bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathology, Immunohistochemistry, and Electron Microscopic features of a Dacryocystorhinostomy Ostium Cicatrix
Authors: Ali Mohammad Javed , Mishra Dilip Kumar , Baig Farhana , Naik Milind N. 
Published: July 2015

Purpose:
The aim of this study is to report the histopathological, Immunohistochemical, and ultrastructural features of a dacryocystorhinostomy ostium cicatrix.

Methods:
A prospective histopathological study was performed in a tertiary eye care setting. Scarred nasal mucosal tissues obtained during endoscopic revisions of 10 previously failed dacryocystorhinostomies secondary to complete cicatricial closure of the ostia were studied. The tissue specimens were analyzed using hematoxylin and eosin, periodic acid-Schiff staining. Special stains used include Masson’s trichrome and Alizarin red. Immunohistochemistry was performed using vimentin, smooth muscle actin, CD3, CD5, and CD20. Specimens were processed for ultrastructural analysis as per standard protocols for transmission electron microscopy.

Results:
The respiratory epithelial regeneration was noted to be complete. Irregular laying of deeply eosinophilic and hyalinized collagen with intervening fibroblasts was noted. Focal areas of new bone formation were seen within the cicatricial tissue with osteocytes and ongoing osteoblastic rimming. The infiltrates were mixture of both T and B lymphocytes and were positive for CD3, CD5, and CD20 immunostaining. Electron microscopy showed disorganized collagen fibrils with numerous fibroblasts and mononuclear inflammatory infiltrate. Amorphous bony osteoid within a fibrillar background with metabolically active osteoblasts showed a vesicular cytoplasm, hyperplastic proliferating mitochondria, large Golgi apparatus, and dense endoplasmic reticulum.

Conclusion:
There is new bone formation within the dense connective tissues of a dacryocystorhinostomy cicatrix. This study may provide useful inputs for further basic science studies aimed at better understanding of wound healing in failed dacryocystorhinostomy.
Diagnostic Accuracy of Cognitive Screening Instruments in Heart Failure
Authors: Cameron Jan , Kure Christina E. , Pressler Susan J. , Ski Chantal F. , Clark Alexander M. , Thompson David R. 
Published: July 2015

Background:
Cognitive impairment is prevalent in heart failure (HF) with severe consequences, including increased risk of mortality and reduced ability to self-manage HF symptoms. Identifying cognitive impairment through screening would assist clinicians in managing HF and comorbid cognitive impairment. However, the accuracy of cognitive screening instruments for HF has not been adequately determined.

Objective:
The aim of this study was to determine the diagnostic accuracy of cognitive screening instruments in screening for mild cognitive impairment (MCI) in HF patients.

Methods:
A systematic review of major electronic bibliographic databases was searched from January 1999 to June 2013. Inclusion criteria were as follows: primary studies examining cognitive impairment in HF, administration of a cognitive screening instrument and neuropsychological test battery, and cognitive impairment indicated by performance on neuropsychological tests 1.5 SDs less than that of normative data. Methodological rigor of included publications was evaluated using 2 bias risk instruments: QUality Assessment of Diagnostic Accuracy Studies and STAndards for the Reporting of Diagnostic accuracy studies. The precision, accuracy, and receiver operating characteristic curves of the Mini Mental State Examination were computed.

Results:
From 593 citations identified, 8 publications met inclusion criteria. Risk of bias included selective HF patient samples, and no study examined the diagnostic test accuracy of the cognitive screening instruments. The Mini Mental State Examination had low sensitivity (26%) and high specificity (95%) with a score of 28 or less as the optimal threshold for MCI screening.

Conclusions:
Screening for cognitive impairment in HF is recommended; however, future studies need to establish the diagnostic accuracy of screening instruments of MCI in this population.
Time Course and Clinical Implications of Development of Antibodies Against Adalimumab in Patients With Inflammatory Bowel Disease
Authors: Steenholdt Casper , Frederiksen Madeline T. , Bendtzen Klaus , Ainsworth Mark A. , Thomsen Ole Ø. , Brynskov Jørn 
Published: July 2015

Background:
Antibodies (Abs) against adalimumab (ADL) have been associated with low ADL levels and treatment failure.

Aim:
To characterize the temporal characteristics of anti-ADL Ab appearance and possible disappearance, and determine the clinical significance on drug efficacy and disease course.

