bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tolerance and Efficacy of Omniscan (Gadodiamide Injection) in MR Imaging of the Central Nervous System
Authors: Ekholm S. , Jonsson E. , Sandvik L. , Fagerlund M. , Holtås S. , Isberg B. , Lindell D. , Lindén B. , Sjöberg S. , Thuomas K.-Å. , Tollesson P. O. 
Published: June 2015

Purpose: This Swedish multicenter trial was performed on patients with known or suspected lesions of the CNS for which an MR examination using a contrast medium was indicated. A total of 8 MR centers participated in the study to establish the safety and efficacy of Omniscan (gadodiamide injection) in clinical routine using a standard dose of 0.1 mmol Gd/kg b.w. Material and Methods: Seven hundred adult patients who had been referred for MR investigation of suspected CNS lesions were included in the study. Since most patients were examined on an outpatient basis, it was decided to use an explicit questionnaire regarding adverse events that developed within 24 h after examination. The efficacy evaluation involved comparisons of detectability, delineation, and number of lesions before and after injection of Omniscan. Results: No serious or unexpected adverse event was found. There were a total of 70 (10.2%) patients with adverse events, excluding those judged not to be contrast media-related. However, only 15 patients (2.2%) had adverse events that possibly or probably were related to the contrast medium. Usually, the symptoms were headache, dizziness, abnormal taste, and nausea. Two patients complained of itching, but only one developed urticaria. The efficacy was similar to that of other currently used Gd-based MR agents. Lesions were more often seen on T2-weighted images, but the contrast medium improved lesion delineation, contributing to higher certainty in diagnosis, and provided more confidence in excluding suspected abnormality. Conclusion: Omniscan was found to be a safe and clinically valuable contrast medium for MR imaging of the CNS.
Prevention of Intimal Hyperplasia by Irradiation
Authors: Hirai T. , Korogi Y. , Harada M. , Takahashi M. 
Published: June 2015

Purpose: This experimental study was designed to investigate the effect of irradiation in prevention of intimal hyperplasia. Material and Methods: Twenty rabbits were divided into 4 groups, which were irradiated with 2, 5, 10, and 20 Gy, respectively. The intima of both femoral arteries was injured by air-drying, and irradiation was performed on the unilateral side. The contralateral femoral artery served as a control. Angiograms as well as histologic specimens were obtained 1 month later. Results: Marked intimal hyperplasia was observed in all control sites. There were no significant differences in thickness of intimal hyperplasia between irradiated and control sites in groups irradiated with 2 and 5 Gy. However, in the 10-Gy- and 20-Gy-irradiated groups, intimal hyperplasia of the irradiated site was significantly suppressed. Medial thinning and dilation of the lumen were observed in the 20-Gy-irradiated group. Conclusion: Radiation may prevent intimal hyperplasia. Further investigation of the optimal dose, timing of irradiation, and long-term patency of irradiated vessels may be needed.
Palliation of Malignant Obstructive Jaundice
Authors: Men S. , Hekimoğlu B. , Kaderoğlu H. , Pinar A. , Conkbayir I. , Soylu S. Özbal , Bulut A. , Yandakçi K. , Baran I. , Aran Y. 
Published: June 2015

Purpose: The aim of this study was to analyze the clinical efficacy of metal stents in the palliation of malignant obstructive jaundice. Material and Methods: Fifty patients with malignant biliary obstruction were palliated by means of drainage with a metallic self-expandable stent (Wallstent). Nineteen patients had pancreatic carcinoma, 22 cholangiocarcinoma, 4 hepatocellular carcinoma, and the remaining 5 metastatic carcinoma from a variety of primary sites. The obstruction was at the level of the liver hilum in 19 cases, in the middle common bile duct in 11, and in the lower common bile duct in 20. Results: The patients were followed over a period of 1–17 months. A total of 36 patients (72%) died; 14 (28%) survived. The mean observation time for the whole group of 50 patients was 3.3 months. The 30-day mortality rate was 14% (7 patients). Short-term complications occurred in 6 patients (12%). Long-term complications included stent occlusion requiring a 2nd intervention in 2 patients (4%), and cholangitis in 2 patients (4%). Excellent palliation was achieved in most of the patients. No stent migration was observed. Conclusion: The metallic stent provides good palliative drainage, and the percutaneous insertion of metallic stents is well tolerated by the patients. The procedure is simple and safe to use and can be executed in one stage. The one-stage procedure, compared to the 2-stage procedure, may reduce hospital stays.
Sleep Apnea Syndrome
Authors: Suto Y. , Inoue Y. 
Published: June 2015

