bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual-phase CT angiography through the port-catheter system for hepatic arterial infusion chemotherapy using multislice CT: assessment of system dysfunction and impact on predicting clinical problems
Authors: Seki Hiroshi , Ozaki Toshirou , Ooi Hiroyuki 
Published: September 2012

Background Hepatic arterial infusion (HAI) chemotherapy is being explored for treatment of malignant liver tumors. Maintenance of HAI systems is important for effective treatment. Purpose To prospectively evaluate the efficacy of dual-phase CT angiography through the port-catheter system for HAI chemotherapy. Material and Methods This study enrolled 47 patients receiving HAI chemotherapy for malignant liver tumors who underwent dual-phase CT angiography through the port-catheter system using multislice CT. Using maximum intensity projection images reconstructed from vascular-phase CT imaging, hepatic arterial patency and catheter location were assessed. Using a combination of vascular- and perfusion-phase CT imaging, system dysfunction and clinical problems were evaluated. Results Dual-phase CT angiography was conducted 156 times. Stenosis and obstruction of the hepatic artery and catheter dislodgment were observed seven times in four patients and four times in three patients, respectively. Diagnostic accuracy using vascular-phase CT imaging was 100%. In addition, development of collateral blood supply to the liver and extrahepatic perfusion to the stomach were observed three times in three patients and twice in two patients, respectively. Overall, system dysfunction occurred 16 times in 12 patients, and system correction and treatment modification were required 11 times in 10 patients. In assessing system dysfunction and predicting clinical problems, the accuracy of dual-phase CT imaging was 100%. Conclusion Dual-phase CT angiography through the port-catheter system is helpful for assessing catheter system dysfunction and predicting clinical problems in HAI chemotherapy.
Lime: Building on the 100-Year Legacy of The ASTM Committee C07
Authors: Thomson Margaret L. , Brisch Joseph H. 
Published: September 2012

Description
Celebrating 100 years of standards development, ASTM Committee C07 on Lime has published 16 peer-reviewed papers, ranging in topics such as historical standards development, current industry activities, and potential areas for future work. Several papers present the more traditional uses of lime in asphalt, soil stabilization, and paper manufacturing.
Other topics include
Acute Liver Failure following Cleft Palate Repair: A Case of Therapeutic Acetaminophen Toxicity
Authors: Iorio Matthew L. , Cheerharan Meera , Kaufman Stuart S. , Reece-Stremtan Sarah , Boyajian Michael 
Published: September 2012

Background Acetaminophen is a widely used analgesic and antipyretic agent in the pediatric population. While the hepatotoxic effects of the drug have been well recognized in cases of acute overdose and chronic supratherapeutic doses, the toxic effects of acetaminophen are rarely documented in cases where therapeutic guidelines are followed. Case An 8-month-old boy underwent cleft palate repair and placement of bilateral myringotomy tubes. His anesthetic course was uneventful, consisting of maintenance with desflurane and fentanyl. He received acetaminophen for routine postoperative pain management and was tolerating liquids and discharged home on postoperative day 1. On day 3, the child was profoundly lethargic with multiple episodes of emesis and was taken to the emergency department. He suffered a 45-second tonic-clonic seizure in transport to the regional children's medical center, and initial laboratory results demonstrated acute hepatitis with AST 24,424 U/L, ALT 12,885 U/L, total bilirubin 3.1 mg/dL, and a serum acetaminophen level of 83 μg/mL. Aggressive supportive measures including blood products and periprocedural fresh frozen plasma, piperacillin/tazobactam, and intravenous infusions of N-acetylcysteine, sodium phenylacetate and sodium benzoate, carnitine, and citrulline were administered. His metabolic acidosis and acute hepatitis began to correct by day 4, and he was discharged home without further surgical intervention on day 15. Conclusion Although acetaminophen is an effective and commonly used analgesic in pediatric practice, hepatotoxicity is a potentially devastating complication. This report challenges the appropriateness of existing guidelines for acetaminophen administration and emphasizes the importance of close follow-up and hydration after even relatively minor surgery.
The Value of Geriatric Assessments in Predicting Treatment Tolerance and All-Cause Mortality in Older Patients With Cancer
Authors: Hamaker Marije E. , Vos Alinda G. , Smorenburg Carolien H. , Rooij Sophia E. , Munster Barbara C. 
Published: September 2012

