bluuebunny/crossref_metadata_2025_split huggingface dataset:
Latissimus dorsi muscle free flap revisited: A novel endoscope‐assisted approach
Authors: Cha Wonjae , Jeong Woo‐Jin , Ahn Soon‐Hyun 
Published: February 2013

AbstractObjectives/Hypothesis:Achieving a functionally favorable and aesthetically acceptable outcome in oncologic and reconstructive surgery is important in the current era. Latissimus dorsi (LD) flap is traditionally performed with a large incision in lateral position. We report an endoscope‐assisted harvest of LD muscle free flap in supine position to avoid a large scar and facilitate a two‐team approach for oral cavity reconstruction.Study Design:Consecutive case series.Methods:Four consecutive patients underwent LD muscle free flap for various oral cavity reconstructions. LD muscle free flaps were harvested under endoscope assistance.Results:Endoscope‐assisted LD free‐flap harvest allowed a small incision in the axillary pit, which can be easily concealed without change of patient position, resulting in shortened operative time. Endoscopic harvest caused no acute complications, and donor site morbidity was minimal. Reconstructions with endoscope‐assisted LD muscle free flap of the oral cavity defect site were successful in all cases.Conclusions:Endoscope‐assisted LD muscle free flap is a feasible and practical option for the reconstruction of selective oral cavity defects with aesthetically excellent donor site scar. Laryngoscope, 2013
Frozen margin analysis as a prognosis predictor in early glottic cancer by laser cordectomy
Authors: Fang Tuan‐Jen , Courey Mark S. , Liao Chun‐Ta , Yen Tsu‐Chen , Li Hsueh‐Yu 
Published: February 2013

Objectives/HypothesisThe impact of margin status on the outcomes of early glottic cancer after endoscopic resection is controversial; second look laryngoscopy has shown a low rate of residual cancer, even in margin positive patients. Intraoperative frozen section analysis has been suggested as an alternative to routine second look procedures. The aim of this study was to evaluate and search for predictors of outcomes in patients following endoscopic resection based on intraoperative frozen section margin analysis.Study DesignRetrospective chart review.MethodsRecords of consecutive patients treated for early glottic cancer by endoscopic resection with the CO2 laser were evaluated for margin status at the time of intervention, disease recurrence rate, and survival data. Kaplan‐Meir survival rates were determined and subgroups were compared with log‐rank test and Chi‐square test.ResultsFrom February 2004 to September 2011, 75 consecutive patients with complete records were identified. The 5‐year overall survival rate and the disease‐specific survival rate are 84 and 98%, respectively. Recurrence within 12 months (P = 0.019) and initially positive frozen section margins, despite enlarging the cordectomy field to obtain negative margins (P = 0.001), were determined to be predictors for poor overall survival.ConclusionsIn endoscopic resection of early glottic cancer with the CO2 laser, initial intraoperative frozen section margin involvement during the primary resection and early local recurrence are poor signs for overall survival.Level of Evidence4.
Lipomas of the cerebellopontine angle and internal auditory canal
Authors: White James R. , Carlson Matthew L. , Van Gompel Jamie J. , Neff Brian A. , Driscoll Colin L. , Lane John I. , Link Michael J. 
Published: February 2013

Objectives/HypothesisTo describe the presentation and clinical course of cerebellopontine angle (CPA) and internal auditory canal (IAC) lipomas.Study DesignRetrospective cohort study at a tertiary academic referral center.MethodsAll patients presenting with a CPA or IAC mass radiographically consistent with a lipoma on high‐resolution magnetic resonance imaging (MRI) were identified. Data including presenting symptomatology, tumor characteristics, management strategy, and patient course were collected.ResultsBetween 1996 and 2012, 15 patients were diagnosed with a CPA or IAC lipoma at the authors' institution and were included in the analysis. The mean duration of radiological and clinical follow‐up was 3.4 years and 5.1 years, respectively. Eight lesions were confined to the IAC, while seven involved the CPA. The median tumor size at diagnosis was 7.2 mm; one patient demonstrated tumor growth on serial MRI while the remaining subjects did not have radiological progression. The most common presenting symptoms were sensorineural hearing loss (40%) and tinnitus (33%); five patients were diagnosed after incidental discovery on MRI. Fourteen patients were managed with observation, while one subject underwent subtotal resection. None of the observed patients reported worsening symptoms at last follow‐up.ConclusionsWhile rare, lipomas should be included in the differential diagnosis of CPA and IAC lesions. Owing to a generally benign clinical course and high morbidity associated with resection, microsurgery should only be considered in cases of definite tumor enlargement with intractable symptoms from mass effect. Careful radiological evaluation is critical for establishing an accurate diagnosis in order to prevent unnecessary morbidity associated with resection.Level of Evidence2b.
A Faith‐ and Community‐Based Approach to Identifying the Individual at Risk for Head and Neck Cancer in an Inner City
Authors: Carter John M. , Winters Ryan D. , Lipin Rosa , Lookabaugh Sara , Cai David , Friedlander Paul L. 
Published: February 2013

