bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic Ligamentum Teres Reconstruction of the Hip in Ehlers-Danlos Syndrome: A Case Study
Authors: Hammarstedt Jon E. , Redmond John M. , Gupta Asheesh , Domb Benjamin G. 
Published: April 2015

Background Ehlers-Danlos syndrome (EDS) is a genetic disorder that affects the structural integrity of collagen within the body. This presents clinically as a connective tissue disorder with increased elasticity of joints, muscles, and ligaments. Multiple joints are affected by hypermobility and joint injury is common in these patients. It is estimated that EDS occurs once in every 5,000 births worldwide. Case review This article focuses on reconstruction of the ligamentum teres (LT) of the hip using a tibialis anterior allograft to treat severe instability and pain in a 43 year-old female with EDS. The LT reconstruction was accompanied by labral repair and capsular plication. The patient was assessed pre- and postoperatively using modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADLS), Hip Outcome Score Sports Specific Subscale (HOS-SSS), Non Arthritic Hip Score (NAHS), Visual Analog Scale (VAS), and satisfaction. One year following surgery the patient has reported positive outcomes in terms of pain and instability. Literature review Ligament reconstruction has been reported in patients with Ehlers-Danlos syndrome for shoulders and knees with positive results and restoration of stability. Currently there is a paucity of literature regarding patients with EDS undergoing hip procedures. In addition, reconstruction of the ligamentum teres for hip instability and pain has rarely been reported in a normal patient cohort. Clinical relevance This is the first study to report ligamentum teres reconstruction of the hip in a patient with Ehlers-Danlos syndrome and hip instability. The patient demonstrated satisfactory results 1 year from surgery.
The Immune Response to Crosslinked Tissue is Reduced in Decellularized Xenogeneic and Absent in Decellularized Allogeneic Heart Valves
Authors: Böer Ulrike , Schridde Ariane , Anssar Marcel , Klingenberg Melanie , Sarikouch Samir , Dellmann Ansgar , Harringer Wolfgang , Haverich Axel , Wilhelmi Mathias 
Published: April 2015

Background The degeneration and failure of xenogeneic heart valves, such as the Matrix P Plus valve (MP-V) consisting of decellularized porcine valves (dec-pV) and equine glutaraldehyde-fixed conduits (ga-eC) have been linked to tissue immunogenicity accompanied by antibody formation. In contrast, decellularized allograft valves (dec-aV) are well-tolerated. Here, we determined tissue-specific antibody levels in patients after implantation of MP-V or dec-aV and related them to valve failure or time period after implantation. Methods and Results Specific antibodies toward whole tissue-homogenates or alphaGal were determined retrospectively by ELISA analyses from patients who received MP-V with an uneventful course of 56.1 ± 5.1 months (n = 15), or with valve failure after 25.3 ± 14.6 months (n = 3), dec-aV for various times from 4 to 46 months (n = 14, uneventful) and from healthy controls (n = 4). All explanted valves were assessed histopathologically. MP-V induced antibodies toward both tissue components with significantly higher levels toward ga-eC than toward dec-pV (68.7 and 26.65 μg/ml IgG). In patients with valve failure, levels were not significantly higher and were related to inflammatory tissue infiltration. Anti-Gal antibodies in MP-V patients were significantly increased in both, the uneventful and the failure group. In contrast, in dec-aV patients only a slight tissue-specific antibody formation was observed after 4 months (6.24 μg/ml) that normalized to control levels after 1 year. Conclusions The strong humoral immune response to glutaraldehyde-fixed tissues is reduced in decellularized xenogeneic valves and almost absent in decellularized allogeneic tissue up to 4.5 years after implantation.
Associated Risk Factors for Chronic Kidney Disease of Unknown Etiologies in 241 Patients
Authors: Xing Xuexue , Lu Jing , Wang Zheng 
Published: April 2015