Purpose: We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG). Subjects and Methods: A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO2 value during sleep. Results: Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO2 value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination. Conclusion: Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS.
US and CT Findings in the Diagnosis of Tuberculous Peritonitis
Authors: Demirkazik F. B. , Akhan O. , Özmen M. N. , Akata D. 
Published: June 2015

Purpose: To evaluate the ultrasonographic and CT findings of tuberculous peritonitis. Material and Methods: Ultrasonographic and CT findings of 11 patients with the ascitic type of tuberculous peritonitis were reviewed. Results: All patients had ascites, and ultrasonography (US) demonstrated fine complete and incomplete mobile septations in 10 patients. In 5 of them, the ascites had a lattice-like appearance. Diffuse regular peritoneal thickening was detected in all patients by CT and in 10 patients by US. CT demonstrated infiltration of the greater omentum in 9 patients, whereas US showed omental thickening in only 5 patients. Conclusion: Peritoneal and omental thickening detected by CT and ascites with fine, mobile septations shown by US strongly suggest the ascitic type of tuberculous peritonitis. The 2 imaging modalities should be used together for accurate diagnosis of tuberculous peritonitis.
Reproducibility of Doppler Ultrasound Measurements
Authors: Mikkonen R. H. M. , Kreula J. M. , Virkkunen P. J. 
Published: June 2015

Purpose: The reproducibility of Doppler ultrasound measurements was studied in a group of radiologists with different experience of such measurements. Material and Methods: The 12 participating radiologists measured peak systolic velocity (PSV), resistance index (RI), and pulsatility index (PI) from 3 arteries and PSV alone in one artery of a healthy person under standardized circumstances. Each participant repeated the measurements 10 times. Results: Significant (p<0.005) interobserver variation was seen in all of the variables, with an up to 14-fold difference in the PSV values measured and most variation resulting from differences between observers. The reproducibility of RI was better, most variation being within observers. Experience improved the reproducibility of the Doppler US measurements. Significant difference (p<0.05) in Doppler US measurements was seen between the 3 experience groups. The difference was marked between the highly experienced and the medium experienced group when the variances of the measured values of PSV, RI, and PI from all 4 arteries were combined. Conclusion: The reproducibility of Doppler ultrasound measurements is poor. The value of the method is questionable.
Degenerative Changes following Anterior Cervical Discectomy and Fusion Evaluated by Fast Spin-Echo MR Imaging
Authors: Wu W. , Thuomas K.-Å. , Hedlund R. , Leszniewski W. , Vavruch L. 
Published: June 2015

Purpose: To review pre- and postoperative fast spin-echo (FSE) MR images of disc herniation and spondylosis in patients after spinal cervical surgery. Material and Methods: Data were reviewed of 68 patients after anterior discectomy and fusion (ADF) operations using the Cloward technique with solid single level (C5–C6 or C6–C7) or 2-level fusions (C5–C7). The average interval from surgery to review was 37 months. Age- and sex-matched controls without neck problems were examined. Results: Preoperatively, the fusion groups had a higher incidence of protruded disc, and anterior and posterior osteophytes at the levels to be fused than the controls. Postoperatively, there was a significantly higher incidence of posterior osteophytes at the fused levels compared with the controls. Furthermore, the disc herniations and anterior osteophytes at the levels above and below the operated segments were more frequent in the fusion group. Conclusion: ADF causes acceleration of the degenerative changes at the fused level and at the levels below and above the fused segments.
CT Findings in General Practice Patients with Suspected Acute Sinusitis
Authors: Lindbæk M. , Johnsen U. L.-H. , Kaastad E. , Dølvik S. , Møll P. , Lærum E. , Hjortdahl P. 
Published: June 2015

