bluuebunny/crossref_metadata_2025_split huggingface dataset:
Schwannoma of the greater superficial petrosal nerve
Authors: Amirjamshidi Abbas , Hashemi Seyyed Mahmood Ramak , Abbassioun Kazem 
Published: October 2009

The authors report the clinical features, imaging and surgical findings, and follow-up of 5 rare cases of schwannoma of the middle fossa with possible origin from the greater superficial petrosal nerve (GSPN). All patients presented to a single neurosurgical institution. The study design was a prospective follow-up of 5 cases of schwannomas of the middle fossa that most likely originated from the GSPN. The presenting features were burning pain in the eyes in 2 cases, epilepsy and behavioral changes in 2 cases, and headache in 1 case. Imaging studies showed a subtemporal mass on the anterosuperior aspect of the petrous bone in all cases. An enhancing tail on the MR images was highly suggestive of the origin of the tumor from the GSPN. All tumors were removed through a subtemporal extra- or intradural approach.
Partial to complete peripheral facial nerve palsy was encountered after surgery in 3 cases, which recovered completely. Dry eye was the long-term permanent deficit in all cases. Mid- to long-term follow-up of the cases has not revealed any tumor recurrence. The 5 cases of schwannoma of the middle fossa with possible origin from GSPN were managed successfully, and their clinical presentation, differential diagnosis, and management are discussed.
Heparanase expression of glioma in human and animal models
Authors: Hong Xin , Nelson Kevin K. , deCarvalho Ana C. , Kalkanis Steven N. 
Published: October 2009

Object
Mammalian heparanase has been shown to function in tumor progression, invasion, and angiogenesis. However, heparanase expression in gliomas has not been well analyzed. To clarify its expression in gliomas, human glioma tissues and glioma animal models were investigated.

Methods
The expression of heparanase mRNA was determined in 33 resected human glioma tissues by semiquantitative real-time polymerase chain reaction. Heparanase expression was verified with a Western blot assay and immunohistochemistry (IHC) staining. Primary neurospheres from human glioblastoma multiforme (GBM) were developed in vitro. Heparanase expression in murine astrocytoma and human primary neurosphere animal models was examined using IHC.

Results
The authors found that heparanase mRNA is greatly increased in gliomas including oligodendroglioma (9 samples), anaplastic astrocytoma (11 samples), and GBM (13 samples) as compared with healthy brain mRNA (3 samples). Note, however, that no significant difference was observed among the 3 tumor groups. Increased heparanase expression was also found in tumor tissues on Western blotting. Immunohistochemistry staining demonstrated that heparanase was expressed by neovessel endothelial cells, infiltrated neutrophils, and in some cases, by neoplastic cells. Heparanase-expressing cells, including GBM tumor cells and neovessel endothelial cells, exhibited decreased expression of CD44, a cell adhesion molecule on the cell membrane that is important for regulating tumor invasion. In addition, heparanase-expressing tumor cells showed an elevated density of the cell proliferation marker Ki 67, as compared with its density in non–heparanase-expressing tumor cells, suggesting that heparanase expression is correlated with enhanced tumor proliferation. Two animal glioma models were tested for heparanase expression. Both murine astrocytoma cells (Ast11.9-2) and cultured primary human GBM neurospheres expressed heparanase when grown in animal brain tissue.

Conclusions
Glioma tissues contain increased levels of heparanase. Multiple cell types contribute to the expression of heparanase, including neovessel endothelial cells, tumor cells, and infiltrated neutrophils. Heparanase plays an important role in the control of cell proliferation and invasion. Animal models using Ast11.9-2 and primary neurospheres are suitable for antitumor studies targeting heparanase.
The Localized Scleroderma Skin Severity Index and Physician Global Assessment of Disease Activity: A Work in Progress Toward Development of Localized Scleroderma Outcome Measures
Authors: ARKACHAISRI THASCHAWEE , VILAIYUK SOAMARAT , LI SUZANNE , O’NEIL KATHLEEN M. , POPE ELENA , HIGGINS GLORIA C. , PUNARO MARILYNN , RABINOVICH EGLA C. , ROSENKRANZ MARGALIT , KIETZ DANIEL A. , ROSEN PAUL , SPALDING STEVEN J. , HENNON TERESA R. , TOROK KATHRYN S. , CASSIDY ELAINE , MEDSGER THOMAS A. 
Published: October 2009

