bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alterations of the cerebral cortex in sporadic small vessel disease: A systematic review of in vivo MRI data
Authors: Peres Roxane , De Guio François , Chabriat Hugues , Jouvent Eric 
Published: January 2016

Cerebral small vessel diseases of the brain are a major determinant of cognitive impairment in the elderly. In small vessel diseases, the most easily identifiable lesions, both at post-mortem evaluation and magnetic resonance imaging, lie in subcortical areas. However, recent results obtained post-mortem, particularly in severe cases, have highlighted the burden of cortex lesions such as microinfarcts and diffuse neuronal loss. The recent development of image post-processing methods allows now assessing in vivo multiple aspects of the cerebral cortex. This systematic review aimed to analyze in vivo magnetic resonance imaging studies evaluating cortex alterations at different stages of small vessel diseases. Studies assessing the relationships between small vessel disease magnetic resonance imaging markers obtained at the subcortical level and cortex estimates were reviewed both in community-dwelling elderly and in patients with symptomatic small vessel diseases. Thereafter, studies analyzing cortex estimates in small vessel disease patients compared with healthy subjects were evaluated. The results support that important cortex alterations develop along the course of small vessel diseases independently of concomitant neurodegenerative processes. Easy detection and quantification of cortex changes in small vessel diseases as well as understanding their underlying mechanisms are challenging tasks for better understanding cognitive decline in small vessel diseases.
Long-term follow-up of large symptomatic hepatic cysts treated by percutaneous ethanol sclerotherapy
Authors: Jang Se Young , Park Soo Young , Tak Won Young , Kweon Young Oh , Ryeom Hunkyu 
Published: January 2016

Background As a minimally invasive treatment, ethanol sclerotherapy has been used for large symptomatic hepatic cysts, but there are not many long-term reports on treatment outcomes and safety. Purpose To evaluate the long-term outcomes of percutaneous ethanol sclerotherapy in patients with large symptomatic hepatic cysts. Material and Methods This study included 43 symptomatic, enlarging hepatic cysts in 42 patients who had undergone ethanol sclerotherapy from 2003 to 2013 and were followed up for >1 year. The treatment outcomes were evaluated in terms of the reduction of cyst size and resolution of symptoms. The patients were followed up for a mean period of 33 months with either ultrasound or computed tomography examination. Results Thirty-nine hepatic cysts (91%) were successfully treated with ethanol sclerotherapy, showing resolution of symptoms and remarkable reduction in cyst volume. Eight hepatic cysts (19%) disappeared completely, and 31 hepatic cysts (72%) decreased in size during the follow-up period. The mean diameter of the cysts decreased from 12.5 ± 4.4 cm to 3.8 ± 3.4 cm during follow-up. There were no immediate serious complications related to the procedure. There were four cases (9%) of treatment failure requiring subsequent surgical procedures. Conclusion Percutaneous ethanol sclerotherapy can be considered as an effective first-line treatment for large symptomatic hepatic cysts.
Signal characteristics of normal adult bone marrow in whole-body diffusion-weighted imaging
Authors: Cui Feng-Zhen , Cui Jian-Ling , Wang Shi-Lei , Yu Hong , Sun Ying-Cai , Zhao Na , Cui Sheng-Jie 
Published: January 2016

Background Knowledge of the signal characteristics of normal adult bone marrow in whole-body diffusion-weighted (DW) images (WB-DWI) is essential for correctly interpreting DW images in clinical practice; however, these factors have not yet been clearly determined. Purpose To evaluate the signal characteristics of normal adult bone marrow in WB-DWI, to correlate these characteristics with age and gender, and to determine the causes of these phenomena. Material and Methods Ninety-eight healthy volunteers underwent WB-DWI (b = 0 and 800 s/mm2). Two radiologists visually evaluated the signal characteristics of bone marrow in DW images separately. One radiologist measured the apparent diffusion coefficient (ADC) of the thoracic and lumbar vertebrae, bilateral femur (including head, neck, and proximal and distal femoral shaft), bilateral humeral head, ilium, and scapula. The signal characteristics of normal bone marrow were analyzed. Results The visual evaluation results of DW images indicated that hyperintensity of bone marrow was more frequently seen in women aged 21–50 years (68.4%) than in men aged 21–50 years (3.3%) ( P < 0.001), men aged 51–81 years (5.9%) ( P < 0.001), and women aged 51–81 years (15.4%) ( P = 0.001). However, no statistically significant difference was found between men and women aged 51–81 years ( P = 0.565). The ADC of bone marrow was significantly higher in women than in men aged 21–50 years. Bone marrow ADC showed significant negative correlation with age in women but not in men. Conclusion The signal intensity of bone marrow varies with age and gender in DW images. ADC and the T2 shine-through effect contributed to the bone marrow signal intensity in DW images, and the latter effect may predominate.
MR appearance of normal uterine endometrium considering menstrual cycle: differentiation with benign and malignant endometrial lesions
Authors: Shitano Fuki , Kido Aki , Kataoka Masako , Fujimoto Koji , Kiguchi Kayo , Fushimi Yasutaka , Konishi Ikuo , Togashi Kaori 
Published: January 2016