Objectives/HypothesisTo perform a subset analysis of faith‐ and community‐based screening events to further identify at‐risk populations for head and neck cancer in hopes of further focusing screening efforts.Study DesignProspective cohort study.MethodsThree hundred fifty‐three individuals (n=353) presented to community events and self‐selected for head and neck cancer screenings. A subgroup analysis focusing on risk factors for the development of head and neck cancer and for poor overall prognosis was performed. Subgroups analyzed were individuals screened at church‐affiliated events, social events, or community outreach events at homeless shelters. Statistical analysis was performed using one‐tailed analysis of variance test.ResultsThe outreach group had more risk factors for development of cancer, and a significantly higher proportion who used tobacco (P<.05) and consumed >1 drink/day (P<.05). Those in the outreach and church groups had a greater number of risk factors for a poor prognosis with and neck cancer in comparison with the social group: number of uninsured subjects (P<.05), fewer subjects with private insurance (P<.05), fewer subjects with a primary care provider (P<.05), and more subjects with a reported barrier to care (P<.05).ConclusionsInhabitants of homeless shelters represent a particularly vulnerable population for both the development and poor prognosis of head and neck cancer. Members of urban church groups are also an at‐risk subpopulation due to the prevalence of poor prognostic risk factors. These groups may benefit from future targeted screenings for head and neck cancer.Level of Evidence2 b
Legal Liability in Iatrogenic Orbital Injury
Authors: Svider Peter F. , Kovalerchik Olga , Mauro Andrew C. , Baredes Soly , Eloy Jean Anderson 
Published: February 2013

Objectives/HypothesisIn this study, we detailed factors governing legal outcomes in iatrogenic orbital injury, with the purpose of discussing strategies to minimize liability and enhance patient safety.Study DesignRetrospective analysis.MethodsJury verdict and settlement reports were searched from publically available federal and state court records using the Westlaw database (Thomson Reuters, New York, NY). After exclusion of nonrelevant cases, 20 cases of iatrogenic orbital injuries were examined for factors such as legal outcome, damages awarded, defendant specialty, alleged causes of malpractice, and patient demographic information.ResultsThe majority (60.0%) of cases were resolved in the defendant's favor. Payment was considerable for the cases decided in support of the plaintiff, averaging $1.13 million. Out‐of‐court settlements averaged $1.78 million (range, $487,500–$3.9 million), whereas jury‐awarded damages averaged $472,661 (range, $75,000–$763,214). Complications stemming from endoscopic sinus surgery were most common (50.0%). Diplopia was the most common medical complaint (50.0%), whereas permanent deficits and having to undergo additional surgery were each present in 65.0% of cases.ConclusionsThe potential for permanent sequelae of iatrogenic orbital injury makes this complication susceptible to malpractice litigation. Otolaryngologists were the most common defendants. Although cases were resolved in the defendant's favor 60% of the time, payments made were considerable, averaging $1.13 million. Steps to minimize liability and improve patient safety include an informed consent process explicitly listing risks, including diplopia and blindness, and obtaining timely ophthalmology consultation when a complication is recognized.Level of EvidenceNA Laryngoscope, 123:2099–2103, 2013
Associations between obesity and inflammatory sinonasal disorders
Authors: Bhattacharyya Neil 
Published: February 2013