Methods:
Cohort study including inflammatory bowel disease patients in whom anti-ADL Abs had been assessed by radioimmunoassay (RIA) and, in case of disappearance, by enzyme immunoassay, and functional reporter gene assay.

Results:
Anti-ADL Abs were evaluated in 133 serum samples from 72 patients. Seventeen patients (24%) tested positive after median of 194 days, interquartile range of 66 to 361. The proportion with anti-ADL Abs was 22% after 1 year, and 32% from 21 months onwards. Anti-ADL Abs generally persisted at repeat assessments during continued ADL therapy (n=8). Disappearance of anti-ADL Abs during therapy (n=3) was presumably caused by methodological biases due to detection of nonfunctional nonpersistent anti-ADL Abs by RIA, or false-negative measurement at reassessment by RIA and reporter gene assay. Anti-ADL Abs appeared pharmacologically active as judged by a median ADL concentration below limit of detection versus 7.4 μg/mL in anti-ADL Ab-negative samples (P<0.0001). Anti-ADL Abs associated with loss of response (odds ratio estimated 67, P<0.0001), and shorter treatment duration (P<0.0001).

Conclusions:
Abs against ADL appear in approximately one fourth of inflammatory bowel disease patients with decreasing frequency over time and usually within 1 year of therapy. Anti-ADL Abs generally persist during continued ADL therapy, and are associated with elimination of drug and treatment failure. Therefore, ADL cessation should be considered when anti-ADL Abs are detected and supported by clinical observations.
Who Applies an Intervention to Influence Cultural Attributes in a Quality Improvement Collaborative?
Authors: Hsu Yea-Jen , Marsteller Jill A. 
Published: July 2015

Objectives
Organizational culture change has been recognized as one of the promising ways to reduce error and increase safety. However, it is still unclear what factors support health care teams implementing interventions aimed to influence the cultural attributes that bolster continuous quality improvement. This study aimed to identify factors related to teams' adoption of the Comprehensive Unit-based Safety Program (CUSP), an approach to improving patient safety culture among intensive care units (ICUs) participating in a bloodstream infection reduction collaborative.

Methods
We analyzed data from the 103 ICUs participating in the Keystone ICU project. We conducted logistic regressions to assess baseline factors associated with ICU teams’ use of CUSP. Predictors included safety climate scales (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions) as measured by the Safety Attitudes Questionnaire, central line-associated bloodstream infection rates, bloodstream infection prevention intervention phase, ICU type, hospital bed size, and hospital teaching status.

Results
Intensive care units with lower perceived safety climate, greater stress recognition, higher perceptions of management, and better working conditions were more likely to adopt CUSP. Intensive care units that implemented the infection prevention interventions late were less likely to adopt CUSP. Mixed ICUs and ICUs in large hospitals were also less likely to use CUSP.

Conclusions
Staff-perceived safety climate, ICU type, and hospital size were related to ICUs’ implementation of CUSP. Better baseline safety climate or lower perceived organizational support reduced uptake. The findings can help hospital leaders and collaborative experts identify units that are less likely to implement cultural interventions.
Evaluation of the Accuracy of Computer-Guided Mandibular Fracture Reduction
Authors: el-Gengehi Mostafa , Seif Sameh A. 
Published: July 2015

Abstract
The aim of the current study was to evaluate the accuracy of computer-guided mandibular fracture reduction. A total of 24 patients with fractured mandible were included in the current study. A preoperative cone beam computed tomography (CBCT) scan was performed on all of the patients. Based on CBCT, three-dimensional reconstruction and virtual reduction of the mandibular fracture segments were done and a virtual bone borne surgical guide was designed and exported as Standard Tessellation Language file. A physical guide was then fabricated using a three-dimensional printing machine. Open reduction and internal fixation was done for all of the patients and the fracture segments were anatomically reduced with the aid of the custom-fabricated surgical guide. Postoperative CBCT was performed after 7 days and results of which were compared with the virtually reduced preoperative mandibular models. Comparison of values of lingula-sagittal plane, inferior border-sagittal plane, and anteroposterior measurements revealed no statistically significant differences between the virtual and the clinically reduced CBCT models. Based on the results of the current study, computer-based surgical guide aid in obtaining accurate anatomical reduction of the displaced mandibular fractured segments. Moreover, the computer-based surgical guides were found to be beneficial in reducing fractures of completely and partially edentulous mandibles.
Freehand Condyle-Positioning During Orthognathic Surgery
Authors: Sander Anna Katharina , Martini Markus , Konermann Anna-Christin , Meyer Ulrich , Wenghoefer Matthias 
Published: July 2015

Objectives:
Purpose of this study was to evaluate changes in the temporomandibular joint (TMJ) position after bilateral sagittal split osteotomy (BSSO) of the mandible by the help of pre- and postoperative cone-beam computed tomography (CBCT) images.