Background The thickness and signal intensity (SI) of normal uterine endometrium on T2-weighted (T2W) imaging changes depend on the menstrual cycle phase. Cases of normal endometrium that appear similar to endometrial lesions sometimes occur, and may result in misdiagnosis. Purpose To investigate normal endometrial appearance in luteal phase (LP) compared to that in follicular phase (FP), and to differentiate these appearances with those of endometrial lesions. Material and Methods Thirty-two normal volunteers prospectively underwent magnetic resonance (MR) examinations during LP and FP. Patients with pathologically confirmed endometrial polyps ( n = 9), hyperplasia ( n = 7), and cancer ( n = 15), who underwent MR examinations, were evaluated for comparison. Endometrial appearance was categorized into the following five types on sagittal T2W imaging and compared between LP, FP, and endometrial lesions: type 1, homogeneous higher SI; type 2, homogeneous iso SI; type 3, a bright midline and a peripheral iso SI layer; type 4, a lower/iso SI central line; and type 5, heterogeneous lower/iso SI. Endometrial thickness and SI were measured and also compared. Results Endometrial lesions were more frequently categorized as type 5 than normal endometrium ( P < 0.05). Endometrial thickness in LP (mean, 1.0 cm) was significantly greater than that in FP (0.6 cm), but not significantly different from polyps (1.1 cm), hyperplasia (1.0 cm), and cancer (0.9 cm). SI in FP was significantly higher than that in LP and that of all endometrial lesions. Conclusion Differentiation between normal endometrium in LP and endometrial lesions may be difficult based on thickness alone. Heterogeneous low SI may help to differentiate normal endometrium from endometrial lesions. Performing MR imaging during FP may also help due to higher SI of normal endometrium.
Understanding the dimensions of home for people returning home post stroke rehabilitation
Authors: Hodson Tenelle , Aplin Tammy , Gustafsson Louise 
Published: January 2016

Introduction Home is a meaningful and important place and the transition to home from hospital is considered a significant point in recovery for people after stroke. Six dimensions of the home environment have previously been described as important for well-being and contributing to one's experience of home: the physical, social, personal, temporal, occupational and societal dimensions. The aim of this study was to understand the experience of home for people with stroke after discharge to home from hospital rehabilitation. Method A secondary template analysis applied the dimensions of home to semi-structured interviews that explored the transition to home experience for seven participants with stroke at 4–6 weeks post discharge. Results All six dimensions were present in the descriptions of returning to home from stroke rehabilitation. The social, personal and occupational dimensions appeared to be the most prominent and often centred on loss or change. Conclusion People returning home after a stroke enter a different home environment than the one they experienced prior to stroke, with changes experienced in all dimensions of home. Closer attention to the dimensions during discharge preparation may enhance the transition experience.
Modified Broström Procedure for Chronic Ankle Instability With Generalized Joint Hypermobility
Authors: Huang Bingzhe , Kim Yong Tae , Kim Jung Uk , Shin Jung Hoon , Park Yong Wook , Kim Hyong Nyun 
Published: January 2016