Objectives/HypothesisDetermine whether adult obesity is associated with chronic rhinosinusitis (CRS) and/or allergic rhinitis (AR).Study DesignCross‐sectional analysis of medical panel survey.MethodsThe Medical Expenditure Panel Survey, a large‐scale household‐based survey of health care utilization in the United States (2008 and 2010) was examined, identifying adult cases of CRS and AR. The presence or absence of obesity (body mass index ≥ 30 kg/m2) was determined. Adjusting for age, sex, race, geographic region, insurance coverage, and Charlson Comorbidity Index, odds ratios for the presence of CRS and/or AR in the presence of obesity were determined. The relations between body mass index as a linear variable and the presence of CRS and AR were determined.ResultsA total of 17.6 ± 0.6 million adults reported AR (7.7% ± 0.3%) and 13.0 ± 0.5 million reported CRS (5.7% ± 0.2%; weighted estimates). Additionally, 64.9 ± 1.4 million adults (29.0% ± 0.4%) were classified as obese based on body mass index. The adjusted odds ratio for AR when obesity was present was 1.22 (P < .001, 95% confidence interval = 1.12–1.33). The adjusted odds ratio for CRS when obesity was present was 1.31 (P < .001, 95% confidence interval = 1.18–1.45). Increasing body mass index as a continuous variable was significantly associated with the presence of both AR (odds ratio = 1.023, P < .001) and CRS (odds ratio = 1.022, P < .001).ConclusionsThe current data demonstrate an increased prevalence of adult obesity associated with both AR and CRS.Level of Evidence2b. Laryngoscope, 123:1840–1844, 2013
Long‐term depression‐like plasticity of the blink reflex for the treatment of blepharospasm
Authors: Kranz Gottfried , Shamim Ejaz A. , Lin Peter T. , Kranz George S. , Hallett Mark 
Published: February 2013

ABSTRACTOur previous work showed a beneficial therapeutic effect on blepharospasm using slow repetitive transcranial magnetic stimulation, which produces a long‐term depression (LTD)‐like effect. High‐frequency supraorbital electrical stimulation, asynchronous with the R2 component of the blink reflex, can also induce LTD‐like effects on the blink reflex circuit in healthy subjects. Patients with blepharospasm have reduced inhibition of their blink recovery curves; therefore, a LTD‐like intervention might normalize the blink reflex recovery (BRR) and have a favorable therapeutic effect. This is a randomized, sham‐controlled, observer‐blinded prospective study. In 14 blepharospasm patients, we evaluated the effects of high‐frequency supraorbital stimulation on three separate treatment days. We applied 28 trains of nine stimuli, 400 Hz, either before or after the R2 or used sham stimulation. The primary outcome was the blink rate, number of spasms rated by a blinded physician and patient rating before, immediately after and 1 hour after stimulation while resting, reading, and talking; secondary outcome was the BRR. Stimulation “before” and “after” the R2 both showed a similar improvement as sham stimulation in physician rating, but patients felt significantly better with the before condition. Improvement in recovery of the blink reflex was noted only in the before condition. Clinical symptoms differed in the three baseline conditions (resting, reading, and talking). Stimulation before R2 increased inhibition in trigeminal blink reflex circuits in blepharospasm toward normal values and produced subjective, but not objective, improvement. Inhibition of the blink reflex pathway by itself appeared to be insufficient for a useful therapeutic effect. © 2013 Movement Disorder Society
The spectrum of movement disorders in children with anti‐NMDA receptor encephalitis
Authors: Baizabal‐Carvallo José Fidel , Stocco Amber , Muscal Eyal , Jankovic Joseph 
Published: February 2013

ABSTRACTBackgroundMovement disorders are frequent but difficult to characterize in patients with anti‐N‐methyl‐d‐aspartate receptor (NMDAR) encephalitis.MethodsThe phenomenology of movement disorders was characterized after a detailed examination of children with anti‐NMDAR‐encephalitis.ResultsWe studied 9 children (5 females), ages 3–14 years, with confirmed anti‐NMDAR‐encephalitis. All patients presented with at least 1 movement disorder, including chorea (n=4), stereotypic movements (n=4), ataxia (n=3), limb dystonia (n=2), limb myorhythmia (n=2), oromandibular dystonia (n=2), facial myorhythmia, blepharospasm, opisthotonus, athetosis, and tremor (n=1, each). More than a single movement disorder was observed in 6 of these patients. Resolution of the abnormal movements was observed in all patients with immunotherapy; 1 patient improved with tetrabenazine.ConclusionsA wide variety of movement disorders, often in combination, can be observed in children with anti‐NMDAR encephalitis. Patients commonly present with more than a single movement disorder. © 2013 Movement Disorder Society
Pilot study of H2 therapy in Parkinson's disease: A randomized double‐blind placebo‐controlled trial
Authors: Yoritaka Asako , Takanashi Masashi , Hirayama Masaaki , Nakahara Toshiki , Ohta Shigeo , Hattori Nobutaka 
Published: February 2013

