bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic value of diffusion‐weighted magnetic resonance imaging compared with fluorodeoxyglucose positron emission tomography/computed tomography for pancreatic malignancy: A meta‐analysis using a hierarchical regression model
Authors: Wu Lian‐Ming , Hu Jia‐Ni , Hua Jia , Liu Man‐Ju , Chen Jie , Xu Jian‐Rong 
Published: March 2012

AbstractBackground and Aim:  To obtain diagnostic performance of diffusion‐weighted magnetic resonance imaging (DWI) and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the detection of pancreatic malignancy.Methods:  We performed a meta‐analysis of all available studies of the diagnostic performance of DWI and PET/CT for pancreatic malignancy. MEDLINE, EMBASE, Cochrane library and some other databases were searched for initial studies. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−), and constructed summary receiver operating characteristic curves (SROC) using hierarchical regression models.Results:  Across 16 studies with 804 patients, PET/CT sensitivity was 0.87 (95% confidence interval [CI], 0.82, 0.81) and specificity was 0.83 (95% CI, 0.71, 0.91). Overall, LR+ was 5.84 (95% CI, 4.59, 7.42) and LR− was 0.24 (95% CI, 0.17, 0.33). DWI sensitivity was 0.85 (95% CI, 0.74, 0.92) and specificity was 0.91 (95% CI, 0.71, 0.98). LR+ was 9.53 (95% CI, 2.41, 37.65) and LR− was 0.17 (95% CI, 0.09, 0.32). In subgroup analysis, the sensitivity of enhanced versus unenhanced PET/CT in the detection of pancreatic cancer was 0.91 (95% CI, 0.86, 0.96) versus 0.84 (95% CI, 0.78, 0.90) (P > 0.05), the specificity 0.88 (95% CI, 0.73, 1.00) versus 0.81 (95% CI, 0.69, 0.94) (P > 0.05).Conclusion:  Positron emission tomography/computed tomography (PET/CT) was highly sensitive and DWI was a highly specific modality in diagnosing patients with pancreatic malignancy. PET/CT and DWI could play different roles in diagnosing pancreatic carcinoma. Enhanced PET/CT seems to be superior to unenhanced PET/CT. Further larger prospective studies are needed to establish its value for diagnosis in pancreatic cancer.
Preliminary study of enteroscopy‐guided, self‐expandable metal stent placement for malignant small bowel obstruction
Authors: Lee Hyuk , Park Jun Chul , Shin Sung Kwan , Lee Sang Kil , Lee Yong Chan 
Published: March 2012

AbstractBackground and Aims:  Technical limitations of conventional endoscopes and delivery systems frequently hamper palliative endoscopic placement of self‐expandable metal stents for malignant small bowel obstruction. This study examined feasibility of the double balloon enteroscope‐guided withdrawal‐reinsertion method as a rescue procedure in patients with failed palliative stent placement for malignant small bowel obstruction.Methods:  We enrolled 19 consecutive patients with small bowel obstruction due to metastatic gastric (n = 15) or colorectal cancer (n = 2), or primary small bowel carcinoma (n = 2), in whom previous attempts to place self‐expandable metal stents using conventional endoscopy had failed. Ten patients had undergone previous gastric surgery. After passing a guide‐wire using an enteroscope with or without the double‐balloon method, the enteroscope was withdrawn. A conventional endoscope was re‐inserted along the guide‐wire, and through‐the‐scope self‐expandable metal stent placement was performed.Results:  Obstruction sites were efferent jejunal loop, proximal jejunum, and third duodenal portion. Technical success was achieved with 94.7% (18/19) of stents, and clinical success occurred with 84.2% (16/19) of patients. The gastric outlet obstruction score (pre‐procedure: 0.68 ± 0.58) increased by one week (2.05 ± 0.52, P < 0.001). Stent migration and restenosis occurred in two (10.5%) and four (21.1%) of 19 stents, respectively. Median stent patency duration was 67 days and median survival was 93 days; these did not differ significantly by palliative chemotherapy (P = 0.76 and 0.67, respectively).Conclusions:  The double‐balloon enteroscopy‐guided method followed by conventional endoscopic self‐expandable metal stent delivery was effective for rescue palliation of malignant small bowel obstruction.
Clinical features and outcomes of primary hepatic neuroendocrine carcinomas
Authors: Park Chan Hyuk , Chung Joo Won , Jang Seon Jung , Chung Moon Jae , Bang Seungmin , Park Seung Woo , Song Si Young , Chung Jae Bock , Park Jeong Youp 
Published: March 2012