Background: Chronic ankle instability with generalized joint hypermobility (GJH) is considered a contraindication for the modified Broström procedure. The most widely accepted definition of GJH is a Beighton score of ≥4 on a 9-point scale. However, it is not clear whether this criterion can be applied to determine the GJH that would lead to a poor outcome after a modified Broström procedure. Some of the previous studies that report unfavorable outcomes do not specify the tests or cutoff scores used to determine the GJH, and, in fact, some of the patients with GJH in these studies had good outcomes. Hypothesis: The modified Broström procedure results in satisfactory outcomes in patients who have chronic ankle instability with GJH if the contralateral uninjured ankle shows a normal varus talar tilt and anterior talar translation during stress tests. Study Design: Case series; Level of evidence, 4. Methods: Modified Broström procedure was performed in 32 patients with chronic ankle instability with GJH if the contralateral uninjured ankle showed a normal varus talar tilt and anterior talar translation on stress tests. The mean patient age at surgery was 21.7 years, and the mean follow-up duration was 27.4 months. Results: The Karlsson-Peterson ankle score significantly improved from a mean ± SD of 63.6 ± 7.1 preoperatively to 90.4 ± 6.7 at the final postoperative follow-up ( P < .001). Sixteen patients were very satisfied with the results, 10 patients were satisfied, 3 patients rated their satisfaction as fair, and 1 patient was dissatisfied with the results. Nine patients sustained ankle sprains after the surgery, 6 of which were mild sprains. Although 3 of these 9 patients had a mechanically unstable ankle on stress radiographs, they were satisfied with the postoperative results. None of the patients required a reoperation. Conclusion: GJH was not a contraindication for the modified Broström procedure if the contralateral uninjured ankle showed a normal varus talar tilt and a normal anterior talar translation on stress tests. Further studies are needed to better define GJH affecting the ankle.
Managing Subdural Bleeding Associated With Rivaroxaban
Authors: Faust Andrew C. , Woodard Sarah , Koehl Jennifer L. , Mees William , Steinke Douglas , Denetclaw Tina Harrach 
Published: January 2016

Objective: To report 3 cases of subdural bleeding associated with rivaroxaban managed by 3-factor prothrombin complex concentrate (PCC3). Case Summaries: Case 1 presented with a 1-cm thick subdural hematoma (SDH) 12 hours after her last dose of rivaroxaban. Case 2 presented with a right 1-cm acute right SDH with 2 to 3 mm of midline shift 24 hours after his last dose of rivaroxaban. Case 3 presented with a 1.8-cm thick right cerebral convexity hematoma 12 hours after her last dose of rivaroxaban. All patients received 23 to 35 units/kg PCC3 with 1 to 3 units of fresh frozen plasm (FFP) and demonstrated no progression in lesions measured by repeat computed tomography (CT). Two patients were discharged to rehabilitation facilities and 1 patient ultimately died due to the location of the lesion. Discussion: Rivaroxaban has no specific antidote. Current bleeding management strategies are based on expert opinion. The risks and benefits for differing strategies are unclear, and no clinical experience has been reported to date. These cases begin to illuminate differences among choices for managing bleeding associated with Xa inhibitors. Conclusion: In this case series, 25 to 35 units/kilogram PCC3 and FFP 1 to 3 units ceased rivaroxaban-associated bleeding without thrombogenic complications.
Cross-Validating Chinese Language Mental Health Recovery Measures in Hong Kong
Authors: Bola John , Chan Tiffany Hill Ching , Chen Eric HY , Ng Roger 
Published: January 2016

Objectives: Promoting recovery in mental health services is hampered by a shortage of reliable and valid measures, particularly in Hong Kong. We seek to cross validate two Chinese language measures of recovery and one of recovery-promoting environments. Method: A cross-sectional survey of people recovering from early episode psychosis ( n = 121) and family members ( n = 49) was taken. Two recovery measures, the Mental Health Recovery Measure and the recovery subscale of the Peer Outcomes Protocol, and one measure of recovery-promoting environments, the Recovery Self-Assessment, were used. The Psychosis Recovery Inventory was incorporated to assess construct validity. Results: Internal consistency reliability for each measure was high ( r = .71–.94); one-factor solutions were parsimonious. People in recovery rated their risk for relapse lower than did their family members. Conclusions: Moderately strong positive correlations among recovery measures lend support to construct validity. Several “recovery-promoting environment” items should be reassessed for cultural fit in Hong Kong.
Rediscussing Anticoagulation in Distal Deep Venous Thrombosis
Authors: Krutman Mariana , Kuzniec Sergio , Ramacciotti Eduardo , Varella Andrea Yasbek Monteiro , Zlotnik Mira , Teivelis Marcelo Passos , Tachibana Adriano , de Campos Guerra João Carlos , Wolosker Nelson 
Published: January 2016

