) residing in the adult hippocampus, we identified the mechanism of increased seizure sensitivity in prenatally VPA-exposed adult mice. Furthermore, we found that voluntary exercise can overcome the adverse effects through normalizing VPA-induced transcriptome alterations in NS/PCs. We believe that our study provides insights for further understanding and developing treatment strategies for neurological disorders induced by prenatal environmental insults.
Thermodynamic limits of energy harvesting from outgoing thermal radiation
Authors: Buddhiraju Siddharth , Santhanam Parthiban , Fan Shanhui 
Published: April 2018

Significance
A large part of the research on renewable energy has focused on harvesting power from solar radiation. But, for the Earth to maintain its temperature, it must radiate to the outer space an amount of power approximately equal to that of the incoming solar radiation. However, far less is understood about the theoretical limits of harvesting power from such outgoing radiation. Here, we identify a duality relation between harvesting incoming and outgoing thermal radiation and use it to derive fundamental limits of harvesting outgoing thermal radiation. Our results indicate a theoretical limit that far exceeds what was previously thought to be possible and highlight the significant potential for harvesting outgoing thermal radiation for renewable energy applications.
Human bony labyrinth is an indicator of population history and dispersal from Africa
Authors: Ponce de León Marcia S. , Koesbardiati Toetik , Weissmann John David , Milella Marco , Reyna-Blanco Carlos S. , Suwa Gen , Kondo Osamu , Malaspinas Anna-Sapfo , White Tim D. , Zollikofer Christoph P. E. 
Published: April 2018

Significance
The cavity system of the inner ear—the so-called bony labyrinth—houses the senses of balance and hearing. This structure is embedded in dense petrous bone, fully formed by birth and generally well preserved in human skeletal remains, thus providing a rich source of morphological information about past populations. Here we show that labyrinthine morphology tracks genetic distances and geography in an isolation-by-distance model with dispersal from Africa. Because petrous bones have become prime targets of ancient DNA recovery, we propose that all destructive studies first acquire high-resolution 3D computed-tomography data prior to any invasive sampling. Such data will constitute an important archive of morphological variation in past and present populations, and will permit individual-based genotype–phenotype comparisons.