AbstractBackground and Aim:  Primary hepatic neuroendocrine carcinomas (PHNECs) are extremely rare, with only about 150 cases having been reported in the English‐language literature. Because of the rarity of PHNECs, its clinical features and treatment outcomes are not well understood. Here, we report our experiences with PHNECs.Methods:  We identified patients diagnosed with PHNEC and analyzed their demographics, baseline laboratory data, tumor characteristics, treatment modalities and outcomes.Results:  A total of 218 consecutive patients were identified with pathologically confirmed neuroendocrine carcinoma. Of these, 12 patients were diagnosed with PHNECs; the median age was 66.5 years (range, 37 to 80 years), and seven patients (58.3%) were male. Two patients who each had a single hepatic mass underwent curative surgical resection. One patient who was of inoperable status at the initial diagnosis because of multiple intrahepatic metastases showed a partial response after the ninth round of systemic chemotherapy and then underwent surgical resection. The median overall survival in the 12 patients was 16.5 months (range, 0.7 to 41.7 months). Three patients who underwent surgical treatment are alive without recurrence for 15.2 months, 18.0 months, and 36.9 months, respectively.Conclusions:  Primary hepatic neuroendocrine carcinoma should be considered as a possible differential diagnosis in the management of hepatic tumors. The liver can be the primary origin of neuroendocrine tumors, and if the tumors are diagnosed as primary hepatic neuroendocrine tumors, surgical resection must be considered for curative treatment.
Improvement in mortality of very low birthweight infants and the changing pattern of neonatal mortality: The 50‐year experience of one perinatal centre
Authors: Battin Malcolm R , Knight David B , Kuschel Carl A , Howie Ross N 
Published: March 2012

Aim:  Neonatology is a relatively new sub‐specialty so we aimed to review survival data in the context of advances in neonatal care.Method:  Review of neonatal survival for very low birthweight babies over the last 50 years.Results:  In the data collected from a single tertiary neonatal unit, survival for babies 501–1000 g improved from below 10% in 1959 to over 60% in 2009. Similarly, survival for babies 1001 to 1500 g has improved from approximately 50% to over 90%. During the study period, death due to extreme prematurity or cardiorespiratory problems, namely respiratory distress syndrome, fell from 90% in 1964 to only 45% of neonatal deaths in 2008.Conclusion:  In addition to reporting the remarkable improvement in neonatal survival over this period, we have highlighted items of historical context.
Odontostomatologic involvement in juvenile localised scleroderma of the face
Authors: Trainito Sabina , Favero Lorenzo , Martini Giorgia , Pedersen Thomas Klit , Favero Vittorio , Herlin Troels , Zulian Francesco 
Published: March 2012

Aim:  Localised scleroderma of the face (LSF) can lead to significant aesthetical and functional abnormalities. Despite their quite frequent clinical observation, the odontostomatologic complications are not thoroughly described. Aim of the study was to describe the clinical features of the most frequent odontostomatologic abnormalities of LSF and to propose clinical and radiologic criteria for the assessment and follow‐up of these complications.Methods:  We performed a cross‐sectional, multicenter study involving a multidisciplinary team formed by paediatric rheumatologists, orthodontists and radiologists. Patients with a diagnosis of LSF underwent a comprehensive rheumatologic evaluation, dental examination, conventional radiology (orthopantomography, teleradiography) and cone beam computed tomography.Results:  16 patients, nine F, seven M, aged 6.5–21.9 years, were investigated. The mean disease duration was 7.7 years, 62.5% had extracutaneous complications. All patients reported at least one odontostomatologic complication. The main alterations were: malocclusion (94%), overgrowth tendency of the anterior lower third of the face (82%), gnatologic alterations (69%), dental anomalies (63%), skeletal asymmetry (56%), bone involvement (50%) and temporomandibular joint involvement (19%).Conclusions:  We found a high incidence of odontostomatologic abnormalities in LSF. Cone beam computed tomography represents a new feasible technique to evaluate and monitor soft and hard tissue changes in LSF. The observed findings highlight the importance of a multidisciplinary and standardised management of this challenging and rare condition.
Outcomes of herniotomy in premature infants: Recent 10 year experience
Authors: Takahashi Atsushi , Toki Fumiaki , Yamamoto Hideki , Otake Sayaka , Oki Yasushi , Kuwano Hiroyuki 
Published: March 2012