Abstract

Learning Objectives
After completing this course, the reader will be able to: Describe the predictive value of geriatric assessments for survival in older cancer patients.Describe the predictive value of geriatric assessments for treatment tolerance (such as toxicity of chemotherapy and perioperative complications) in older cancer patients.Explain the concept of frailty compared to individual geriatric conditions.
CME This article is available for continuing medical education credit at CME.TheOncologist.com

Background.
Awareness of the use of geriatric assessments for older patients with cancer is increasing. The aim of this review is to summarize all available evidence on the association between geriatric assessments and relevant oncologic outcomes.

Method.
A systematic search was conducted in Medline and Embase of studies on geriatric assessment in oncology, focusing on the association between baseline assessment and outcome.

Results.
The literature search identified 2008 reports; 51 publications from 37 studies were selected for inclusion in the review. The quality of studies was heterogeneous and generally poor. A median of five geriatric conditions were assessed per study (interquartile range: 4–8). Little consistency was found in the results of the studies. Furthermore, different tools appear to be predictive depending on the outcome measure: frailty, nutritional status, and comorbidity assessed by the Cumulative Illness Rating Scale for Geriatrics were predictive for all-cause mortality; frailty was predictive for toxicity of chemotherapy; cognitive impairment and activities of daily living impairment were predictive for chemotherapy completion; and instrumental activities of daily living impairment was predictive for perioperative complications.

Conclusion.
Although various geriatric conditions appear to be of some value in predicting outcome in elderly patients with cancer, the results are too inconsistent to guide treatment decisions. Further research is needed to elucidate the role of geriatric assessments in the oncologic decision-making process for these patients.
Association between body mass index, body fat per cent and muscle power output in soccer players
Authors: Nikolaidis Pantelis 
Published: September 2012

Abstract
The objectives of this study were to examine (a) the prevalence of overweight/obesity, (b) the relationship between body mass index (BMI) and body fat percent (BF), and (c) the association between BMI, BF and power output in adult male soccer players. Members of competitive soccer clubs (n=169, aged 22.7±4.2yr) were examined for anthropometric characteristics and body composition, and performed the physical working capacity in heart rate 170 min−1 test (PWC170), a force-velocity test (F-v) and the Wingate anaerobic test (WAnT). Based on international BMI cut-off points, 17.8% (n=30) of participants were classified as overweight. BMI was correlated with BF (r=0.67, p<0.001) and could be predicted based on the equation BF=1.193·BMI-12.24 (standard error of estimate 2.49). BMI and BF were in inverse relationship with mean power during WAnT (r=−0.30, p<0.001; r=−0.47, p<0.001, respectively). BF was also in inverse relationship with PWC170 (r=−0.26, p<0.001) and maximal power of the F-v test (r=−0.18, p=0.020).The prevalence of overweight among participants was lower than what is observed in general population. The findings confirmed previous observations on general population about the negative effect of overweight and fatness on selected parameters of physical fitness.
Association of CSF glucose concentration with neurosyphilis diagnosis
Authors: Pastuszczak Maciej , Wojas-Pelc Anna , Jaworek Andrzej 
Published: September 2012

