bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audiologic Outcomes After Vestibulotomy in Patients With Congenital Absence of the Oval Window
Authors: Song Bokhyun , Koh Sung Min , Kim Junyoung , Cho Yang-Sun 
Published: May 2024

Objective
To examine the clinical features and surgical outcomes in patients with congenital absence of the oval window (CAOW), and to investigate the potential factors that affect audiologic results.

Study Design
A retrospective chart review.

Setting
A tertiary academic center.

Patients and Intervention
A total of 17 ears among 16 patients were confirmed to have CAOW. Among them, 13 ears underwent vestibulotomy for hearing reconstruction. Clinical parameters associated with the hearing outcomes were analyzed.

Main Outcome Measures
A mean air-bone gap (ABG) after 6-month and long-term follow-up was compared with preoperative measurements.

Results
Intraoperative findings showed that anomalies of the malleus or incus were observed in 11 ears (64.7%), stapes anomalies were present in all ears (100%), and facial nerve anomalies were present in 10 ears (58.8%). Because of unfavorable facial nerve anomalies, hearing reconstruction was aborted in four cases (23.5%). In the hearing reconstruction group, the mean ABG at 6 months postoperation was significantly reduced after compared with the preoperative value (44.0 ± 8.4 dB versus 58.8 ± 9.1 dB, p = 0.006). After dividing ears into a success subgroup (ABG ≤ 30 dB, seven ears) and non-success subgroup (ABG > 30 dB, six ears), the use of a drill during vestibulotomy was significantly related to a poor hearing outcome (100% versus 16.7%, p = 0.015). The long-term follow-up result (mean, 60 mo) revealed no deterioration compared with the 6-month postoperative result. Five ears (29.4%) underwent revision surgery, and three of them showed ABG improvements. No serious complications were reported.

Conclusion
Vestibulotomy is an effective and safe option for hearing restoration in patients with CAOW, particularly when the use of a drill is not required. The long-term audiologic outcome is also reliable.
The Role of Gut Microbiota and Innate Immune Response in an Autoimmune Pancreatitis Model
Authors: Ito Suguru , Higashiyama Masaaki , Nishimura Hiroyuki , Tomioka Akira , Tanemoto Rina , Nishii Shin , Mizoguchi Akinori , Akita Yoshihiro , Okada Yoshikiyo , Kurihara Chie , Narimatsu Kazuyuki , Komoto Shunsuke , Tomita Kengo , Hokari Ryota 
Published: May 2024

Background
Although the involvement of intestinal microbiota in innate immunity has been reported recently, the pathogenicity of autoimmune pancreatitis (AIP) remains unclear. This study aimed to investigate whether probiotics ameliorate inflammation in AIP through interactions with innate immunity.

Materials and Methods
The AIP mouse model was generated by intraperitoneal administration of Escherichia coli to C56BL/6 female mice. Alterations in the intestinal microbiota in the AIP group were evaluated using high-throughput sequencing. Peritoneal macrophages (PMs) were collected and cocultured in vitro with Lactobacillus gasseri (LG) or ligands of Toll-like receptors (TLRs). LG was administered intraperitoneally to AIP model mice, and pancreatitis activity was evaluated to examine the ameliorative effects of LG.

Results
In the AIP model mice, inflammation was significantly induced in the pancreas, and the intestinal microbiota was altered with decreased LG. Antimicrobial treatment suppressed pancreatitis. In vitro, E. coli stimulation increased inflammatory cytokine expression, which was significantly decreased when the LG or TLR7 ligand was cocultured with PMs. Intraperitoneal administration of LG to AIP model mice significantly suppressed pancreatitis.

Conclusion
The mouse model demonstrated the involvement of intestinal microbiota in pancreatitis, and LG administration suppressed pancreatitis, possibly through TLR7 signaling in PMs. LG may be a helpful probiotic for treating AIP.
Certolizumab Has Favorable Efficacy on Preventing Pancreas and Target Organs Damage in Acute Pancreatitis
Authors: Cirak Zafer , Tanoglu Alpaslan , Yeniceri Murat , Tanoglu Esra Guzel , Kaplan Mustafa , Sade Ayşe Gökcen 
Published: May 2024

Objective
It was targeted to assess the efficacy of certolizumab on pancreas and target organs via biochemical parameters and histopathologic scores in experimental acute pancreatitis (AP).