BackgroundOxidative stress is involved in the progression of Parkinson's disease (PD). Recent studies have confirmed that molecular hydrogen (H2) functions as a highly effective antioxidant in cultured cells and animal models. Drinking H2‐dissolved water (H2‐water) reduced oxidative stress and improved Parkinson's features in model animals.MethodsIn this a placebo‐controlled, randomized, double‐blind, parallel‐group clinical pilot study, the authors assessed the efficacy of H2‐water in Japanese patients with levodopa‐medicated PD. Participants drank 1,000 mL/day of H2‐water or pseudo water for 48 weeks.ResultsTotal Unified Parkinson's Disease Rating Scale (UPDRS) scores in the H2‐water group (n=9) improved (median, −1.0; mean±standard deviation, −5.7±8.4), whereas UPDRS scores in the placebo group (n=8) worsened (median, 4.5; mean±standard deviation, 4.1±9.2). Despite the minimal number of patients and the short duration of the trial, the difference was significant (P<0.05).ConclusionsThe results indicated that drinking H2‐water was safe and well tolerated, and a significant improvement in total UPDRS scores for patients in the H2‐water group was demonstrated. © 2013 Movement Disorder Society
Developing dopaminergic cell therapy for Parkinson's disease—give up or move forward?
Authors: Lindvall Olle 
Published: February 2013

ABSTRACTDespite 3 decades of basic and clinical studies, there is still no dopaminergic cell therapy for Parkinson's disease. Several arguments have been put forward why this approach, so far tested with transplantation of human fetal mesencephalic dopamine‐rich tissue, will never be of clinical use and should be abandoned: (1) Lack of efficacy in 2 sham surgery‐controlled trials; (2) occurrence of troublesome off‐medication dyskinesias in a subgroup of grafted patients; (3) disease process destroys grafted neurons; and (4) non‐motor symptoms will not be influenced by intrastriatal dopaminergic grafts. Here, the author argues that, based on recent scientific advancements, the development of a dopaminergic cell therapy for Parkinson's disease should continue. Factors influencing the outcome after transplantation have now been identified, and dopaminergic neurons can be generated in large numbers from stem cells. Mechanisms of graft‐induced dyskinesias are much better understood, and patients with well functioning grafts can exhibit long‐term motor recovery of therapeutic value even in the presence of non‐motor symptoms. © 2013 Movement Disorder Society
Cyclic Systems Distribution Along Similarity Measures: Insights for an Application to Activity Landscape Modeling
Authors: Pérez‐Villanueva Jaime , Méndez‐Lucio Oscar , Soria‐Arteche Olivia , Izquierdo Teresa , Concepción Lozada M. , Gloria‐Greimel Walter A. , Medina‐Franco José L. 
Published: February 2013

AbstractThe emerging concept of the activity landscape has been widely applied for structureactivity relationships (SAR) characterization. Since chemical space representation plays a crucial role in activity landscape modeling, an adequate selection of similarity measures is desirable. Herein a set of 658 cyclooxygenase inhibitors were structurally analyzed using 12 molecular similarity representations and two levels of chemotype classification. Then, three uncorrelated similarity measures and mean similarity (obtained with data fusion) were combined with chemotype information using the herein proposed chemotypesimilarity graphs. Chemotype‐similarity graphs showed the cumulative distribution of molecular pairs with the same and different chemotype along similarity values; leading to establish an interpretable, quantitative and activity independent threshold in similarity measures based on chemotype distributions. This approach gave additional information to similarity measures and can be considered as an interpretable criterion to define high and low similar compounds. The results were applied to model the activity landscape using StructureActivity Similarity (SAS)‐like maps. Some examples of pairs in each region of the SAS‐like maps were analyzed which showed valuable SAR information for cyclooxygenase inhibitors.
Multi‐Turn Transmit Coil to Increase B1 Efficiency in Current Source Amplification
Authors: Gudino N. , Griswold M. A. 
Published: February 2013