Abstract
The most specific criterion for diagnosing neurosyphilis is a reactive CSF VDRL. Unfortunately, there are in Europe, including Poland small number of specialized laboratories for serological diagnosis of syphilis. Thus, CSF serology results are obtained with delay. Therefore, the decision on recommended therapy for neurosyphilis is taken on the basis of CSF basic tests. In this paper we attempt to determine the utility of CSF glucose concentration and its cut-off values in prediction of asymptomatic neurosyphilis. CSF and blood were collected from 55 HIV-uninfected patients with syphilis of unknown duration. Patients with neurosyphilis (14.5%) were characterized by higher CSF pleocytosis (p<0.0001), elevated CSF protein concentration (p<0.05) and lower CSF glucose concentration (p<0.0001). Multivariate regression analysis identified CSF pleocytosis and CSF glucose concentration as the two independent predictors of reactive CSF VDRL (p<0.0001). In the selected group of patients with CSF pleocytosis ≥5/µL (n=25) CSF glucose concentration ≤2.72 mmol/L was associated with 100% sensitivity (95%CI: 63–100%) and 100% specificity (95%CI: 75.3–100%) for reactive CSF VDRL. CSF glucose concentration may be particularly useful as a predictive marker of neurosyphilis in HIV uninfected patients with syphilis of unknown duration with CSF plecytosis ≥5/µL.
Sepsis with multiple abscesses caused by staphylococcus warneri: a case report
Authors: Ivić Ivo , Karanović Jakica , Pavičić-Ivelja Mirela 
Published: September 2012

Abstract
Coagulase-negative Staphylococcus warneri is a rare cause of human disease, which as a rule manifests as an insidious and protracted infection of various prostheses and endovascular catheters. A case of Staphylococcus warneri sepsis with multiple abscesses in an immunocompetent patient free from the usual predisposing factors for coagulase-negative staphylococcal infection is presented. To our knowledge, this is the first case of sepsis with multiple abscesess caused by this bacterium reported in the literature.
Application of time-gated CCD camera with image intensifier in contactless detection of absorbing inclusions buried in optically turbid medium which mimics local changes in oxygenation of the brain tissue
Authors: Sawosz P. , Zolek N. , Kacprzak M. , Maniewski R. , Liebert A. 
Published: September 2012

AbstractThe near infrared spectroscopy may be implemented using various optoelectronic techniques, however, most of them do not allow to carry out measurements at short source-detector separation. We propose a method, based on time-gated intensified CCD camera, which allows for contactless measurements and can be carried out at short source-detector separation. This technique was tested on a phantom with absorbing inclusions buried in an optically turbid medium which mimics local changes in oxygenation of the brain tissue.
Do cystic vestibular schwannomas have worse surgical outcomes? Systematic analysis of the literature
Authors: Thakur Jai Deep , Khan Imad Saeed , Shorter Cedric D. , Sonig Ashish , Gardner Gale L. , Guthikonda Bharat , Nanda Anil 
Published: September 2012

Object
The goal of this study was to perform a systematic quantitative comparison of the surgical outcomes between cystic vestibular schwannomas (CVSs) and solid vestibular schwannomas (SVSs).

Methods
A review of English-language literature published between 1990 and 2011 was performed using various search engines including PubMed, Google Scholar, and the Cochrane database. Only studies that reported surgical results of CVSs in comparison with SVSs were included in the analysis. The primary end point of this study was surgical outcomes, defined by the following: 1) facial nerve outcomes at latest follow-up; 2) mortality rates; or 3) non–facial nerve complication index. Secondary end points included extent of resection and brainstem adherence.

Results
Nine studies comprising 428 CVSs and 1287 SVSs were included in the study. The mean age of patients undergoing surgery was 48.3 ± 6.75 and 47.1 ± 9 years for CVSs and SVSs, respectively (p = 0.8). The mean tumor diameter for CVSs was 3.9 ± 0.84 cm and that for SVSs was 3.7 ± 1.2 cm (p = 0.7). There was no significant difference in the extent of resection among CVSs and SVSs (81.2% vs 80.7%, p = 0.87) Facial nerve outcomes were significantly better in the cohort of patients with SVSs than in those with CVSs (52.1% vs 39%, p = 0.0001). The perioperative mortality rates for CVSs and SVSs were not significantly different (3% and 3.8%, respectively; p = 0.6). No significant difference was noted between the cumulative non–facial nerve complication rate (including mortality) among patients with CVSs and SVSs (24.5% and 25.6%, respectively; p = 0.75)