Materials and Methods
Forty male Sprague Dawley rats were divided into the following 5 equal groups: group 1 (sham group), group 2 (AP group), group 3 (AP + low-dose certolizumab group), group 4 (AP + high-dose certolizumab group), and group 5 (placebo group). Rats in all groups were sacrificed 24 hours after the last injection and amylase, tumor necrosis factor α, transforming growth factor β, interleukin 1β, malondialdehyde, superoxide dismutase, and glutathione peroxidase levels were studied in blood samples. Histopathological investigation of both the pancreas and target organs (lungs, liver, heart, kidneys) was performed by a pathologist blind to the groups. In silico analysis were also accomplished.

Results
The biochemical results in the certolizumab treatment groups were identified to be significantly favorable compared to the AP group (P < 0.001). The difference between the high-dose group (group 4) and low-dose treatment group (group 3) was found to be significant in terms of biochemical parameters and histopathological scores (P < 0.001). In terms of the effect of certolizumab treatment on the target organs (especially on lung tissue), the differences between the low-dose treatment group (group 3) and high-dose treatment group (group 4) with the AP group (group 2) were significant.

Conclusions
Certolizumab has favorable protective effects on pancreas and target organs in AP. It may be a beneficial agent for AP treatment and may prevent target organ damage.
Early Hypophosphatemia as a Prognostic Marker in Acute Pancreatitis
Authors: Stewart Connor F. , Adeniran Esther A. , Yadav Dhiraj , Gorelick Fred S. , Liddle Rodger A. , Wu Bechien , Pandol Stephen J. , Jeon Christie Y. 
Published: May 2024

Objectives
Acute pancreatitis (AP) is a complex disease representing a significant portion of gastrointestinal-related hospitalizations in the U.S. Understanding risk factors of AP might provide attractive therapeutic targets. We evaluated hypophosphatemia a prognostic marker in AP.

Methods
We performed a retrospective review of electronic health records of patients with AP from 01/ 01/2012–12/31/2021 at Cedars-Sinai Medical Center with serum phosphate measured within 48 hours of admission. Multivariable logistic regression modeling was used to evaluate associations with ICU admission and AP severity. Multivariable log-linear modeling was employed to examine associations with length of stay (LOS).

Results
Of 1526 patients admitted for AP, 33% (499) had a serum phosphate level measured within 48 hours. Patients with hypophosphatemia were more likely to have ICU admission (adjusted odds ratio (AOR) = 4.57; 95% confidence interval (CI): 2.75–7.62; P < 0.001), have a longer hospital stay (log-LOS = 0.34; SE; 0.09; 95% CI: 0.17–0.52; P < 0.001), and have moderate or severe AP (AOR = 1.80; 95% CI: 1.16–2.80; P < 0.001) compared with those without hypophosphatemia.

Conclusion
Serum phosphate is infrequently measured in patients with AP and shows promise as an early prognostic marker for outcomes of AP.
Lipase-to-Amylase Ratio for the Prediction of Clinically Relevant Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy
Authors: Chui Juanita N. , Ziaziaris William A. , Nahm Christopher B. , Fuchs Talia , Sahni Sumit , Lim Christopher S.H. , Gill Anthony J. , Samra Jaswinder S. , Mittal Anubhav 
Published: May 2024

Objective
Postoperative pancreatic fistula (POPF) represents a leading cause of morbidity and mortality following major pancreatic resections. This study aimed to evaluate the use of postoperative drain fluid lipase-to-amylase ratio (LAR) for the prediction of clinically relevant fistulae (CR-POPF).

Methods
Consecutive patients undergoing pancreaticoduodenectomy between 2017 and 2021 at a tertiary centre were retrospectively reviewed. Univariable and multivariable analyses were performed to identify predictors for CR-POPF (ISGPS grade B/C). Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the performance of LAR and determine optimum prediction thresholds.

Results
Among 130 patients, 28 (21.5%) developed CR-POPF. Variables positively associated with CR-POPF included soft gland texture, acinar cell density, diagnosis other than PDAC or chronic pancreatitis, resection without neoadjuvant therapy, and postoperative drain fluid lipase, amylase, and LAR (all P<0.05). Multivariable regression analysis identified LAR as an independent predictor of CR-POPF (P<0.05). ROC curve analysis showed that LAR had moderate ability to predict CR-POPF on POD1 (AUC,0.64; 95%CI,0.54–0.74) and excellent ability on POD3 (AUC,0.85; 95%CI,0.78–0.92) and POD 5 (AUC,0.86; 95%CI,0.79–0.92). Optimum thresholds were consistent over PODs 1 to 5 (ratio>2.6) and associated with 92% sensitivity and 46% to 71% specificity.

