bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive Histologic Scoring to Maximize the Predictability of Pathology-generated Equation of Breast Cancer Oncotype DX Recurrence Score
Authors: Khoury Thaer , Huang Xiao , Chen Xiwei , Wang Dan , Liu Song , Opyrchal Mateusz 
Published: January 2016

Background:
Pathology-generated equations have been introduced to predict Oncotype DX recurrence score (ORS) in breast cancer. The purpose of the study is to improve these equations.

Materials and Methods:
Slides from 416 (test set) consecutive breast cancers with available Oncotype DX were reviewed. A validation set (n=91) was prospectively scored using the generated formulas from the test set. The following histopathologic features were graded: Nottingham grade (designated as current Nottingham grade), necrosis, and degree of tumor-infiltrating lymphocytes. The following data were extracted from the pathology report: Nottingham grade (designated as reported Nottingham grade), tumor size, ER/PR Allred scores, HER2 status, and ORS. Equations were calculated, one included the reported Nottingham grade, one included the current Nottingham grade, and one included the current Nottingham grade with the other significant histopathologic variables.

Results:
In the equation that included the reported Nottingham grade, ER, PR, and HER2, the overall concordance with the ORS was 64.86%. After excluding the intermediate category detected by the formula, the concordance rate was 95.28%. When the current Nottingham grade was included, the concordance rate became 69.61% and 98.62%, respectively. When necrosis and the degree of tumor-infiltrating lymphocytes were added to the previous equation, these rates became 70.1% and 98.63%, respectively.

Conclusions:
Our equation has better correlation with ORS than previously published results.
Granuloma Faciale and Eosinophilic Angiocentric Fibrosis: Similar Entities in Different Anatomic Sites
Authors: Stelini Rafael F. , Moysés Mayara D. G. , Cintra Maria L. , Soares Tânia C. B. , Souza Elemir M. d. , Altemani Albina M. d. A. M. , Teixeira Fernanda 
Published: January 2016

Background:
Eosinophilic angiocentric fibrosis (EAF) and granuloma faciale (GF) share several histopathologic features, including eosinophil-rich inflammation, microangiitis, and progressive fibrosis. Concurrent presentation of EAF and GF suggests a pathogenetic link between them.

Objectives:
To identify histologic findings that tell them apart and construe the pathogenetic mechanisms behind each morphologic variable, 14 immunohistochemical markers were used to study the cells subpopulations in 14 cases of GF and 3 cases of EAF.

Materials and Methods:
The lesions were classified according to their stage of development. The antibodies studied were: CD4, Foxp3, CD8, granzymes A and B, perforin, granulysin, CD20, CD56, CD68, ICAM-1, CD34, CD105, and 1A4.

Results:
The intensity of the sclerotic response and the density of 1A4-immunostained cells were significantly higher in EAF. In both diseases, CD68+ cells were the most numerous, followed by CD20+, CD8+, and CD4+ cells. About 30% of cells expressed ICAM-1. Among cells with cytotoxic granules, granulysin-positive cells were the most frequent.

Conclusions:
Differences between GF and EAF were found to be mostly like due to anatomic site (usually skin of the face vs. sinonasal cavity) and stage of the disease development (usually earlier in cutaneous lesions because of their visibility). Innate and adaptive immunity, including B cells, T cells, and cytotoxic granules have a role in their pathogenesis.
Napsin A Expression in Anaplastic Lymphoma Kinase-positive Diffuse Large B-Cell Lymphoma: A Diagnostic Pitfall
Authors: Jain Deepali , Mallick Saumya R. , Singh Varsha , Singh Geetika , Mathur Sandeep R. , Sharma Mehar C. 
Published: January 2016

Background:
Napsin A is frequently used to classify a tumor of unknown origin as lung primary. Recent studies have shown that Napsin A positivity occurs in adenocarcinomas of nonpulmonary origin such as renal cell carcinomas, endometrial carcinomas, and clear cell carcinomas of ovary. Nonspecific reactivity has been reported with polyclonal Napsin A antibody. On the basis of an index case of anaplastic lymphoma kinase-positive diffuse large B-cell lymphoma (ALK-DLBCL) expressing Napsin A, which was misdiagnosed as poorly differentiated carcinoma of pulmonary origin, we studied Napsin A expression in our archived cases of ALK-DLBCL.