Materials and Methods:
A collective of n = 78 patients was investigated between 2009 and 2011 before and after BSSO of the mandible in mono- or bimaxillary orthognathic surgery procedures. No intraoperative fixation of the condyles was administered. CBCT scans were performed in all patients before and immediately after surgery with the KaVo 3DeXam device in the position of terminal occlusion. Subsequently, all scans were analyzed by help of the eXam Vision program and the ImageJ image processing software. Alterations of the TMJs were quantified by determining pre- to postoperative differences of the intercondylar distance, the mandibular angle on both sides, and the condylar angles in the transversal plane.

Results:
The difference between pre- and postoperatively ascertained values was minimal (means: lateral condylar distance −0.17 mm; distance of condylar centers −0.32 mm; medial condylar distance −0.49 mm; left mandibular angle +1.06°; right mandibular angle +2.06°; condylar angles in relation to a reference line: left −2.93, right −0.75; angle of cutting +3.42). There is no apparent tendency toward a positional change in any of the 3 examined planes. Between bi- and monomaxillarily operated patients there was no difference either, except for the osteotomy plane.

Conclusions:
A 3-dimensional analysis of CBCT data of the TMJ seems to be appropriate to determine the condylar position pre- and postoperatively. Performed by an experienced orthognathic surgeon, BSSO of the mandible does not effectuate any relevant changes of the TMJ-position, thus making an intraoperative condyle-fixation unnecessary.
Optimal Viscosity and Particle Shape of Hyaluronic Acid Filler as a Scaffold for Human Fibroblasts
Authors: Kim Deok-Yeol , Namgoong Sik , Han Seung-Kyu , Won Chang-Hoon , Jeong Seong-Ho , Dhong Eun-Sang , Kim Woo-Kyung 
Published: July 2015

Abstract
The authors previously reported that cultured human fibroblasts suspended in a hyaluronic acid filler can produce human dermal matrices with extended in vivo stability in animal and clinical studies. The present study was undertaken to determine the optimal viscosity and particle shape of hyaluronic acid filler as a scaffold for cultured human dermal fibroblasts to enhance the maximal viability of injected cells. The fibroblasts were suspended in either 1 of 3 hyaluronic acid viscosities at 2 different particle shapes. The viscosities used in this study were low (600,000–800,000 centipoises), moderate (2,000,000–4,000,000 centipoises), and high (8,000,000–12,000,000 centipoises). The particle shape was evaluated by testing round and irregular shapes. The fibroblast mixed bioimplants were injected into the back of individual athymic nude mice. The levels of type I collagen were measured using fluorescent-activated cell sorting (FACS) and immunohistochemical staining at 16 weeks after the injections. Results of FACS demonstrated that the mean cell ratio with human collagens in the moderate viscosity group was greater than those of control, low, and high viscosity groups. An immunohistochemical study showed similar results. The moderate viscosity group demonstrated the highest positive staining of human collagens. However, there were no significant differences between groups of irregular and round shape particles. A hyaluronic acid bioimplant with moderate viscosity is superior to that with low or high viscosity in the viability for human fibroblasts. However, the particle shape does not influence the viability of the fibroblasts.
What Is the Best Way to Handle the Involutional Blepharoptosis Repair?
Authors: Wada Yoshitaka , Hashimoto Takahiro , Kakizaki Hirohiko , Isogai Noritaka , Asamura Shinichi 
Published: July 2015