Conclusions
Facial nerve outcomes are worse in patients undergoing resection for CVSs than in patients undergoing resection for SVSs. There were no significant differences in the extent of resection or postoperative morbidity and mortality rates between the cohorts of patients with vestibular schwannomas.
Hearing preservation surgery for vestibular schwannoma: experience with the middle fossa approach
Authors: DeMonte Franco , Gidley Paul W. 
Published: September 2012

Object
In the early 1960s William F. House developed the middle fossa approach for the removal of small vestibular schwannomas (VSs) with the preservation of hearing. It is the best approach for tumors that extend laterally to the fundus of the internal auditory canal, although it does have the potential disadvantage of increased facial nerve manipulation, especially for tumors arising from the inferior vestibular nerve. The aim of this study was to monitor the hearing preservation and facial nerve outcomes of this approach.

Methods
A prospective database was constructed, and data were retrospectively reviewed.

Results
Between December 2004 and January 2012, 30 patients with small VSs underwent surgery via a middle fossa approach for hearing preservation. The patients consisted of 13 men and 17 women with a mean age of 46 years. Tumor size ranged from 7 to 19 mm. Gross-total resection was accomplished in 25 of 30 patients. Preoperative hearing was American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Class A in 21 patients, Class B in 5, Class C in 3, and undocumented in 1. Postoperatively, hearing was graded as AAO-HNS Class A in 15 patients, Class B in 7, Class C in 1, Class D in 2, and undocumented in 5. Facial nerve function was House-Brackmann (HB) Grade I in all patients preoperatively. Postoperatively, facial nerve function was HB Grade I in 28 patients, Grade III in 1, and Grade IV in 1. There were 3 complications: CSF leakage in 1 patient, superficial wound infection in 1, and extradural hematoma (asymptomatic) in 1. The overall hearing preservation rate of at least 73% and HB Grade I facial nerve outcome of 93% in this cohort are in keeping with other contemporary reports.

Conclusions
The middle fossa approach for the resection of small VSs with hearing preservation is a viable and relatively safe option. It should be considered among the various options available for the management of small, growing VSs.
A stepwise illustration of the translabyrinthine approach to a large cystic vestibular schwannoma
Authors: Nickele Christopher M. , Akture Erinc , Gubbels Samuel P. , Başkaya Mustafa K. 
Published: September 2012

Of the presigmoid approaches, the translabyrinthine approach is often used when a large exposure is needed to gain access to the cerebellopontine angle but when hearing preservation is not a concern. At the authors' institution, this approach is done with the aid of ENT/otolaryngology for temporal bone drilling and exposure.
In the present article and video, the authors demonstrate the use of the translabyrinthine approach for resection of a large cystic vestibular schwannoma, delineating the steps of positioning, opening, temporal bone drilling, tumor resection, and closure. Gross-total resection was achieved in the featured case. The patient's postoperative facial function was House-Brackmann Grade II on the side ipsilateral to the tumor, although function improved with time.
The translabyrinthine route to the cerebellopontine angle is an excellent approach for masses that extend toward the midline or anterior to the pons. Although hearing is sacrificed, facial nerve function is generally spared.
Longitudinal analysis of hearing before and after radiosurgery for vestibular schwannoma
Authors: Yomo Shoji , Carron Romain , Thomassin Jean-Marc , Roche Pierre-Hugues , Régis Jean 
Published: September 2012

Object
The aim of this study was to perform an accurate analysis of changes in hearing in patients with vestibular schwannoma (VS) who have undergone Gamma Knife surgery (GKS) and distinguish the impact of radiosurgery from the natural course of hearing deterioration due to the tumor itself.

Methods
This study was a retrospective review of prospectively collected patient data. A group of 154 patients with unilateral nonsurgically treated VS was conservatively monitored for more than 6 months and then treated with GKS between July 1997 and September 2005. They were followed up with serial clinical examination, MRI, and audiometry. The annual hearing decrease rate (AHDR) was measured before and after radiosurgery, and the possible prognostic factors for hearing preservation were investigated.