Materials and Methods:
A total of 3 cases of ALK-DLBCL were studied for Napsin A immunohistochemistry along with typical immunophenotypic profile of these cases. Archived paraffin-embedded tissue blocks and cytology aspiration smears were used for morphologic interpretation and immunohistochemistry. Rabbit monoclonal Napsin A antibody has been used.

Results and Conclusions:
All 3 cases were positive for Napsin A exhibiting strong cytoplasmic positivity. To the best of our knowledge, expression of monoclonal Napsin A in lymphomas has never been reported. ALK-DLBCL should be considered in the differential diagnosis when evaluating a Napsin A-positive tumor of poorly differentiated morphology and of unknown primary. As Napsin A has not been described in the lymphoid tissue development, the significance of Napsin A positivity in hematolymphoid neoplasms is unknown and warrants further investigation.
Correlation of Classic and Molecular Cytogenetic Alterations in Soft-Tissue Sarcomas: Analysis of 46 Tumors With Emphasis on Adipocytic Tumors and Synovial Sarcoma
Authors: Rao Uma N.M. , Cieply Kathleen , Sherer Carol , Surti Urvashi , Gollin Susanne M. 
Published: January 2016

Introduction:
Sarcomas are heterogeneous, and their treatment and prognosis are driven by the morphologic subtype and the clinical stage. Classic cytogenetics and fluorescence in situ hybridization (FISH) analysis play an important role in their diagnostic work up.

Materials and Methods:
Forty-six cases of soft-tissue sarcoma were reviewed that underwent karyotyping and simultaneous FISH analysis at initial diagnosis. They included 10 dedifferentiated liposarcomas, 10 myxoid liposarcomas, and 14 synovial sarcomas. Six tumors were investigated for EWSR1 rearrangement. Six high-grade miscellaneous sarcomas were also examined.

Results:
The dedifferentiated liposarcoma had complex karyotypes and MDM2 amplification by FISH, and of these, 5 tumors with myxoid changes also had complex signals for DDIT3. All but 4 myxoid liposarcomas had complex karyotypes, in addition to the characteristic translocation. FISH analysis displayed DD1T3 rearrangement. All synovial sarcomas except 1 recurrence had a t(X;18) translocation by karyotyping and FISH. The EWSR1 rearrangement was present in all extraskeletal myxoid chondrosarcomas, angiomatoid fibrous histiocytoma, atypical Ewing sarcoma, and a clear-cell sarcoma, all of which had characteristic karyotypes. Seven high-grade sarcomas had no specific karyotype or rearrangements for DDIT3, SS18, and EWSR1 by FISH.

Conclusions:
There is good correlation between karyotyping and FISH. Complex FISH signals found in dedifferentiated liposarcomas may be related to an increased chromosome 12 copy number and ploidy. Karyotyping is an important baseline standard for the quality assurance of newly developed FISH probes. It also provides a global view of chromosomal changes and the opportunity to investigate the role of other genetic alterations and potential therapeutic targets.
Comparison of Diffusion-Weighted Imaging in the Human Brain Using Readout-Segmented EPI and PROPELLER Turbo Spin Echo With Single-Shot EPI at 7 T MRI
Authors: Kida Ikuhiro , Ueguchi Takashi , Matsuoka Yuichiro , Zhou Kun , Stemmer Alto , Porter David 
Published: January 2016

Objectives
The purpose of the present study was to compare periodically rotated overlapping parallel lines with enhanced reconstruction–type turbo spin echo diffusion-weighted imaging (pTSE-DWI) and readout-segmented echo planar imaging (rsEPI-DWI) with single-shot echo planar imaging (ssEPI-DWI) in a 7 T human MR system. We evaluated the signal-to-noise ratio (SNR), image distortion, and apparent diffusion coefficient values in the human brain.

Materials and Methods
Six healthy volunteers were included in this study. The study protocol was approved by our institutional review board. All measurements were performed at 7 T using pTSE-DWI, rsEPI-DWI, and ssEPI-DWI sequences. The spatial resolution was 1.2 × 1.2 mm2 in-plane with a 3-mm slice thickness. Signal-to-noise ratio was measured using 2 scans.