Abstract
There are many different operations to correct involutional blepharoptosis (IB); however, the outcome of the corrective surgery is rather unpredictable, regardless of the procedure employed. A reasonably predictable outcome can be achieved with careful intraoperative evaluation of the condition, with measuring of the margin reflex distance-1 (MRD-1) in supine position of the patients. With these prepositions, we collected data that indicated that our approach can achieve a predictable outcome.
This was a prospective study of 21 consecutive patients (8 men and 13 women) involving 42 eyelids with IB. IB was defined as an MRD-1 of <2 mm. All 21 patients were informed of the purposes of the study, and underwent levator aponeurosis advancement. The MRD-1 was measured intraoperatively with the patients in a supine position and in the 3-month postoperative inspection with the patients in a sitting position. Statistical analyses using paired t-tests were performed.
From intraoperative measurement, mean MRD-1 values were 4.31 mm on the right side (range 3.0–4.5) and 4.29 mm on the left side (range 3.5–5.0). Three months after the operations, mean MRD-1 values were 3.07 mm on the right side (range 1.5–4.0) and 3.07 mm on the left side (range 2.0–4.0). Compared with the intraoperative MRD-1 measurements, those of the postoperatives were significantly 1.2 mm reduced (right: P < 0.01, left: P < 0.01).
The intraoperative measurement of MRD-1 without changing position of patients could result in successful outcome of the operation.
Effect of Modified Fujita Technique Uvulopalatoplasty on Oxidative DNA Damage Levels in Patients With Obstructive Sleep Apnea Syndrome
Authors: Bakan Ebubekir , Fidan Vural , Alp Hamit Hakan , Baygutalp Nurcan Kilic , Cokluk Erdem 
Published: July 2015

Abstract
Snoring is a social hindrance problem and it can cause life threatening problems. Because of this it must be taken seriously and must be treated. Although there are many ways for treating this problem, still uvulopalatopharngoplasty (UPPP) which is an accepted classical method maintains its importance. Antioxidant status in patients with snoring have been investigated. All studies investigated the effect of CPAP treatment on the level of antioxidant agents. In this study we have examined the effect of UPPP on the level of antioxidant agents in patients with snoring.
Split Cartilage Resection of Nasal Dome
Authors: Tuğrul Selahattin , Doğan Remzi , Koçak Ilker , Eren Sabri Baki , Ozturan Orhan 
Published: July 2015

Objective:
In ptotic noses, it is rather difficult to achieve the intended functional and cosmetic result without modifying the alar cartilage and creating a new nasal tip. The split cartilage resection method was intended to create a new and permanent nasal tip to protect the physiologic and cosmetic appearance of the nose in the presence of long and ptotic nasal tip.

Method:
A total of 53 patients who had nasal tip ptosis were included in the study: 26 patients (Group 1) who underwent lateral crural overlap because of the alar cartilage problem and 27 patients (Group 2) who underwent dome split cartilage resection. After at least 1 year of follow-up, the pre- and postoperative measurements of patients indicating their rotations and projections in their computerized images were compared and acoustic rhinometry was performed to determine the nasal valve function.

Results:
There were no significant differences between the 2 groups with respect to the pre- and postoperative nasolabial angels, rotation angles, Goode index, and nasofacial angle. There were no significant differences between the nasal cavity volume values of the 2 groups; the volume increase in wide nasal cavity in Group 2 was higher. After the operation, the increase in minimum cross-sectional area values in Group 2 was significantly >1 in Group 1.

Conclusions:
The nasal tip split resection method is a method that can be implemented and should be kept in mind as a technique, which must be considered as an alternative method for noses with ptotic and long nasal tip disorder.
Optimization of Cranio-Orbital Remodeling
Authors: Isaac Kathryn V. , Koenemann Jochen , Fukasawa Ricardo , Qian David , Linhares Andre , Saber Nikoo R. , Drake James , Forrest Christopher R. , Phillips John H. , Nguyen Phuong D. 
Published: July 2015