Background Apart from the well-known etiologies, there are still a high proportion of patients with chronic kidney disease of unknown etiology (CKDu), which has rarely been reported on. In this study, we explored the potential associated risk factors for CKDu and identified those that occur in childhood. Methods 700 patients with CKD we were selected randomly from 4 hospitals in Chengdu and 241 were screened for CKDu. The following clinical information was analyzed: demographic data, life style, personal and family history, nephrotoxic drugs, exposure to poison, allergies, and recurrent respiratory infections in childhood. Results Among 700 CKD patients, 34.43% (241/700) were CKDu. Of the 241 patients, there were 67.63% (163/241) with at least 1 associated risk factor and 56.44% (92/163) with more than 1. Patients with a personal history of an associated risk factor represented the largest proportion (31.95%, 77/241), while 28.63% (69/241) of the CKDu patients had risk factors appearing in childhood. Logistic regression analysis supported the results. Conclusions The study demonstrated that most so-called CKDu patients do have an identifiable etiology, and that several associated risk factors contribute to it. Of all the risk factors, age >60 years, nephrotoxic drugs, exposure to poison, and alcohol consumption were the independent significant factors for CKDu. Furthermore, many risk factors that caused kidney injury started in childhood.
Correlation of miRNA Expression Profiling in Surgical Pathology Materials, with Ki-67, HER2, ER and PR in Breast Cancer Patients
Authors: Sakurai Minako , Masuda Mariko , Miki Yasuhiro , Hirakawa Hisashi , Suzuki Takashi , Sasano Hironobu 
Published: April 2015

Background New molecular markers related to prognosis and/or clinical outcome have been extensively studied in breast cancer. In particular, microRNA (miRNA) has attracted the interest of both basic and clinical investigators as one of the promising molecular markers of breast cancer patients. MiRNAs are a class of short noncoding RNAs that regulate mRNAs at posttranscriptional level and are deregulated in various human malignancies. Previous studies have reported that miRNAs were stably conserved in 10% formalin-fixed paraffin-embedded tissues without significant degradation, in contrast to more fragile RNA. Methods Therefore, in this study, we examined 21 surgical breast cancer specimens using the Human Cancer microRNA PCR Array system (QIAGEN) to explore potential molecular targets of miRNAs. Results Profiling of miRNA expression in archival materials demonstrated that a group of deregulated miRNAs was associated with clinicopathological parameters of the patients, such as Ki-67, HER2, ER and PR. For instance, an abundant expression of multiple let-7 miRNA family, also known as tumor suppressor, was detected in low Ki-67 and HER2 groups. Elevated expression of 8 miRNAs overlapped between Ki-67+/HER2+/ER+/PR+ groups, including several known oncogenic miRNAs such as miR-148b, miR-15b, miR-200c, miR-150, miR-191, miR-96, miR-25 and miR-21. Conclusions These results all indicated that when analyzing miRNAs in surgical pathology specimens of breast cancer as a biomarker, they should be examined as a cluster through miRNA profiling, rather than relying on the analysis of a single miRNA.
Hemodialysis Catheter-related Infection: Prophylaxis, Diagnosis and Treatment
Authors: Böhlke Maristela , Uliano Gustavo , Barcellos Franklin C. 
Published: April 2015

Purpose Infectious complications associated with central venous catheters (CVCs) are a major source of morbidity and mortality among hemodialysis (HD) patients. This review aims to discuss prevention, diagnosis criteria and management of CVC-related infections in HD patients. Methods We searched Medline for articles published in the last 10 years, with the keywords “catheter,” “hemodialysis,” “infection,” “treatment,” “diagnosis,” “prophylaxis” and “adults.” Only English language articles were reviewed. We reviewed prophylaxis and surveillance protocols, diagnosis criteria, including new molecular tools, and the management of catheter-related infections, including antibiotic regimen, empiric and according to causal agents, lock therapy, catheter salvage or removal choice and treatment of complications. Results To prevent infectious complications, first of all we need to avoid using catheters. If we need CVC, adoption of prophylaxis and surveillance protocols, and antibiotic ointment at the exit site reduce infectious complications. The diagnosis of CVC-related infections should be made with drainage and/or blood cultures. Empiric systemic antibiotics should cover Gram-positive and -negative microorganisms, and final regimen should be based on culture results. In selected cases, salvage of site, by CVC exchange over wire, or salvage of catheter, using antibiotic lock, under the cover of systemic antibiotics, could be attempted. Conclusions The best approach to prevent CVC-related infection would be to avoid the use of CVC. However, in patients for whom it is impossible, the adoption of adequate prophylaxis protocols, early diagnosis and effective treatment of infectious complications are essential to improve outcomes.
Outcomes of Patients with Squamous Cell Carcinoma of Esophagus who did not receive Surgical Resection after Neoadjuvant Radiochemotherapy
Authors: Fakhrian Khashayar , Ordu Arif Deniz , Nieder Carsten , Lordick Florian , Kup Philipp Günther , Theisen Jörg , Combs Stephanie E. , Geinitz Hans 
Published: April 2015