Results
The ssEPI-DWI sequence showed significant image blurring, whereas pTSE-DWI and rsEPI-DWI sequences demonstrated high image quality with low geometrical distortion compared with reference T2-weighted, turbo spin echo images. Signal loss in ventral regions near the air-filled paranasal sinus/nasal cavity was found in ssEPI-DWI and rsEPI-DWI but not pTSE-DWI. The apparent diffusion coefficient values for ssEPI-DWI were 824 ± 17 × 10−6 and 749 ± 25 × 10−6 mm2/s in the gray matter and white matter, respectively; the values obtained for pTSE-DWI were 798 ± 21 × 10−6 and 865 ± 40 × 10−6 mm2/s; and the values obtained for rsEPI-DWI were 730 ± 12 × 10−6 and 722 ± 25 × 10−6 mm2/s. The pTSE-DWI images showed no additional distortion comparison to the T2-weighted images, but had a lower SNR than ssEPI-DWI and rsEPI-DWI. The rsEPI-DWI sequence provided high-quality images with minor distortion and a similar SNR to ssEPI-DWI.

Conclusions
Our results suggest that the benefits of the rsEPI-DWI and pTSE-DWI sequences, in terms of SNR, image quality, and image distortion, appear to outweigh those of ssEPI-DWI. Thus, pTSE-DWI and rsEPI-DWI at 7 T have great potential use for clinical diagnoses. However, it is noteworthy that both sequences are limited by the scan time required. In addition, pTSE-DWI has limitations on the number of slices due to specific absorption rate. Overall, rsEPI-DWI is a favorable imaging sequence, taking into account the SNR and image quality at 7 T.
The Short Breath-Hold Technique, Controlled Aliasing in Parallel Imaging Results in Higher Acceleration, Can Be the First Step to Overcoming a Degraded Hepatic Arterial Phase in Liver Magnetic Resonance Imaging
Authors: Yoo Jung Lim , Lee Chang Hee , Park Yang Shin , Kim Jeong Woo , Lee Jongmee , Kim Kyeong Ah , Seol Hae Young , Park Cheol Min 
Published: January 2016

Objective
The aim of this study was to assess whether a short breath-hold technique can improve hepatic arterial phase (HAP) image quality in gadoxetic acid–enhanced magnetic resonance (MR) imaging compared with a conventional long breath-hold technique.

Materials and Methods
Institutional review board approval and patient consent were obtained for this prospective randomized control study. One hundred nineteen patients undergoing gadoxetic acid–enhanced MR imaging were randomly assigned to groups A or B. Group A patients underwent an 18-second long breath-hold MR technique (conventional VIBE [volumetric interpolated breath-hold examination] technique with GRAPPA [generalized autocalibrating partially parallel acquisition]), and group B patients underwent a 13-second short breath-hold MR technique (VIBE technique with CAIPIRINHA [controlled aliasing in parallel imaging results in higher acceleration]). Respiratory-related graphs of the precontrast and HAP were acquired. The breath-hold degree was graded based on the standard deviation (SD) value of respiratory waveforms. Gadoxetic acid–related dyspnea was defined as when the SD value of the HAP was 200 greater than that of the precontrast phase without degraded image quality in the portal and transitional phases (SD value of the HAP − SD value of the precontrast phase). The overall image quality and motion artifacts of the precontrast and HAP images were evaluated. The groups were compared using the Student t or Fisher exact test, as appropriate.

Results
The incidence of breath-holding difficulty (breath-hold grades 3 and 4) during the HAP was 43.6% (27/62) and 36.8% (21/57) for group A and B, respectively. The SD value during the precontrast phase and the SD value difference between the precontrast and HAP were both significantly higher in group A than in group B (P = 0.047 and P = 0.023, respectively). Gadoxetic acid–related dyspnea was seen in 19.4% (12/62) of group A and 7.0% (4/57) of group B. Group B showed better precontrast and HAP image quality than group A (P < 0.001). Degraded HAP (overall image quality ≥4) was observed in 9.7% (6/62) and 3.5% (2/57) of group A and B, respectively.

Conclusions
The short breath-hold MR technique, CAIPIRINHA, showed better HAP image quality with less degraded HAP and a lower incidence of breath-hold difficulty and gadoxetic acid–related dyspnea than the conventional long breath-hold technique.
Human Imaging With Photon Counting–Based Computed Tomography at Clinical Dose Levels
Authors: Gutjahr Ralf , Halaweish Ahmed F. , Yu Zhicong , Leng Shuai , Yu Lifeng , Li Zhoubo , Jorgensen Steven M. , Ritman Erik L. , Kappler Steffen , McCollough Cynthia H. 
Published: January 2016

Objectives
The purpose of this work was to measure and compare the iodine contrast-to-noise ratio (CNR) between a commercial energy-integrating detector (EID) computed tomography (CT) system and a photon-counting detector (PCD) CT scanner capable of human imaging at clinical dose rates, as well as to determine clinical feasibility using human cadavers.