Abstract
Cranio-orbital remodeling aims to correct the dysmorphic skull associated with craniosynostosis. Traditionally, the skull is reconstructed into a shape that is subjectively normal according to the surgeon's perception. We present a novel technique using a mathematical algorithm to define the optimal location for bony osteotomies and to objectively reshape the fronto-orbital bar into an ideal normal skull contour.
Using pre-operative computed tomography images, the abnormal skull contour at the frontal-orbital region was obtained for infants planned to undergo cranio-orbital remodeling. The ideal skull shape was derived from an age- and sex-matched normative skull library. For each patient, the mathematical technique of dynamic programming (DP) was applied to compare the abnormal and ideal skull shapes. The DP algorithm identifies the optimal location of osteotomy sites and calculates the objective difference in surface area remaining between the normative and dysmorphic skull shape for each solution applied. By selecting the optimal solution with minimal objective difference, the surgeon is guided to reproducibly recreate the normal skull contour with defined osteotomies.
The DP algorithm was applied in 13 cases of cranio-orbital remodeling. Five female and 8 male infants with a mean age of 11 months were treated for craniosynostosis classified as metopic (n = 7), unicoronal (n = 4), or bicoronal (n = 2). The mean OR time was 190.2 min (SD 33.6), mean estimated blood loss 244 cc (SD 147.6), and 10 infants required blood transfusions. Compared with a historical crania-orbital remodeling group treated without application of the algorithm, there was no significant difference in OR time, estimated blood loss, or transfusion rate.
This novel technique enables the craniofacial surgeon to objectively reshape the fronto-orbital bar and reproducibly reconstruct a skull shape resembling that of normal infants.
One-Stage Cleft Lip and Palate Repair in an Older Population
Authors: Guneren Ethem , Canter Halil Ibrahim , Yildiz Kemalettin , Kayan Resit Burak , Ozpur Mustafa Aykut , Baygol Emre Gonenc , Sagir Haci Omer , Kuzu Ismail Melih , Akman Onur , Arslan Serap 
Published: July 2015

Background:
In underdeveloped countries one-stage definitive repair of cleft lip and palate is considered for late-presenting patients.

Materials and Methods:
A total of 25 patients with unoperated cleft lip and palate more than 2 years of age were enrolled in this study for one-stage simultaneous repair of cleft lip and palate. According to Veau-Wardill-Kilner push-back technique, 2 flap palatoplasties were performed for palatal repairs; all of the lips were repaired with the Millard II rotation-advancement technique.

Results:
The authors experienced no perioperative or postoperative life-threatening complications. With respect to the registered operation periods, longer times were required to perform these double operations, but this elongation is shorter than the sum of the periods if the 2 operations had been performed separately. Although the authors were unable to evaluate the late postoperative results because the authors could not follow-up the patients after they were discharged the day after surgery, the early results related to the success of the operation without any surgical complication were prone to meet the parents’ and patients’ expectations.

Discussion:
The authors presented their experiences with many volunteer cleft lip and palate trips to third world countries; however the structure of this article is not a new hypothesis and data based to support a scientific study, but observations are objective to get a conclusion. To perform one-stage definitive repair of the cleft lip and palate in late-presented patients was the reality that they had only 1 chance to undergo these operations. According to the terms and conditions of this challenging operation, one-stage simultaneous repair of cleft lip and palate is a more demanding and time-consuming procedure than is isolated cleft lip repair or cleft palate repair. Although technically challenging, single-stage repair of the whole deformity in late-presenting patients is a feasible, reliable, successful, and safe procedure in authors’ experience.
Morphometric Analysis of Styloid Process Using Multidetector Computed Tomography
Authors: Yilmaz Mehmet T. , Akin Duygu , Cicekcibasi Aynur E. , Kabakci Anil D.A. , Seker Muzaffer , Sakarya Mehmet E. 
Published: July 2015

Abstract
Styloid process (SP) is a cylindrical anatomical structure located at the anterior side of stylomastoid foramen. Normally, it is 20 to 25 mm in length and can vary with ageand sex. An elongated SP is an unusual source of craniofacial and cervical pain. In this study, the clinical role of morphometric data of SP was discussed.
In this study, 64-slice multidetector computed tomography images (Somatom Sensation 64, Siemens, Germany) from Radiology Department's archive of Necmettin Erbakan University were used. The examined images were collected from 100 patients (31 female and 69 male). Length of SP (SPL), SP width (SPW), distance between SP rooths (DBR), SP's angulation, and the distance between SP and internal carotid artery (SP-ICA) were measured.
Statistical differences were found regarding to the data of SPL, SPW, DBR, and SP-ICA left between sexes. No statistical significance was detected between right and left side SPL (paired t test; P = 0.989, P > 0.05). SP was observed as mostly type A1 (right %55, left %52). These parameters were also compared with those of previous studies.
The present study showed side and sex differences and types of SP. We believe that it was necessary to determine the normal range of values for different populations, and this knowledge will provide guidance to surgeons in the examination of this area.