Conclusions
Postoperative drain fluid LAR represents a reliable predictor for the development of CR-POPF. With early prognostication, the postoperative care of patients at risk of developing high-grade fistulas may be optimized.
Cancer-Derived Small Extracellular Vesicles Affect Vascular Endothelial Cells and Promote Adhesiveness of Pancreatic Cancer Cells
Authors: Furuke Hirotaka , Arita Tomohiro , Konishi Hirotaka , Kataoka Satoshi , Shibamoto Jun , Takabatake Kazuya , Takaki Wataru , Shimizu Hiroki , Yamamoto Yusuke , Morimura Ryo , Komatsu Shuhei , Shiozaki Atsushi , Ikoma Hisashi , Otsuji Eigo 
Published: May 2024

Objectives
Pancreatic cancer (PC) is one of the most aggressive malignancies due to the high rate of metastasis. The mechanisms underlying metastasis need to be elucidated. Small extracellular vesicles (sEVs) mediate cell-to-cell communication, and cancer-derived sEVs contribute to the formation of premetastatic niches. The present study examined changes in adhesiveness by the internalization of PC-derived sEVs into vascular endothelial cells, and investigated the molecular mechanisms underlying metastasis.

Materials and Methods
Pancreatic cancer-derived sEVs were internalized into vascular endothelial cells, and changes in adhesiveness were evaluated. We evaluated the effects of sEVs on the formation of liver metastasis in vivo. We also assessed molecular changes in vascular endothelial cells by the internalization of PC-derived sEVs.

Results
The internalization of PC-derived sEVs into vascular endothelial cells promoted the adhesiveness of vascular endothelial cells and PC cells. Pancreatic cancer-derived sEVs contained high levels of transforming growth factor β1 mRNA and acted as its transporter. Once PC-derived sEVs were internalized into vascular endothelial cells, the expression of fibronectin 1 increased on the cell surface, and the adhesiveness of vascular endothelial cells was enhanced.

Conclusions
We investigated association between PC-derived sEVs and adhesiveness. Regulation of PC-derived sEVs has potential as a therapeutic modality to suppress the metastasis of PC.
Severity of Gallstone-, Sludge-, or Microlithiasis-Induced Pancreatitis—All of the Same?
Authors: Sirtl Simon , Bretthauer Katharina , Ahmad Mahmood , Hohmann Eric , Schmidt Vanessa F. , Allawadhi Prince , Vornhülz Marlies , Klauss Sarah , Goni Elisabetta , Vielhauer Jakob , Orgler Elisabeth , Saka Didem , Knoblauch Mathilda , Hofmann Felix O. , Schirra Jörg , Schulz Christian , Beyer Georg , Mahajan Ujjwal M. , Mayerle Julia , Zorniak Michal 
Published: May 2024

Background/Aim
Severity of microlithiasis- and sludge-induced pancreatitis in comparison to gallstone-induced pancreatitis has never been studied for a lack of definition.

Materials and Methods
In this retrospective cohort study, 263 patients with acute biliary pancreatitis treated at a tertiary care center from 2005 to 2021 were stratified according to the recent consensus definition for microlithiasis and sludge. The gallstone-pancreatitis cohort was compared to microlithiasis, sludge, and suspected stone passage pancreatitis cohorts in terms of pancreatitis outcome, liver function, and endosonography/endoscopic retrograde cholangiopancreatography results using one-way analysis of variance and χ2 test. Multinomial logistic regression analysis was performed to correct for bias.

Results
Microlithiasis- and sludge-induced pancreatitis, classified according to the revised Atlanta classification, did not present with a milder course than gallstone-induced pancreatitis (P = 0.62). Microlithiasis and sludge showed an increase in bilirubin on the day of admission to hospital, which was not significantly different from gallstone-induced pancreatitis (P = 0.36). The likelihood of detecting biliary disease on endosonography resulting in bile duct clearance was highest on the day of admission and day 1, respectively.

Conclusions
Microlithiasis and sludge induce gallstone-equivalent impaired liver function tests and induce pancreatitis with similar severity compared with gallstone-induced acute biliary pancreatitis.
Screening of Amino Acids as a Safe Energy Source for Isolated Rat Pancreatic Acini
Authors: Zub Anastasiia M. , Manko Bohdan O. , Manko Volodymyr V. 
Published: May 2024

Objectives
Amino acids play an essential role in protein synthesis, metabolism, and survival of pancreatic acini. Adequate nutritional support is important for acute pancreatitis treatment. However, high concentrations of arginine and lysine may induce acute pancreatitis. The study aimed to identify the most suitable l-amino acids as safe energy sources for pancreatic acinar cells.