Materials and Methods
A research dual-source PCD-CT scanner was used, where the “A” tube/detector subsystem used an EID and the “B” tube/detector subsystem used a PCD. Iodine CNR was measured in 4 anthropomorphic phantoms, simulating 4 patient sizes, at 4 tube potential settings. After biospecimen committee approval, PCD scans were performed on a fresh-frozen human head and a whole-body cadaver using clinical dose rates. Scans were repeated using the EID and identical parameters, and qualitative side-by-side comparisons were performed.

Results
For the same photon fluence, phantom measurements demonstrated a mean increase in CNR of 11%, 23%, 31%, 38% for the PCD system, relative to the EID system, at 80, 100, 120, and 140 kV, respectively. Photon-counting detector CT additionally provided energy-selective imaging, where low- and high-energy images reflected the energy dependence of the iodine signal. Photon-counting detector images of cadaveric anatomy demonstrated decreased beam hardening and calcium blooming in the high-energy bin images and increased contrast in the low-energy bins images relative to the EID images. Threshold-based PCD images were qualitatively deemed equivalent in other aspects.

Conclusions
The evaluated research PCD-CT system was capable of clinical levels of image quality at clinical dose rates. It further provided improved CNR relative to state-of-the-art EID-CT. The energy-selective bin images provide further opportunity for dual-energy and multienergy analyses.
Bioeffects of Diagnostic Dynamic 3-Dimensional (4-Dimensional) Ultrasound on Ultrastructure of Cerebral Cells of Fetal Mice in Late Pregnancy
Authors: Li Jianhui , Zhang Lei 
Published: January 2016

Abstract
The aim of this study was to study the bioeffects of diagnostic dynamic 3-dimensional ultrasound (4D) on ultrastructure of cerebral cells of fetal mice in late pregnancy. Thirty pregnant mice carrying 18th embryonic day fetuses were randomly allocated into 6 groups, namely, control group, sham-exposed group, 5 minute–exposed group, 10 minute–exposed group, 20 minute–exposed group, and 30 minute–exposed groups (5 in each group). In exposure groups, mice were put under the dynamic 3D ultrasound system's probe for 5 to 30 minutes. Mice in sham-exposed group did not receive ultrasound wave. At 24th hour after birth, 10 pups of each group were randomly selected (2 in each litter) and euthanized by decapitation, and the brains were immediately removed. Right parietal lobes were taken as specimen. The specimens were firstly fixed with glutaraldehyde and secondly with osmic acid, then sections were made and observed under the transmission electron microscope. There were no obvious abnormal ultrastructure changes in control group, sham-exposed group, and 5 minute–exposed group under transmission electron microscope. Ten minute–exposed group showed some enlarged mitochondria, broken crista, vacuolated endoplasmic resticulums, and a few apoptosis cells. More abnormal organelles and apoptosis cells were observed in 20 minute–exposed and 30 minute–exposed groups (P < 0.05). Dynamic 3D (4D) ultrasound exposure for more than 10 minutes may result in abnormal neuronal ultrastructure changes and apoptosis cells in fetal mouse cerebrum.
Point Shear Wave Elastography in Assessment of Hepatic Fibrosis
Authors: Perry Michael T. , Savjani Neal , Bluth Edward I. , Dornelles Adriana , Therapondos George 
Published: January 2016

Abstract
The objective of this study was to prospectively evaluate the use of point shear wave elastography for the assessment of liver fibrosis and to determine the usefulness and optimal location for obtaining elastography measurements in native and transplanted livers. Point shear wave elastography measurements were obtained from 100 consecutive patients presenting for percutaneous liver biopsy. Measurements were acquired within both the superior right hepatic lobe (segments VII/VIII) via an intercostal approach and the inferior right hepatic lobe (segments V/VI) via a subcostal approach. Analysis of variance was used to assess statistical differences between the degree of fibrosis on percutaneous liver biopsy and elastography measurements. No statistical difference was present when comparing elastography measurements in patients with hepatic steatosis compared with patients without steatosis (P = 0.2759). There was no difference in the accuracy of elastography measurements in native livers versus transplanted livers (P = 0.221). Point shear wave elastography can accurately differentiate between patients with no-to-mild hepatic fibrosis (F0–F1) and moderate-to-severe hepatic fibrosis (≥F2) with sensitivity of 72% and specificity of 69%. Point shear wave elastography can be used as a noninvasive method to assess fibrosis in patients with native or transplanted livers. In addition, measurements can be combined or taken separately from either the superior or inferior right hepatic lobe. The presence of hepatic steatosis does not affect the accuracy of point shear wave elastography. However, shear wave elastography values in patients with body mass index greater than 40 should be interpreted with caution.
Primary Overcorrection of the Unilateral Cleft Nasal Deformity
Authors: Lonic Daniel , Morris David E. , Lo Lun-Jou 
Published: January 2016