Aims and Background The primary objective was to assess the different reasons for refusal of surgical resection (SR) in patients with esophageal squamous cell cancer (ESCC), who were initially planned for neoadjuvant radiochemotherapy (N-RCT) + SR, but SR was not performed after N-RCT. Methods and Study Design From 1988 to 2011, 311 patients with ESCC were treated with N-RCT in a tertiary referral center for esophageal diseases. Fifty-three patients were analyzed who received RCT with 40–45 Gy and concomitant chemotherapy in neoadjuvant intention, but in whom the treatment was stopped or switched to definitive RCT due to progression, patient decision, or new findings. Results The reasons for refusal of SR for these 53 patients were as follows: ( 1 ) patients' or physicians' preference for the planned treatment was changed during the N-RCT, such that RCT was continued to a curative dose without a break (group 1, n = 23, 44%); ( 2 ) patients were restaged after 4 weeks, and the tumor board decided to continue RCT because RO resection was unlikely and/or patients were medically unfit (group 2, n = 15, 28%); ( 3 ) patients refused continuation of any treatment (group 3, n = 15, 28%). Refusal of SR was significantly more likely in patients with longitudinal tumor dimension >8 cm and those with an Eastern Cooperative Oncology Group performance status score of 2. Median follow-up time from the start of N-RCT was 57 months (range 1–137 months). The survival rates at 2 and 5 years were 36 ± 7% and 27 ± 7%, respectively. Group 1 had significantly longer survival. Conclusions The planned N-RCT+SR could not be completed in a considerable number of patients in a tertiary referral center. More strict selection criteria for multimodality treatment including SR could spare some of these patients an incomplete treatment and probably lead to increased utilization of definitive RCT.
Helical Tomotherapy for the Treatment of Anal Canal Cancer: A Dosimetric Comparison with 3D Conformal Radiotherapy
Authors: Ugurluer Gamze , Ballerini Giorgio , Moeckli Raphael , Matzinger Oscar , Bourhis Jean , Ozsahin Mahmut 
Published: April 2015

Aims and Background The standard treatment of anal canal cancer (ACC) is combined chemotherapy and radiation therapy (RT), which is complex because of the shape of the target volumes and the need to minimize the irradiation of normal pelvic structures. In this study we compared the dosimetric results of helical tomotherapy (HT) plans with traditional 3D conformal RT (3DRT) plans for the treatment of ACC. Methods and Study Design Twelve patients (median age 57 years, range 38–83; F/M 8/4) treated with HT and concurrent chemotherapy for locally advanced ACC were selected. All had histologically confirmed squamous-cell carcinoma. A clinical target volume including the tumor and pelvic and inguinal lymph nodes was treated with HT to a total dose of 36 Gy in 1.8-Gy daily fractions. Then a sequential boost of 23.4 Gy in 1.8-Gy daily fractions (total dose 59.4 Gy) was delivered to the tumor and involved nodes. For all 12 patients, 3DRT plans were generated for comparison. Treatment plans were evaluated by means of standard dose-volume histograms. Dose coverage of the planning target volumes (PTVs), homogeneity index (HI), and mean doses to organs at risk (OARs) were compared. Results The coverage of PTV was comparable between the two treatment plans. HI was better in the HT vs. 3DRT plans (1.25 and 3.57, respectively; p<0.0001). HT plans resulted in better sparing of OARs (p<0.0001). Conclusions HT showed superior target dose conformality and significant sparing of pelvic structures compared with 3DRT. Further investigation should determine if these dosimetric improvements will improve clinical outcomes regarding locoregional control, survival, and treatment-related acute and late morbidity.
Multifraction Radiotherapy for Palliation of Painful Bone Metastases: 20 Gy versus 30 Gy
Authors: Valeriani Maurizio , Scaringi Claudia , Blasi Luciana , Carnevale Alessia , De Sanctis Vitaliana , Bonome Paolo , Bracci Stefano , Marrone Gianluca , Minniti Giuseppe , Enrici Riccardo Maurizi 
Published: April 2015