Purpose: To study CT findings in general practice patients with a clinical diagnosis of acute sinusitis, and to examine the interobserver variation between 2 radiologists with regard to their CT evaluation. Material and Methods: Two hundred and one patients were examined with coronal CT images of the paranasal sinuses within 2 days of the clinical diagnosis. Patients with chronic sinusitis were excluded. Fluid level or total opacification of any sinus were used as evidence of sinusitis. Results: One hundred and twenty-seven (63%) patients had fluid level or total opacification in a sinus region, most in more than one region. One hundred and fifteen had CT signs of sinusitis in the ethmoid region, 84 in the maxillary, 18 in the frontal, and 10 in the sphenoid. Forty-nine patients had a negative CT. In the evaluation of interobserver agreement, the overall assessment of the CT yielded a kappa value of 0.70. Conclusion: The study demonstrated great variation in the CT findings in general practice patients with suspected acute sinusitis. More than one sinus region was affected in most patients in whom sinusitis was confirmed by CT imaging; the most common combination was ethmoid and maxillary sinuses. The interobserver agreement was substantial.
Susceptibility Contrast Imaging of CO2-Induced Changes in the Blood Volume of the Human Brain
Authors: Rostrup E. , Larsson H. B. W. , Toft P. B. , Garde K. , Ring P. B. , Henriksen O. 
Published: June 2015

Purpose: To investigate changes in the regional cerebral blood volume (rCBV) in human subjects during rest and hypercapnia by MR imaging, and to compare the results from contrast-enhanced and noncontrast-enhanced susceptibility-weighted imaging. Material and Methods: Five healthy volunteers (aged 24–29 years) were studied during inhalation of atmospheric air and 7% CO2. A bolus injection of Gd-DTPA was given during the acquisition of a series of susceptibility-weighted, fast gradient echo images (TR/TE=27/22 ms). The images were converted to ΔR2* maps, and CBV was calculated pixelwise by fitting a gamma-variate function to the data. The tissue concentration vs time curves were deconvoluted using an input function obtained by arterial sampling. Results: The ratio of gray to white matter CBV (1.9–2.5) as well as the fractional increase in rCBV during hypercapnia (about 30%) was found to be in accordance with results obtained by other methods. Noncontrast functional MR (fMR) imaging showed signal increases in gray matter, but also inconsistent changes in some white matter regions. Conclusion: In this experiment, contrast-enhanced imaging seemed to show a somewhat higher sensitivity towards changes in cerebral hemodynamics than noncontrast-enhanced imaging. The results of the deconvolution analysis suggested that perfusion calculation by conventional tracer kinetic methods may be impracticable because of nonlinear effects in contrast-enhanced MR imaging.
Inter-rater reliability and face validity of the Executive Function Performance Test (EFPT)
Authors: Cederfeldt Marie , Carlsson Gunnel , Dahlin–Ivanoff Synneve , Gosman–Hedstrom Gunilla 
Published: June 2015

Introduction Occupational therapists need an instrument to assess executive dysfunctions before patients are discharged from acute wards. The Executive Function Performance Test (EFPT) appears to be suitable, since it evaluates dysfunctions in complex activities. The aim of this study was to translate the EFPT from English into Swedish and to evaluate its properties when used with older persons with mild stroke in an acute setting. Method The study consisted of three parts: (1) a translation procedure using a forward and backward method; (2) evaluation of face validity; (3) inter-rater reliability by four raters (two pairs) who made 34 assessments in 17 older patients with mild stroke in an acute ward. Results The inter-rater reliability for the EFPT was good. The median was 88% of the percentage agreement. No occasional disagreement was found between the raters, but there was a systematic disagreement in one out of 20 items. The translation and face validity process resulted in further clarification of the semantic and cultural equivalence of the EFPT, and the manual was changed accordingly. Conclusion This study showed that inter-rater reliability was good and that the EFPT was found to be an interesting assessment, although further research is needed.
Post hoc subgroups in clinical trials: Anathema or analytics?
Authors: Weisberg Herbert I , Pontes Victor P 
Published: June 2015