Background: Distal deep venous thrombosis (DVT) accounts for approximately half of all the cases of lower limb thrombosis. The impact and management of this condition is still controversial. This study aims to evaluate the incidence of pulmonary embolism (PE) in patients with distal DVT in comparison to proximal DVT and evaluate the correlation between DVT and PE extension. Methods: 100 patients with acute lower limb DVT diagnosed with whole leg Doppler ultrasound from January 2006 to December 2014 were retrospectively analyzed. Active investigation for PE was carried out in all patients using multislice computed tomography angiography. Classification of DVT and PE was based on the proximal extension of the thrombus. Results: The overall incidence of PE in our sample patients was 72%. In the subgroup analysis, incidence of PE was equal in both the proximal and distal DVT groups (77%, p > 0.99). PE was detected in 43% of the patients with isolated calf vein thrombosis (ICVT). No statistical difference was observed between the distribution of lobar, segmental and subsegmental PE in the 3 DVT subgroups (p = 0.665); however, truncular PE was only observed in the proximal DVT group. Conclusion: Distal DVT is associated with a high incidence of PE compared to proximal DVT. Distal DVT and ICVT can provoke PE with involvement of proximal vessels in the pulmonary arterial tree, even in asymptomatic patients. Our study arises discussion in the controversial debate regarding the need for routine anticoagulation in distal DVT.
Frequency of abdominal aortic expansion after thoracic endovascular repair of type B aortic dissection
Authors: Weber Tim F , Böckler Dittmar , Müller-Eschner Matthias , Bischoff Moritz , Kronlage Moritz , von Tengg-Kobligk Hendrik , Kauczor Hans-Ulrich , Hyhlik-Dürr Alexander 
Published: January 2016

Purpose To determine abdominal aortic expansion after thoracic endovascular aortic repair (TEVAR) in patients with aortic dissection type B and 36 months minimum follow-up. Methods Retrospective study of 18 TEVAR patients with follow-up >36 months. Abdominal aortic diameters at celiac trunk (location B) and infrarenal aorta (location C) were recorded on the first and last imaging after TEVAR. False lumen thrombosis was determined at level of endograft (A) and at B and C. Aortic expansion was defined as diameter increase of 5 mm or 15%. Correlation analyses were performed to investigate potential determinants of expansion. Results Median follow-up was 75.2 months. Sixteen of 18 patients (88.9%) demonstrated abdominal expansion. Mean expansion was 9.9 ± 6.1 mm at B and 11.7 ± 6.5 mm at C, without a difference between acute and chronic dissections. Critical diameters of 55 mm were reached in two patients treated for chronic dissection (11.1%). Annual diameter increase was significantly greater at locations with baseline diameters >30 mm (2.1 ± 1.1 mm vs. 1.0 ± 0.6 mm, p = 0.009). Baseline diameters were greater in patients with chronic dissections. Conclusion Abdominal aortic expansion can be frequently recognized after TEVAR for aortic dissection type B and occurs independently from thoracic false lumen thrombosis. Clinical significant abdominal aortic expansion may occur more frequently in patients treated with TEVAR for chronic dissection.
In vitro pressure manifolding distribution evaluation of ABThera™ Active Abdominal Therapy System, V.A.C.® Abdominal Dressing System, and Barker’s vacuum packing technique conducted under dynamic conditions
Authors: Delgado Angel , Sammons Alexander 
Published: January 2016

Objectives: Temporary abdominal closure methods allow for management of open abdomens where immediate primary closure is not possible and/or where repeat abdominal entries are necessary. We assessed pressure mapping and fluid extraction efficiency of three open abdomen dressing systems: ABThera™ Active Abdominal Therapy System, V.A.C.® Abdominal Dressing System, and Barker’s vacuum packing technique. Methods: An in vitro test model was designed to simulate physical conditions present in an open abdomen. The model consisted of a rigid rest platform with elevated central region and a flexible outer layer with centrally located incision. Constant −125 mmHg negative pressure was applied according to the type of system, under simulated dynamic conditions, using albumin-based solution with a viscosity of 14 cP. Data were collected by pressure sensors located circumferentially into three concentric zones: Zone 1 (closest to negative pressure source), Zone 2 (immediately outside of manifolding material edge), and Zone 3 (area most distal from negative pressure source). Each value was the result of approximately 100 pressure readings/zone/experiment with a total of three experiments for each system. Results: Pressure distribution of ABThera Therapy was significantly (p < 0.05) superior to Barker’s vacuum packing technique in all three evaluated zones. Similarly, V.A.C. Abdominal Dressing System pressure distribution was significantly (p < 0.05) improved compared to Barker’s vacuum packing technique in all zones. There were no pressure distribution differences in Zone 1 between ABThera Therapy and V.A.C. Abdominal Dressing System; however, in Zones 2 and 3, ABThera Therapy was significantly (p < 0.05) superior to V.A.C. Abdominal Dressing System. Conclusions: These data suggest that all approaches to negative pressure therapy for open abdomen treatment are not equal. Additional research should be conducted to elucidate clinical implications of data demonstrated here.
Endoscopic balloon dilatation of Crohn’s‐associated intestinal strictures: High patient satisfaction and long‐term efficacy
Authors: Rueda Guzmán Anna , Wehkamp Jan , Kirschniak Andreas , Naumann Aline , Malek Nisar P. , Goetz Martin 
Published: January 2016