Results
The mean dose prescribed to the tumor margins was 12.1 Gy. The mean radiological follow-up period after GKS was 60 months (range 7–123 months). The tumor control rate was 94.8%, and 8 patients underwent subsequent intervention due to tumor progression. The mean audiological follow-up times before and after GKS were 22 and 52 months, respectively. The mean AHDRs before and after GKS were 5.39 dB/year (95% CI 3.31–7.47 dB/year) and 3.77 dB/year (95% CI 3.13–4.40 dB/year), respectively (p > 0.05). The mean pre- and post-GKS AHDRs in patients who initially had Gardner-Robertson (GR) Class I hearing were −0.57 dB/year (95% CI −2.95 to 1.81 dB/year) and 3.59 dB/year (95% CI 2.52–4.65 dB/year), respectively (p = 0.007). The mean pre- and post-GKS AHDRs in patients who initially had GR Class II hearing were 5.09 dB/year (95% CI 1.36–8.82 dB/year) and 4.98 dB/year (95% CI 3.86–6.10 dB/year), respectively (p > 0.05). A subgroup of 80 patients had both early and late post-intervention AHDR assessment (with early referring to the period from GKS to the assessment closest to the 2-year follow-up point and late referring to the period from that assessment to the most recent one); in these patients, the mean early post-GKS AHDR was 5.86 dB/year (95% CI 4.25–7.50 dB/year) and the mean late post-GKS AHDR was 1.86 dB/year (95% CI 0.77–2.96 dB/year) (p < 0.001). A maximum cochlear dose of less than 4 Gy was found to be the sole prognostic factor for hearing preservation.

Conclusions
The present study demonstrated the absence of an increase in AHDR after radiosurgery as compared with the preoperative AHDR. There was even a trend indicating a reduction in the annual hearing loss after radiosurgery over the long term. To fully elucidate a possible protective effect of radiosurgery, longer-term follow-up with a larger group of patients will be required.
Neurosurgical complications of left ventricular assist devices in children
Authors: Mayer Rory R. , Hwang Steven W. , Reddy Gaddum D. , Morales David L. , Whitehead William E. , Curry Daniel J. , Bollo Robert J. , Luerssen Thomas G. , Jea Andrew 
Published: September 2012

Object
Left ventricular assist devices (LVADs) are continuous or pulsatile flow devices that could potentially be life-saving measures for patients with end-stage heart failure. These devices have clear advantages over extracorporeal membrane oxygenation (ECMO) and are often used in adults. They are only recently being commonly used in the pediatric age group. As the use of LVADs becomes more mainstream in children, it is important to determine the complication profile associated with these devices. Furthermore, with the increasing application of LVADs in children, pediatric neurosurgeons are seeing a correlative increase in associated neurological complications. In this study, the authors reviewed the incidence of neurological complications due to LVAD use in the pediatric age group and the role of neurosurgery in treatment.

Methods
The authors examined data regarding patients with LVADs from the Texas Children's Hospital Heart Center database (July 01, 2007, to June 30, 2011) and recorded neurological complications requiring neurosurgical consultation. They identified 2 children who underwent craniotomies during LVAD treatment.

Results
Intracranial hemorrhage occurred in 3 (6.5%) of the 46 patients treated with an LVAD at the authors' institution. Of these patients, 2 were treated with craniotomies for life-threatening intracranial hemorrhages. The 3 patients in the neurosurgical cohort presented with cerebral infarction, decreased level of consciousness, and/or seizure. At the last follow-up (286, 503, and 550 days), 1 patient (Case 2) had no decline in neurological status, underwent a successful heart transplant, and was discharged home; 1 patient (Case 1) died of refractory cardiac failure; and 1 patient (Case 3) was on an LVAD for destination therapy (that is, the LVAD is not a bridge to transplantation but rather the final treatment). This patient was discharged from the hospital, but he died of overwhelming fungemia at 286 days while on VAD support.

Conclusions
Intracranial hemorrhage is a serious and feared complication of LVAD treatment. While the surgical risk is substantial due to systemic anticoagulation and significant medical comorbidities, neurosurgical evacuation of hemorrhage plays an important life-saving role that can yield successful and acceptable outcomes.