Materials and Methods
Pancreatic acini were isolated from male Wistar rats. Effects of amino acids (0.1–20 mM) on uncoupled respiration of isolated acini were studied with a Clark electrode. Cell death was evaluated with fluorescent microscopy and DNA gel electrophoresis.

Results
Among the tested amino acids, glutamate, glutamine, alanine, lysine, and aspartate were able to stimulate the uncoupled respiration rate of isolated pancreatic acini, whereas arginine, histidine, and asparagine were not. Lysine, arginine, and glutamine (20 mM) caused complete loss of plasma membrane integrity of acinar cells after 24 hours of incubation. Glutamine also caused early (2–4 hours) cell swelling and blebbing. Aspartate, asparagine, and glutamate only moderately decreased the number of viable cells, whereas alanine and histidine were not toxic. DNA fragmentation assay and microscopic analysis of nuclei showed no evidence of apoptosis in cells treated with amino acids.

Conclusions
Alanine and glutamate are safe and effective energy sources for mitochondria of pancreatic acinar cells.
Early Endoscopic Retrograde Cholangiopancreatography in Gallstone Pancreatitis Is Safe
Authors: Maloof Tassiana , Rodrigues Darren , Li Thomas , Rodrigues Terrance , Lancki Nicola , Keswani Rajesh N. 
Published: May 2024

Objectives
There is concern that performing early endoscopic retrograde cholangiopancreatography (ERCP) in the setting of gallstone pancreatitis (GSP) with choledocholithiasis can worsen underlying pancreatitis. This study was designed to assess outcomes of early versus delayed ERCP in patients with GSP with choledocholithiasis in the absence of cholangitis.

Materials and Methods
In this single-center retrospective study, we identified 124 patients who underwent ERCP for choledocholithiasis in the setting of GSP without cholangitis between 2012 and 2022. Timing of ERCP was categorized as early (<48 hours after time of diagnosis) versus delayed (>48 hours). Data on patient demographics, complications, length of stay (LOS), and mortality were collected.

Results
Cannulation success rates were similar for early and delayed ERCP (97% vs 100%). The adverse event rate for early ERCP was 15% compared to 29% for delayed ERCP. LOS for patients with predicted mild pancreatitis was shorter for early versus delayed ERCP (4.2 vs 7.1 days, P = 0.007). There were no deaths in either group.

Conclusions
There was a trend toward fewer adverse events and there was a shorter LOS among patients with GSP with choledocholithiasis undergoing early versus delayed ERCP. Early ERCP should be considered, particularly in patients with predicted mild pancreatitis.
Quality of Life Following Total Pancreatectomy With Islet Autotransplantation
Authors: Barthold Laura , Smith Kerrington D. , Chaidarun Sushela S. , Fischer Dawn A. , Gardner Timothy B. 
Published: May 2024

Objectives
Total pancreatectomy with islet autotransplantation (TPIAT) is performed to improve the quality of life (QOL) of patients with chronic pancreatitis. Few reports have documented QOL following TPIAT, with none using the pancreatitis-specific Pancreatitis Quality of Life Instrument (PANQOLI). We surveyed patients at our center who underwent TPIAT to document postoperative QOL.

Materials and Methods
We collected survey data from 18 adult patients who underwent TPIAT at our medical center from 2012 to 2020. Patients were asked questions assessing QOL following TPIAT and completed the Short-Form Health Survey and PANQOLI instruments.

Results
Forty-three patients who underwent TPIAT were mailed surveys, and 18 were returned. The mean age was 45 years, and 67% of respondents were female. Almost half (44%) had hereditary pancreatitis. Sixty-seven percent believed that their overall QOL had improved after surgery. The mean postoperative Short-Form Health Survey physical score was 38.9 and mean mental score was 44. The mean PANQOLI score was 66 (physical function 20, role function 16, emotional function 14, self-worth 15). Following surgery, 33% were using opiate medications and 67% were using antihyperglycemic medications.