Objective.To develop and evaluate a Localized Scleroderma (LS) Skin Severity Index (LoSSI) and global assessments’ clinimetric property and effect on quality of life (QOL).Methods.A 3-phase study was conducted. The first phase involved 15 patients with LS and 14 examiners who assessed LoSSI [surface area (SA), erythema (ER), skin thickness (ST), and new lesion/extension (N/E)] twice for inter/intrarater reliability. Patient global assessment of disease severity (PtGA-S) and Children’s Dermatology Life Quality Index (CDLQI) were collected for intrarater reliability evaluation. The second phase was aimed to develop clinical determinants for physician global assessment of disease activity (PhysGA-A) and to assess its content validity. The third phase involved 2 examiners assessing LoSSI and PhysGA-A on 27 patients. Effect of training on improving reliability/validity and sensitivity to change of the LoSSI and PhysGA-A was determined.Results.Interrater reliability was excellent for ER [intraclass correlation coefficient (ICC) 0.71], ST (ICC 0.70), LoSSI (ICC 0.80), and PhysGA-A (ICC 0.90) but poor for SA (ICC 0.35); thus, LoSSI was modified to mLoSSI. Examiners’ experience did not affect the scores, but training/practice improved reliability. Intrarater reliability was excellent for ER, ST, and LoSSI (Spearman’s rho = 0.71–0.89) and moderate for SA. PtGA-S and CDLQI showed good intrarater agreement (ICC 0.63 and 0.80). mLoSSI correlated moderately with PhysGA-A and PtGA-S. Both mLoSSI and PhysGA-A were sensitive to change following therapy.Conclusion.mLoSSI and PhysGA-A are reliable and valid tools for assessing LS disease severity and show high sensitivity to detect change over time. These tools are feasible for use in routine clinical practice. They should be considered for inclusion in a core set of LS outcome measures for clinical trials.
Prevalence of Flare and Influence of Demographic and Serologic Factors on Flare Risk in Systemic Lupus Erythematosus: A Prospective Study
Authors: PETRI MICHELLE , SINGH SUKHMINDER , TESFASYONE HANNA , MALIK ASHIMA 
Published: October 2009

Objective.We determined the prevalence of and risk factors for British Isles Lupus Activity Group (BILAG) flare in patients with systemic lupus erythematosus (SLE).Methods.We followed 299 patients for 1 year with the BILAG scores calculated using British Lupus Integrated Prospective System software and confirmed with manual calculation.Results.“A” flares occurred at a rate of 0.254/year, “B” flares 1.637/year, and A or B flares 1.765/year. The most common A flares were renal and mucocutaneous. The most common B flares were hematologic, renal, mucocutaneous, and musculoskeletal. Risk factors for a later A or B flare in the hematological system included: low C3 (p < 0.0001), low C4 (p = 0.0004), and positive anti-double-stranded (ds)DNA (p = 0.003); in the mucocutaneous system: low C3 (p = 0.02) and low C4 (p = 0.0004); and in the renal system: low C3 (p = 0.02) and low C4 (p = 0.02). In a stepwise regression model, only ethnicity (p = 0.02) and low C4 (p = 0.0002) remained as independent predictors of later A or 2B flares.Conclusion.The organ system distribution of A and B flares is very different, with A flares more common in renal and mucocutaneous, and B flares more common in hematologic and renal systems. A or 2B flares are significantly more common in African Americans and in patients with abnormal serologies (low C3, low C4, or high anti-dsDNA). If flare is an outcome in an SLE clinical trial, these factors must be balanced by taking them into account at baseline in terms of randomization, or by statistical adjustment in final analyses.
Circulating Surfactant Protein D Is Decreased in Systemic Lupus Erythematosus
Authors: HOEGH SILJE VERMEDAL , VOSS ANNE , SORENSEN GRITH LYKKE , HØJ ANETTE , BENDIXEN CHRISTIAN , JUNKER PETER , HOLMSKOV UFFE 
Published: October 2009

Objective.Deficiencies of innate immune molecules like mannan binding lectin (MBL) have been implicated in the pathogenesis of systemic lupus erythematosus (SLE). Surfactant protein D (SP-D) and MBL belong to the same family of innate immune molecules — the collectins, which share important structural and functional properties. We aimed to compare concentrations of serum SP-D in patients with SLE and in healthy controls, and to investigate if SP-D is associated with selected disease indicators. We investigated the possible association of the Met11Thr polymorphism with disease, since this polymorphism is an important determinant for serum level, oligomerization pattern, and function of SP-D.Methods.Serum SP-D was measured using a 5-layer ELISA in 70 SLE patients and 1476 healthy subjects. DNA was genotyped for the Met11Thr variant.Results.Median SP-D level in serum was 911 ng/ml (95% CI 776–1118) in patients and 1068 ng/ml (95% CI 901–1246) in controls (p = 0.0004). Circulating SP-D did not differ significantly in patients with high, intermediate, or low SLE disease activity. Similarly, SP-D did not correlate with C-reactive protein, erythrocyte sedimentation rate, and anti-dsDNA seropositivity. Genetic analysis did not support an association of the Met11Thr genotype with SLE.Conclusion.These findings suggest that low SP-D, unrelated to conventional disease indicators, represents an aspect of SLE etiopathogenesis.
Perturbed Insulin-like Growth Factor-1 (IGF-1) and IGF Binding Protein-3 Are Not Associated with Chronic Widespread Pain in Men: Results from the European Male Ageing Study
Authors: McBETH JOHN , TAJAR ABDELOUAHID , O’NEILL TERENCE W. , MACFARLANE GARY J. , PYE STEPHEN R. , BARTFAI GYORGY , BOONEN STEVEN , BOUILLON ROGER , CASANUEVA FELIPE , FINN JOSEPH D. , FORTI GIANNI , GIWERCMAN ALEKSANDER , HAN THANG S. , HUHTANIEMI ILPO T. , KULA KRZYSZTOF , LEAN MICHAEL E.J. , PENDLETON NEIL , PUNAB MARGUS , SILMAN ALAN J. , VANDERSCHUEREN DIRK , WU FREDERICK C.W. ,   and the EMAS Group
Published: October 2009