Background
Because primary nasal correction by the time of lip repair has been incorporated into the treatment approach, many patients have benefitted from this combined procedure. However, primary nasal correction cannot guarantee an excellent result. Although overcorrection has been mentioned as a treatment rationale of the unilateral cleft lip nasal deformity, a detailed approach and quantitative evidence of the rationale are rare. This study evaluates whether overcorrection in the primary repair results in a quantitative improvement in nasal appearance.

Patients and Methods
In this retrospective study, the inclusion criteria were patients with complete unilateral cleft lip and palate who underwent primary lip and nose repair by the age of 3 to 4 months. Primary nasal overcorrection was achieved by application of muscle to septal base suture, alar cinching suture and Tajima reversed U incision method. Patients were further divided into an overcorrected (n = 19) and nonovercorrected group (n = 19). The following parameters were identified on basilar photos of all patients taken at least 12 months after repair, ratios of cleft to noncleft side in each patient were taken and the mean for each parameter calculated: Ac angle (ACA/ACA′), alar height (AH/AH′), alar width (AW/AW′), nostril height (NH/NH`), nostril width (NW/NW′), and columellar deviation from the midline (CD/NW). The means of the overcorrected and nonovercorrected groups were then compared using the t test.

Results
From all investigated measuremens, Alar height (AH/AH': overcorrected, 0.983 to nonovercorrected, 0.941; P = 0.03) and nostril height ratio (NH/NH') (NH/NH': covercorrected, 0.897 to nonovercorrected, 0.680; P = 0.003) showed statistically significant differences favoring the overcorrected group at least 12 months after surgery.

Conclusions
Primary nasal overcorrection including muscle to columella base suture, alar cinch suture, and Tajima method resulted in quantitatively more long-term symmetric alae and nostril height compared to nonovercorrected patients.
On Beyond Lidocaine
Authors: Hsia Henry C. 
Published: January 2016

Abstract
The use of tumescent solution in liposuction is now considered standard of care; however, much debate still exists regarding its ideal components, especially surrounding the inclusion of local anesthetics. This article reviews the discussion regarding the use of local anesthetics in tumescent liposuction and how it may evolve in the future. The need for local anesthetic additives in tumescent liposuction has been questioned, and the use of longer-acting agents discouraged; however, increasing number of reports in recent years have described the increasingly widespread use of tumescent anesthesia where a wetting solution is infiltrated to achieve anesthesia in an operative field for procedures other than liposuction. More high-level evidence, such as randomized controlled clinical trials, will be required; however, it should be possible to develop a useful standardized algorithm that can guide surgeons to optimize patient safety as well as patient experience.
Is the Target of 1 Day of Stay per 1% Total Body Surface Area Burned Achieved in Chemical Burns?
Authors: Tan Teresa , Wong David S. Y. 
Published: January 2016

Abstract
The length of hospital stay (LOS) is a standard parameter used to reflect quality and evaluate outcomes in acute burn care. This study aims to assess whether the target of 1 day of stay per 1% total body surface area (TBSA) burned was achieved in acute chemical burns management and factors affecting the LOS. A retrospective analysis of the records of patients who suffered from chemical burn injuries admitted to a university burn center over a continuous 14-year period was performed.
A total of 118 patients were admitted over the period for chemical burns. Only 14% of cases achieved the target stated. Factors associated with lengthening of the hospital stay included TBSA, ocular involvement, the cause of injury, and the need for surgery during the same admission.
The LOS in chemical burns frequently exceeds 1 day of stay per 1% TBSA burned. Many factors can contribute to a patient’s LOS and are worth exploring in order to see if the impact of these factors could be minimized. Early surgical intervention should help to reduce the LOS if reliable methods of burn wound depth assessment are available.