IntroductionStricture formation is a common long‐term complication of Crohn’s disease. Endoscopic balloon dilatation offers a bowel‐sparing treatment option, but long‐term outcome and its association with patient‐, stricture‐, and procedure‐related factors is only poorly understood. Patient satisfaction with endoscopic balloon dilatation is largely unknown.MethodsWe performed a retrospective review of all endoscopic balloon dilatation for Crohn’s disease‐related strictures between January 2005 and January 2013. Long‐term outcome, complication rates and predictive factors were evaluated. Patient satisfaction was assessed using a questionnaire and telephone interviews.ResultsA total of 118 balloon dilatations were performed for 69 strictures in 46 patients. One patient was excluded from further analysis due to malignancy. Median time from diagnosis of Crohn’s disease to symptomatic stricture formation was 19 years. Technical success, defined as passage of the endoscope after dilatation, was reportedly obtained in 95 of 106 procedures (89.6%). Two perforations occurred, one of which could be managed conservatively. No episodes of severe bleeding were recorded (procedure‐related complication rate: 2/118; 1.7%). During a median follow‐up of 4.8 years (range 0.4–8.7), 55.6% (25/45) of patients were able to avoid surgery. Of the patients, 35.6% (16/45) did not need any further intervention, 40.0% (18/45) underwent more than one dilatation, and 24.4% (11/45) were operated after the first dilatation. The percentage of patients who were satisfied with the procedure and would again opt for balloon dilation as first line therapy was 83.3% (35/42). None of the risk factors examined in this study correlated with the necessity for subsequent surgery.DiscussionEndoscopic balloon dilatation is a safe and effective first line therapy for Crohn’s disease‐related strictures. No technical, stenosis‐, or patient‐related factor reliably predicted sustained dilatation success. Patient satisfaction was high.
Hematopoietic stem/progenitor cell commitment to the megakaryocyte lineage
Authors: Woolthuis Carolien M. , Park Christopher Y. 
Published: January 2016

Abstract
The classical model of hematopoiesis has long held that hematopoietic stem cells (HSCs) sit at the apex of a developmental hierarchy in which HSCs undergo long-term self-renewal while giving rise to cells of all the blood lineages. In this model, self-renewing HSCs progressively lose the capacity for self-renewal as they transit into short-term self-renewing and multipotent progenitor states, with the first major lineage commitment occurring in multipotent progenitors, thus giving rise to progenitors that initiate the myeloid and lymphoid branches of hematopoiesis. Subsequently, within the myeloid lineage, bipotent megakaryocyte-erythrocyte and granulocyte-macrophage progenitors give rise to unipotent progenitors that ultimately give rise to all mature progeny. However, over the past several years, this developmental scheme has been challenged, with the origin of megakaryocyte precursors being one of the most debated subjects. Recent studies have suggested that megakaryocytes can be generated from multiple pathways and that some differentiation pathways do not require transit through a requisite multipotent or bipotent megakaryocyte-erythrocyte progenitor stage. Indeed, some investigators have argued that HSCs contain a subset of cells with biased megakaryocyte potential, with megakaryocytes directly arising from HSCs under steady-state and stress conditions. In this review, we discuss the evidence supporting these nonclassical megakaryocytic differentiation pathways and consider their relative strengths and weaknesses as well as the technical limitations and potential pitfalls in interpreting these studies. Ultimately, such pitfalls will need to be overcome to provide a comprehensive and definitive understanding of megakaryopoiesis.