AbstractBackground:  The timing of herniotomy in premature infants is controversial.Methods:  Outcomes of herniotomy in 47 premature infants admitted to the neonatal intensive care unit (NICU) were retrospectively reviewed for preoperative clinical features, respiratory interventions, and anesthetic and surgical complications. The data were compared with those of full‐term infants (n= 52). Fourteen of the premature infants underwent herniotomy before NICU discharge and 33 after discharge. The predictive factors for anesthetic and surgical complications were also investigated via multiple regression analysis.Results:  Mean post‐conceptional age at surgery in premature infants and full‐term infants was 47 weeks and 50 weeks, respectively. Mean bodyweight at surgery in those infants was 4087 g and 5454 g, respectively. The rate of incarcerated hernia and emergency surgery was lower in premature infants. Delayed extubation of the tracheal tube after surgery was noted in four premature infants, but not in full‐term infants. Two cases of cryptorchidism in premature infants and one recurrence in a full‐term infant that required reoperation were noted. On multiple regression analysis no factor (including respiratory interventions) was found to be capable of predicting complications.Conclusion:  Although no predictive factor for complications was identified, there were some anesthetic and surgical complications in premature infants. If there is no risk of incarceration, herniotomy in premature infants should be performed at a time when the risk of anesthetic complications is decreased. If there is a risk of incarcerated hernia, herniotomy should be performed carefully in order to avoid occurrence of anesthetic and surgical complications.
Ovarian ligament adenomyoma: Report of a rare entity with review of the literature
Authors: Sisodia Shantilal M. , Khan Wasif Ali Z. A. , Goel Aparajita 
Published: March 2012

AbstractAdenomyoma is a benign tumor composed of endometrial glands, specialized endometrioid stroma, and smooth muscle. These tumors typically originate within the uterus. An extrauterine adenomyoma is an extremely rare entity. We present the case of a 56‐year‐old perimenopausal woman with a right adnexal mass, diagnosed histopathologically as an ovarian ligament adenomyoma. This report documents a fourth case of an extrauterine adenomyoma and only the second case in ovarian ligament. The differential diagnosis includes endometrioma, leiomyomatosis peritonealis disseminata, uterus‐like mass lesion and extrauterine leiomyoma with entrapped endometrioid glands and stroma. Two theories for the etiology of adenomyoma have been proposed: (i) Müllerian duct fusion defect and (ii) metaplasia.
Risk factors of treatment discontinuation due to uterine bleeding in adenomyosis patients treated with dienogest
Authors: Nagata Chie , Yanagida Satoshi , Okamoto Aikou , Morikawa Asuka , Sugimoto Kohei , Okamoto Shigehisa , Ochiai Kazunori , Tanaka Tadao 
Published: March 2012

AbstractAim:  Adenomyosis patients treated with dienogest are considered to be at higher risk of uterine bleeding; however, the mechanisms which cause severe uterine bleeding in those patients are unknown. This study aims to investigate the risk factors of uterine bleeding among adenomyosis patients treated with dienogest.Material and Methods:  Clinical data of 51 adenomyosis patients treated with dienogest were retrospectively collected from their medical records. The impact of potential risk factors (age, sagittal square area of the uterus before treatment, and estradiol at the third month of treatment) and confounders (hemoglobin before treatment and prior medical treatments) on the time to treatment discontinuation due to uterine bleeding was assessed using log–rank tests and a Cox proportional hazard model.Results:  Age (<38 years, P = 0.004), hemoglobin before treatment (<12 g/dL, P = 0.047), and estradiol at the third month of treatment (≥60 pg/mL, P = 0.027) had statistically significant effects on the time to treatment discontinuation due to uterine bleeding. Age was still statistically significant after controlling for hemoglobin (P = 0.023).Conclusion:  Adenomyosis patients treated with dienogest are at higher risk of treatment discontinuation due to uterine bleeding, especially when they are of younger age, have anemia before treatment, and/or have mildly suppressed or unsuppressed estradiol after they started dienogest treatment. Clinicians should pay special attention when they prescribe dienogest for such patients.
Endometrial stromal sarcoma arising from endometriosis of the terminal ileum: The role of immunohistochemistry in the differential diagnosis
Authors: Biliatis Ioannis , Akrivos Nikolaos , Sotiropoulou Maria , Rodolakis Alexandros , Simou Maria , Antsaklis Aris 
Published: March 2012