Conclusions
TPIAT resulted in improved self-reported QOL in most patients, although postoperative physical and mental QOL are less compared to the average healthy United States adult.
Essential Fatty Acid Deficiency Is Common After Total Pancreatectomy and Islet Autotransplantation
Authors: Downs Elissa M. , Hodges James S. , Trikudanathan Guru , Freeman Martin L. , Chinnakotla Srinath , Kirchner Varvara , Pruett Timothy L. , Beilman Gregory , Schwarzenberg Sarah Jane , Bellin Melena D. 
Published: May 2024

Objectives
Total pancreatectomy and islet autotransplantation (TPIAT) for pancreatitis may induce risk for essential fatty acid deficiency (EFAD) due to exocrine pancreatic insufficiency and intestinal alterations. The prevalence of EFAD post-TPIAT is currently unknown.

Methods
We abstracted essential fatty acid (EFA) profiles (n = 332 samples) for 197 TPIAT recipients (72% adult, 33% male). Statistical analyses determined the prevalence of, and associations with, EFAD post-operatively. EFAD was defined as a Triene-to-Tetraene ratio ≥0.05 if <18 years old, or ≥0.038 if ≥18 years old.

Results
Prevalence of EFAD was 33%, 49%, and 53.5% at 1, 2, and ≥3 years. At 1-year post-TPIAT, older age at transplant (P = 0.03), being an adult versus a child (P = 0.0024), and obstructive etiology (P = 0.0004) were significant predictors of EFAD. Only 6% of children had EFAD 1-year post-TPIAT versus 46% of adults. The alpha-linolenic acid levels were lower with lower body mass index at transplant (P = 0.011). EFAD was associated with the presence of other intestinal diseases (P < 0.0001).

Conclusions
One-third of individuals had EFAD 1-year post-TPIAT, highlighting the need for systematic monitoring. Older age at transplant increased risk and adults were more affected than children. Other diagnoses affecting intestinal health may further increase risk for EFAD.
Development of the Split-Bolus Pulmonary Arteriovenous Separating Computed Tomography Angiography Protocol Based on Time Enhancement Curve for Lung Cancer Surgery
Authors: Kiriki Masato , Koizumi Masashi , Maeda Katsuhiko , Sakai Toshiyuki , Kotoura Noriko 
Published: May 2024

Objective
We devised a split-bolus injection and imaging protocol for pulmonary artery and vein separation computed tomography (CT) angiography based on time enhancement curve characterization. Furthermore, we aimed to evaluate the contrast enhancement effect and success rate of blood vessel separation between the pulmonary artery and vein of this proposed protocol.

Methods
In this study, 102 patients (45 patients with the standard protocol and 57 patients with the proposed protocol) who underwent pulmonary arteriovenous computed tomography angiography were included. The CT values of various vessels, CT value difference between the pulmonary trunk and left atrium, and coefficient of variation in pulmonary arteries and veins were obtained from images of the standard and proposed protocols.

Results
The CT values in the proposed protocol for the pulmonary trunk were significantly higher than those in the standard protocol (487.3 [415.5–546.9] HU vs. 293.0 [259.0–350.0] HU, P < 0.01). The CT value difference between the pulmonary trunk and left atrium in the proposed protocol was significantly higher than that in the conventional protocol (211.3 [158.0–265.7] HU vs. 32 [−30.0–55.0] HU, P < 0.01). The coefficient of variation in the proposed protocol was 0.08 (0.06–0.10) and 0.09 (0.08–0.11) in pulmonary arteries and 0.08 (0.06–0.09) and 0.09 (0.07–0.12) in pulmonary veins, respectively.

Conclusions
The proposed protocol achieved separation between the pulmonary artery and vein in many patients, making it useful for the preoperative assessment of individual thoracic anatomy.
Negative 18F-Piflufolastat PET/CT, But Positive 18F-Fluciclovine PET/CT, in a Patient With Biochemically Recurrent Prostate Cancer
Authors: Ulaner Gary A. 
Published: May 2024

Abstract
An 83-year-old man with prostate cancer post external beam radiotherapy presented with biochemical recurrence (PSA, 29.7 ng/mL). PSMA-targeted 18F-Piflufolastat PET/CT was performed, but no avid lesions were identified. Given the high PSA and high suspicion for recurrence, an 18F-Fluciclovine PET/CT was performed. Fifteen 18F-fluciclovine–avid pelvic, abdominal, retrocrural, and left supraclavicular nodal metastases were then identified. Although the majority of prostate cancer metastases are avid on PSMA-targeted PET, some metastases are not. This case demonstrates the ability of metabolic tracers such as 18F-Fluciclovine PET to localize and quantitate disease extent in a patient whose metastases are not avid on PSMA-targeted PET.