Background: There is currently much interest in generating more individualized estimates of treatment effects. However, traditional statistical methods are not well suited to this task. Post hoc subgroup analyses of clinical trials are fraught with methodological problems. We suggest that the alternative research paradigm of predictive analytics, widely used in many business contexts, can be adapted to help. Methods: We compare the statistical and analytics perspectives and suggest that predictive modeling should often replace subgroup analysis. We then introduce a new approach, cadit modeling, that can be useful to identify and test individualized causal effects. Results: The cadit technique is particularly useful in the context of selecting from among a large number of potential predictors. We describe a new variable-selection algorithm that has been applied in conjunction with cadit. The cadit approach is illustrated through a reanalysis of data from the Randomized Aldactone Evaluation Study trial, which studied the efficacy of spironolactone in heart-failure patients. The trial was successful, but a serious adverse effect (hyperkalemia) was subsequently discovered. Our reanalysis suggests that it may be possible to predict the degree of hyperkalemia based on a logistic model and to identify a subgroup in which the effect is negligible. Conclusion: Cadit modeling is a promising alternative to subgroup analyses. Cadit regression is relatively straightforward to implement, generates results that are easy to present and explain, and can mesh straightforwardly with many variable-selection algorithms.
Investigation of the sorption of mercury vapour from exhaust gas by an Ag-X zeolite
Authors: Wdowin Magdalena , Macherzyński Mariusz , Panek Rafał , Górecki Jerzy , Franus Wojciech 
Published: June 2015

AbstractThe removal of gaseous mercury from flue gases from coal-fired power plants is currently an environmental challenge under investigation. Therefore, the main aim of this paper was to evaluate the suitability of faujasite group zeolites (Na-X) to adsorb mercury compounds. Previous, initial tests showed negligible Hg0 uptake by Na-X zeolite, but silver impregnation improved adsorption markedly. Therefore, the testing of mercury adsorption from flue gases into Ag+- impregnated Na-X synthetic zeolite (Ag-X zeolite) derived from coal fly ash was carried out. This material was characterized by X-ray diffraction, scanning electron microscopy and energy dispersive spectroscopy, X-ray fluorescence and nitrogen adsorption/desorption before being evaluated for mercury removal from exhaust gas. After preliminary mercury adsorption tests (fixed bed) under a nitrogen atmosphere, the adsorbent was examined with a simulated flue gas composition under various conditions, i.e. weight of zeolite, temperature of experiment and zeolite in powder and granulated forms. The removal of mercury was shown to depend on the sorbent texture (powder or granulate), exhaust gas flow rate and contact time, as well as the temperature of the experiment. The Ag-X zeolite tested reduced the level of mercury in the flue gas and, depending on the experimental conditions, long-time mercury breakthrough ranges from 15 to 40% were obtained. The best results for mercury capture were obtained for granulated material.
Removal of Reactive Black 5 from wastewater using natural clinoptilolite modified with apolaccase
Authors: Nadaroglu Hayrunnisa , Kalkan Ekrem , Celebi Neslihan , Tasgin Esen 
Published: June 2015

AbstractIn this study, a clinoptilolite modified with apolaccase was used to adsorb Reactive Black 5 (RB5) dye from aqueous solution using the batch procedure. The influences of pH, contact time, temperature and absorbent dosage on the adsorption were investigated. The optimum adsorption was obtained at pH = 6, contact time = 60 min, temperature = 25ºC and adsorbent dosages of 1.62 and 1.59 mg/50 mL per gram of clinoptilolite and of apolaccase-modified clinoptilolite (LMC), respectively). The adsorption experimental data fitted both the Langmuir and Freundlich isotherm models well. In addition, pseudo-first-order and pseudo-second-order kinetics were used to study the kinetics of RB5 dye adsorption onto natural clinoptilolite and LMC. Adsorption appears to follow pseudo-second-order kinetics with a high correlation coefficient. Thermodynamic parameters such as changes in the free energy (ΔG°), enthalpy (ΔH°) and entropy (ΔS°) of adsorption were calculated. The thermodynamic parameters indicate that the adsorption of RB5 dye onto LMC was less spontaneous, feasible and endothermic. The LMC can be used as an alternative low-cost adsorbent for the dye removal from aqueous solutions.
Protective effect of cytotoxic T lymphocytes targeting HTLV-1 bZIP factor
Authors: Sugata Kenji , Yasunaga Jun-ichirou , Mitobe Yuichi , Miura Michi , Miyazato Paola , Kohara Michinori , Matsuoka Masao 
Published: June 2015