Aims and Background To compare 2 multifraction radiotherapy schedules in the palliation of painful bone metastases. Methods and Study Design We retrospectively analyzed clinical data of 105 patients with a total of 140 painful bone metastases who were treated with 20 Gy in 5 fractions or 30 Gy in 10 fractions. The primary tumors were breast (30%), lung (28%), and prostate (14%). The main sites of irradiation were spine (n = 79) and sacrum or pelvis (n = 39). Pain was graded by patients according to the pain numeric rating scale just before and 1 month after radiotherapy. Pain progression was defined as an increase ≥2 on pain scale after an initial response. Results The overall response rate at 1 month was 88.6%. Overall response rate was 89.6% in the 20-Gy arm and 87.3% in the 30-Gy arm (p = 0.669). The rate of complete response was statistically better in patients treated with 30 Gy (p = 0.019). The mean reduction in pain was 3.2 in the 20-Gy group and 3.6 in the 30-Gy group. Pain progression was 6.5% and 1.6%, respectively. The incidence of acute toxicity was statistically significantly higher in the 30-Gy arm (23.8%) than in the 20-Gy arm (2.6%) (p = 0.001). One pathologic fracture of the irradiated bone was observed in the 30-Gy arm. Two lesions, one in each group, were re-irradiated for pain recurrence. Pain progression was found in 6.5% of the irradiated lesions in the 20-Gy arm and in 1.6% in the 30-Gy arm. Conclusions In our series, both regimens achieved high rate of pain relief, although the group treated with higher total dose reported better complete response rate. The 30-Gy arm had a significantly higher rate of acute toxicity.
Sources, Problems, and Prospects for a History on the Piety of Jan Długosz, with Special Reference to Liturgy
Authors: Radzilowski Paul J. 
Published: April 2015

AbstractWhile remembered primarily as author of a landmark fifteenth- century chronicle of Polish history, Jan Długosz was also a diplomat and priest, among other occupations. This article attempts to highlight Długosz’s “piety,” in its medieval sense emphasizing the qualities of holy mercy and charity, chiefly through an examination of liturgical sources. After weighing the complexities of issues and evidence, the author concludes that a satisfactory picture of the piety of Długosz emerges, consistent with the themes and exhortations found in his historical writings.
Heroes and the Monstrous Event of the Holocaust inSchindler’sList andKorczak
Authors: Szczypa Piotr 
Published: April 2015

AbstractTwo notable films set against the backdrop of wartime Poland and the Holocaust, released three years apart—Andrzej Wajda’s Korczak and Steven Spielberg’s Schindler’s List—are compared. Numerous similarities are found, possibly because Spielberg was influenced by the earlier work. Both films are structured around their title characters—alike in some ways, profoundly different in others—the first a Polish- Jewish educator and orphanage director who remained faithful to his youthful charges even unto death at Treblinka, the second a German Nazi profiteer who repented and famously arranged to save the lives of his Jewish workers. Each is presented as a strong fatherly figure, although Korczak is presented as an idealist who stays true to his principles despite the war and Schindler as a man transformed for the better by the conflict. While there is strong reason to believe that Schindler offers an idealized picture of its protagonist, Wajda’s portrayal of Korczak can be considered historically accurate.
The Polish American Congress and the Organized Polish American Community Since 1999 Defining a New Mission After Poland’s Entry to NATO
Authors: Pienkos Donald E. 
Published: April 2015