PurposeA multi‐turn transmit surface coil design was presented to improve B1 efficiency when used with current source amplification.MethodsThree different coil designs driven by an on‐coil current‐mode class‐D amplifier with current envelope feedback were tested on the benchtop and through imaging in a 1.5 T scanner. Case temperature of the power field‐effect transistor at the amplifier output stage was measured to evaluate heat dissipation for the different current levels and coil configurations. In addition, a lower power rated device was tested to exploit the potential gain in B1 obtained with the multi‐turn coil.ResultsAs shown both on the benchtop and in a 1.5 T scanner, B1 was increased by almost 3‐fold without increasing heat dissipation on the power device at the amplifier's output using a multi‐turn surface coil. Similar gain was obtained when connecting a lower power rated field‐effect transistor to the multi‐turn coil.ConclusionIn addition to reduce heat dissipation per B1 in the device, higher B1 per current efficiency allows the use of field‐effect transistors with lower current ratings and lower port capacitances, which could improve the overall performance of the on‐coil current source transmit system. Magn Reson Med 69:1180–1185, 2013. © 2013 Wiley Periodicals, Inc.
Positive Contrast MR Imaging of Tendons, Ligaments, and Menisci by Subtraction of Signals From a Double Echo Steady State Sequence (Sub‐DESS)
Authors: Martirosian Petros , Schraml Christina , Springer Fabian , Schwenzer Nina F. , Würslin Christian , Schick Fritz , Deimling Michael 
Published: February 2013

PurposeTo improve the visualization of fibrous tissues as tendons, ligaments and fibrocartilage structures as menisci by positive contrast using a new 3D Double Echo Steady State (DESS) sequence.MethodsThe proposed 3D DESS sequence works with separate acquisition of a first echo with an echo time (TE1) of 1.2 ms followed by a more heavily T2‐weighted second echo recorded at time TE2. Subtraction of images from both echoes leads to positive signal from fibrous tissues, whereas in other tissues as musculature and fat the subtraction signal nearly vanishes due to almost similar signal strength in both echoes. Systematic measurements in healthy volunteers with different sets of pulse repetition time (TR), TE1, readout bandwidth and flip angle were performed to determine optimal sequence parameters.ResultsThe presented 3D sequence with Cartesian readout requires relatively short measuring time, provides reasonable signal‐to‐noise ratio and can be easily implemented in protocols for clinical musculoskeletal MR imaging. Degenerative changes or tears of tendons, ligaments and fibrocartilage are known to cause increased water content and therefore prolongation of transverse relaxation times, which leads to reduced signal intensities in the “subtraction images.”ConclusionPositive contrast of fibrous tissue as demonstrated by the proposed sub‐DESS approach provides improved conspicuity and allows for three‐dimensional reconstruction especially of structures with curved geometry. Magn Reson Med 71:294–301, 2014. © 2013 Wiley Periodicals, Inc.
Real‐Time Multipoint Gastrointestinal 19‐Fluorine Catheter Tracking
Authors: Hahn Tobias , Kozerke Sebastian , Schwizer Werner , Fried Michael , Boesiger Peter , Steingoetter Andreas 
Published: February 2013

PurposeTo develop MR based real‐time gastrointestinal 19‐Fluorine (19F) catheter tracking and visualization allowing for real‐time detection and feedback of 3D catheter shape and movement as well as catheter‐driven adjustments of 1H imaging geometry parameters.MethodsData were acquired on a 3T clinical system using 3D Golden Angle radial sampling. Two gastrointestinal catheters incorporating four fiducial 19F markers (65 or 50 µL marker volume) were tracked while being pulled through a gel phantom by an operator inside the MR room with velocities of 2–18 mm/s. During continuous acquisition, k‐space profiles were transferred in real‐time to an external computer for concurrent reconstruction of 3D 19F images and detection and visualization of marker positions. Based on αthe marker positions, automatic adjustments of 1H imaging planes to facilitate targeted anatomical scanning was implemented.ResultsMean tracking reliabilities were 94.5 and 83.6% (catheters 1 and 2) for temporal resolutions 185–740 ms. Reconstruction times of 196 ms were achieved. Real‐time visual feedback allowed the operator to accurately control the catheter movement. Catheter‐guidance for 1H imaging was reliable.ConclusionThe presented real‐time 19F MR based framework for the tracking of 19F labeled devices is applicable to combined 19F and 1H MRI guidance of gastrointestinal devices in vivo. Magn Reson Med 71:302–307, 2014. © 2013 Wiley Periodicals, Inc.