Key PointsVaccination with HBZ can induce cytotoxic T lymphocytes and suppress an HBZ-expressing lymphoma cell line in vivo. Immunodominant epitopes of HBZ have been identified in mice, monkeys, and humans.
Enhanced Antifungal Activity by Ab-Modified Amphotericin B-Loaded Nanoparticles Using a pH-Responsive Block Copolymer
Authors: Tang Xiaolong , Dai Jingjing , Xie Jun , Zhu Yongqiang , Zhu Ming , Wang Zhi , Xie Chunmei , Yao Aixia , Liu Tingting , Wang Xiaoyu , Chen Li , Jiang Qinglin , Wang Shulei , Liang Yong , Xu Congjing 
Published: June 2015

Abstract
Fungal infections are an important cause of morbidity and mortality in immunocompromised patients. Amphotericin B (AMB), with broad-spectrum antifungal activity, has long been recognized as a powerful fungicidal drug, but its clinical toxicities mainly nephrotoxicity and poor solubility limit its wide application in clinical practice. The fungal metabolism along with the host immune response usually generates acidity at sites of infection, resulting in loss of AMB activity in a pH-dependent manner. Herein, we developed pH-responsive AMB-loaded and surface charge-switching poly(d,l-lactic-co-glycolic acid)-b-poly(l-histidine)-b-poly(ethylene glycol) (PLGA-PLH-PEG) nanoparticles for resolving the localized acidity problem and enhance the antifungal efficacy of AMB. Moreover, we modified AMB-encapsulated PLGA-PLH-PEG nanoparticles with anti-Candida albicans antibody (CDA) (CDA-AMB-NPs) to increase the targetability. Then, CDA-AMB-NPs were characterized in terms of physical characteristics, in vitro drug release, stability, drug encapsulation efficiency, and toxicity. Finally, the targetability and antifungal activity of CDA-AMB-NPs were investigated in vitro/in vivo. The result demonstrated that CDA-AMB-NPs significantly improve the targetability and bioavailability of AMB and thus improve its antifungal activity and reduce its toxicity. These NPs may become a good drug carrier for antifungal treatment.
Cost effectiveness of lanthanum carbonate in chronic kidney disease patients in Spain before and during dialysis
Authors: Gros Blanca , Galán Antonio , González-Parra Emilio , Herrero Jose A , Echave Maria , Vegter Stefan , Tolley Keith , Oyagüez Itziar 
Published: June 2015

Abstract

AIMS
In Spain, the first line treatment of hyperphosphatemia in Chronic Kidney Disease (CKD) consists of calcium-based phosphate binders (CB). However, their use is associated with vascular calcification and an increased mortality risk. The aim of this study was to assess the incremental cost-effectiveness of second-line Lanthanum Carbonate (LC) treatment in patients not responding to CB (calcium carbonate and calcium acetate).

Material and methods
A lifetime Markov model was developed considering three health states (predialysis, dialysis and death). Transitions between states and efficacy data were obtained from randomized clinical trials and the European Dialysis and Transplant Association Annual report. Mortality rate was adjusted with the relative risk related to serum phosphorus levels.
According to the Spanish healthcare system perspective, only medical direct costs were considered. Dialysis costs (2013 prices in Euros) were obtained from diagnosis-related groups. Drug costs were derived from ex-factory prices, adjusted with 7.5% mandatory rebate. Quality of life estimates were based on a published systematic review. Costs and benefits were discounted at 3%. Deterministic and probabilistic sensitivity analyses (PSA) were conducted.

Results
At the end of simulation, costs per patient with LC therapy were €1,169 and €5,044 with CB alone. 4.653 Quality Adjusted Life Years (QALYs) were gained per patient treated with LC, and 4.579 QALYs with CB. CB therapy is dominated by the LC strategy (i.e. lower costs, higher QALYs). Assuming a €30,000/QALY threshold, LC was dominant in 100% of PSA simulations.

Conclusions
LC is a cost-effective second line treatment of hyperphosphatemia in CKD patients irrespective of dialysis status in Spain.