Abstract
The liberation of Poland from dictatorship and foreign domination, and its transformation into a democracy allied with the United States after its admission to NATO (the North Atlantic Treaty Organization), fulfilled the original mission of the Polish American Congress (PAC), founded in 1944. This success brought with it the challenge of rethinking the organization’s objectives. For a variety of reasons, little was done to meet this challenge until 2008, when the PAC began taking a series of steps to determine its future course. These steps have included the adoption of a revised mission statement and a pair of meetings held in 2014. Still, the task of equipping the PAC to play a significant role in American civic life remains a work in progress.
Use of a Novel Assay to Measure Pre-to Posttraining Palpatory Skills of First-Year Osteopathic Medical Students
Authors: Loh Meredith S. , Gevitz Norman , Gilliar Wolfgang G. , Iacono Lauren M. , Jung Min-Kyung , Krishnamachari Bhuma , Amsler Kurt 
Published: April 2015

Abstract

Context: Although palpation is a central skill in the practice of osteopathic medicine, few data are available on factors affecting the development of palpatory skills.

Objective: To use a novel palpatory skills assay to assess the role of training and practice in the development of palpatory skills in an osteopathic medical student population.

Methods: The palpatory skills of first-year osteopathic medical students were assessed using a simple, objective palpation assay that consisted of locating a dime placed under sheets of copy paper at depths of 50, 100, 150, 200, 300, and 400 sheets. Two trials were performed at each depth. The assay was performed at the beginning and at the end of the students' first term. To determine whether practice with the assay impacted participant performance, a third assay was conducted to compare the performance of students who completed the assays at the beginning and at the end of the term with that of students who had never completed the assay.

Results: Sixty-three participants completed the assays at the beginning and end of the term. Fifty-seven of those 63 participants and 192 participants who had not previously completed the assay completed the third assay. A wide variability in number of correct responses per participant was observed at both the beginning (range, 0-11 correct) and the end (range, 2-12 correct) of the term. The mean (SD) number of correct responses per participant increased from the beginning (5.49 [2.78]) to the end (7.17 [2.27]) of the term. Analysis using the generalized estimating equation model demonstrated that both paper depth and experience (ie, beginning vs end of the term) were statistically significant determinants of the number of correct responses (P<.001). The Kaplan-Meier method indicated that the median paper depth at which participants first scored no correct responses increased from 200 sheets (95% CI, 171-229) at the beginning of the term to 300 sheets (95% CI, 232-367) at the end of the term (P<.001). In the third assay, no significant differences were noted in the performance of students who had completed the 2 previous assays vs participants who had not completed the previous assays (P=.136).

Conclusion: Participants' palpatory skills improved from the beginning to the end of the term. The range of participants' palpatory skills at the beginning of the term suggests that other factors in addition to training influenced participants' palpatory skill level. Additional research is needed to identify and investigate factors that influence the development of palpatory skills. J Am Osteopath Assoc. 2015;115(1):32-40 doi:10.7556/jaoa.2015.005
Sonography of Traumatic Quadriceps Tendon Tears With Surgical Correlation
Authors: Foley Ryan , Fessell David , Yablon Corrie , Nadig Jeffrey , Brandon Catherine , Jacobson Jon 
Published: April 2015

ObjectivesUsing surgical correlation as the reference standard, the purpose of this study was to assess the ability of sonography to detect quadriceps tendon tears that require surgical treatment (high‐grade partial tears and complete ruptures).MethodsTwo hundred thirty‐nine consecutive sonographic reports of the knee (May 2001 to October 2008) with subsequent surgical correlation were retrospectively reviewed for surgical intervention on the quadriceps tendon. All sonograms were blindly and retrospectively reviewed. Surgical findings were compared with results from the consensus review. Results from the original sonographic reports (nonretrospective interpretation) were also compared with the surgical findings.ResultsOn the retrospective consensus review, the sensitivity (23 of 23), specificity (16 of 16), and accuracy (39 of 39) were 100% for identifying high‐grade partial tears or complete ruptures versus a normal quadriceps tendon. For the original, nonretrospective sonographic reports, 22 of 23 high‐grade partial tears or complete ruptures (96%) were correctly diagnosed.ConclusionsSonography is an effective tool for identifying quadriceps tendon tears that require surgical treatment (high‐grade partial tears and complete ruptures).