AbstractLow‐grade endometrial stromal sarcoma (LESS) is an uncommon uterine malignancy. Occasionally, it may develop in extrauterine endometriotic lesions and present morphological characteristics mimicking various neoplasms, making its diagnosis very challenging. We report a rare case of a 56‐year‐old woman presenting with a pelvic mass, initially presumed to be of ovarian origin. After surgical excision the diagnosis of a LESS arising from foci of endometriosis of the terminal ileum was established. Pelvic lymph nodes and omentum were also infiltrated. The patient received adjuvant chemotherapy and medroxyprogesterone; she is alive with no evidence of disease after a follow‐up of 38 months. Immunohistochemical characteristics of the tumor are very important for the differential diagnosis of this rare neoplasm and include diffuse strong positivity for CD 10, estrogen receptor expression and CD 34 negativity.
Guidelines for office gynecology in Japan: Japan Society of Obstetrics and Gynecology and Japan Association of Obstetricians and Gynecologists 2011 edition
Authors: Takeda Takashi , Wong Tze Fang , Adachi Tomoko , Ito Kiyoshi , Uehara Shigeki , Kanaoka Yasushi , Kamada Masaharu , Kitagawa Hiroaki , Koseki Satoshi , Gomibuchi Hideto , Saito Juichiro , Shirasu Kazuhiro , Sueoka Kou , Sugimoto Mitsuhiro , Suzuki Mitsuaki , Sumi Toshiyuki , Takeda Satoru , Tasaka Keiichi , Noguchi Yasuyuki , Fujii Shunsaku , Fujii Tsuneo , Fujiwara Michihisa , Maeda Tsugio , Matsumoto Koji , Momoeda Mikio , Morita Mineto , Yoshimura Kazuaki , Hirai Yasuo , Kubota Toshiro , Sakuragi Noriaki , Kawabata Masakiyo , Yoshikawa Hiroyuki , Kobayashi Hiroshi , Yaegashi Nobuo 
Published: March 2012

AbstractGynecology in the office setting is developing worldwide. Clinical guidelines for office gynecology were first published by the Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists in 2011. These guidelines include a total of 72 clinical questions covering four areas (Infectious disease, Malignancies and benign tumors, Endocrinology and infertility, and Healthcare for women). These clinical questions were followed by several answers, backgrounds, explanations and references covering common problems and questions encountered in office gynecology. Each answer with a recommendation level of A, B or C has been prepared based principally on evidence or consensus among Japanese gynecologists.These guidelines would promote a better understanding of the current standard care practices for gynecologic outpatients in Japan.
Community scale 15N isoscapes: tracing the spatial impact of an exotic N2‐fixing invader
Authors: Rascher Katherine G. , Hellmann Christine , Máguas Cristina , Werner Christiane 
Published: March 2012

Ecology Letters (2012) 15: 484–491AbstractPlant–plant interactions are key processes shaping plant communities, but methods are lacking to accurately capture the spatial dimension of these processes. Isoscapes, i.e. spatially continuous observations of variations in stable isotope ratios, provide innovative methods to trace the spatial dimension of ecological processes at continental to global scales. Herein, we test the usefulness of nitrogen isoscapes (δ15N) for quantifying alterations in community functioning following exotic plant invasion. Nitrogen introduced by an exotic N2‐fixing acacia could be accurately traced through the ecosystem and into the surrounding native vegetation by combining native species foliar δ15N with spatial information regarding plant location using geostatistical methods. The area impacted by N‐addition was at least 3.5‐fold greater than the physical area covered by the invader. Thus, downscaling isoscapes to the community level opens new frontiers in quantifying the spatial dimension of functional changes associated with invasion and in resolving the spatial component of within‐community interactions.
When reproductive value exceeds economic value: an example from the Newfoundland cod fishery
Authors: Xu Cailin , Schneider David C , Rideout Cassandra 
Published: March 2012

AbstractThe Northern Cod (Gadus morhua) fishery supported the removal of approximately 200 000 tonnes per year for centuries until collapse in the late 1980s and closure in 1992. Long recovery times, on the order of a decade or more, are now known to be regular concomitant of steep population declines in fish populations. We investigated reproductive value as an alternative to economic value in assessing fisheries sustainability. Our analysis showed that in cod, price‐driven heavy fishing (i.e. fishing mortality positively related to body mass and its dollar value) dramatically impaired reproductive capacity by sacrificing future egg production of large fish. Management based upon current value (either in terms of biomass or equivalently dollar value) substantially underestimates the value of large individuals to the stock; this drove the Northern Cod stock towards collapse by failing to protect individuals with high future value. Our results provide a general explanation for the erosion, collapse and prolonged recovery of a long‐lived species where reproductive value increases rapidly with increasing size. Failure to compute and communicate future value relative to current dollar value to resource harvesters leads to unrealistic perceptions of sustainable resource use.
A DYNAMIC ANALYSIS OF DEBT‐LED AND DEBT‐BURDENED GROWTH REGIMES WITH MINSKIAN FINANCIAL STRUCTURE
Authors: Nishi Hiroshi 
Published: March 2012

ABSTRACTIn this paper, we formally derive a version of the Minskian taxonomy of the firms' financial structure (hedge, speculative and Ponzi types), under the economic growth context in the long run. As for the economic growth, we formalize the mechanism of debt‐led (debt‐burdened) growth where the economy expands as the debt variables increase (decrease). By explicitly introducing the relationship between the finance growth regime and Minskian taxonomy in a dynamic model, the model in this paper enables us to evaluate whether or not the economic growth regime is sounded in terms of the firms' financial positions.
Post‐Retirement Financial Strategies: Forecasts and Valuation
Authors: Sharpe William F. 
Published: March 2012

Abstract This paper uses a discrete‐time, discrete‐state Monte Carlo simulation model to evaluate representative strategies for investing and spending a fixed sum designed to fund consumption during the period after retirement. Two assets are considered – one providing a riskless real return, the other a market portfolio of bonds and stocks. A stochastic process for the returns from the market portfolio is proposed. Then a set of Arrow‐Debreu state prices is obtained on the assumption that the market portfolio is an efficient investment strategy. The model is used to forecast ranges of consumption and ranges of the ratios of year‐to‐year consumption, and also to estimate the values of components of future consumption.
Low molecular weight heparin versus unfractionated heparin in cerebral venous sinus thrombosis: a randomized controlled trial
Authors: Misra U. K. , Kalita J. , Chandra S. , Kumar B. , Bansal V. 
Published: March 2012

Background:  There is no randomized controlled trial (RCT) evaluating the efficacy and safety of low molecular weight heparin (LMWH) compared to unfractionated heparin (UFH) in cerebral venous sinus thrombosis (CVST). In this RCT, we have evaluated the efficacy and safety of LMWH versus UFH in CVST.Methods:  Consecutive patients with CVST diagnosed on the basis of MR venography (MRV) who was free of bleeding diathesis, malignancy, hepatic or renal failure were prospectively enrolled. History, clinical findings and risk factors were evaluated. MRI and MRV findings were recorded. The patients were randomized to LMWH and UFH groups for 14 days followed by oral anticoagulant. The hospital mortality and 3 months outcome as assessed by Barthel index (BI) score were noted.Results:  32 patients received UFH and 34 received LMWH. The baseline demographic, clinical and radiological parameters were similar in both the groups. Six patients died and all were in UFH group (P = 0.01). At 3 months, insignificantly higher number of patients recovered completely in LMWH compared to UFH group (30 vs. 20). There was no serious side effect needing withdrawal of drugs except one was withdrawn from UFH because of heparin‐induced thrombosis.Conclusion:  Low molecular weight heparin resulted in significantly lower hospital mortality in CVST compared to UFH.