Objective.To determine whether perturbations of insulin-like growth factor-1 (IGF-1) and IGF binding protein-3 (IGFBP-3) were associated with the presence of chronic widespread pain (CWP) in men.Methods.The European Male Ageing Study (EMAS) is an 8-center population-based study of men aged 40–79 years recruited from population registers. A questionnaire asked about the presence and duration of musculoskeletal pain, from which subjects reporting CWP were identified. Subjects also had an interviewer-assisted questionnaire: levels of physical activity and mood were assessed, and height and weight were measured. IGF-1 and IGFBP-3 were assayed from a fasting blood sample. Logistic regression models were used to determine the association between IGF measures and CWP. Results were expressed as odds ratios or relative risk ratios.Results.A total of 3206 subjects provided full data. Of those, 1314 (39.0%) reported no pain in the past month and 278 (8.3%) reported pain that satisfied criteria for CWP. IGF-1 concentrations were similar among subjects who reported no pain and those with CWP: 131.5 mg/l and 128.4 mg/l, respectively. This was true also for IGFBP-3 (4.3 and 4.3 mg/l). Obesity was associated with low IGF-1 and a high IGFBP-3/IGF-1 ratio, indicating less bioavailable IGF-1, irrespective of pain status. This relationship persisted after adjustment for comorbidities, depression, smoking, alcohol consumption, and quality of life.Conclusion.Overall CWP was not associated with perturbations in IGF-1 and IGFBP-3 concentrations. Hypofunctioning of the axis was noted among subjects who were obese and this was not specific to CWP. These data suggest that IGF-1 is unlikely to be etiologically important in relation to CWP, although the relationship with growth hormone remains to be elucidated.
Which Aspects of Functioning Are Relevant for Patients with Ankylosing Spondylitis: Results of Focus Group Interviews
Authors: BOONEN ANNELIES , van BERKEL MONIQUE , CIEZA ALARCOS , STUCKI GEROLD , van der HEIJDE DÉSIRÉE 
Published: October 2009

Objective.To investigate whether concepts important to patients with ankylosing spondylitis (AS) are covered by disease-specific self-report health status instruments.Methods.A qualitative focus group study was conducted with AS patients on problems in daily functioning. Group sessions with 4 to 5 patients each were organized up to the point that no new information was brought forward. Group sessions were tape-recorded, transcribed, and divided into meaning units. Concepts contained in the meaning units were extracted. Self-report instruments on health status specific for AS were identified in a literature search. Using the International Classification of Functioning, Disability and Health (ICF) as a common reference, it was determined whether the concepts identified in the focus groups were covered by the instruments.Results.Nineteen patients participated in 4 focus group interviews. In total, 332 unique meaning units were linked to 90 second-level ICF categories, of which 25 referred to body functions, 10 to body structures, 35 to activities and participation and 30 to environmental factors. In addition, several concepts relating to personal factors were identified. Only 47 categories were also covered by one of the self-report instruments in AS. Only a minority of concepts addressed by the AS-specific questionnaires were not revealed as relevant in the interviews.Conclusion.Relevant aspects of the influence of AS are not covered by the classic disease-specific instruments. In particular, the influence of AS on socializing and leisure and the relevance of environmental and personal factors are not adequately assessed by available instruments.
Clinical and Serologic Characterization of an Argentine Pediatric Myositis Cohort: Identification of a Novel Autoantibody (anti-MJ) to a 142-kDa Protein
Authors: ESPADA GRACIELA , MALDONADO COCCO JOSE A. , FERTIG NOREEN , ODDIS CHESTER V. 
Published: October 2009

Objective.Autoantibodies are frequently found in adult patients with polymyositis (PM), dermato-myositis (DM), and overlap myositis disorders. They are less common in pediatric patients with myositis. We investigated the autoantibody pattern in a pediatric Argentine Caucasian cohort to characterize novel autoantibodies.Methods.Sera from children that satisfied published criteria for idiopathic inflammatory myopathy were analyzed for autoantibodies by RNA and protein immunoprecipitation and immunoblotting techniques. Routine myositis-specific and myositis-associated autoantibodies as well as autoantibody specificities were determined.Results.We tested sera from 64 consecutive pediatric myositis patients, including 40 with juvenile DM, 7 with juvenile PM, and 17 with overlap myositis syndromes. Sixteen (25%) patients were found to have anti-MJ autoantibody exclusively, which appears to identify a subset of pediatric myositis patients with severe disease characterized by muscle contractures and atrophy and significant compromise of functional status. Fourteen (22%) patients were found to have an antibody targeting 2 proteins of 155 and 140 kDa. Other myositis-specific autoantibodies were uncommon in this pediatric cohort.Conclusion.A newly recognized autoantibody, anti-MJ, was the most common antibody found in this Argentine pediatric cohort. The clinical features indicated that this antibody is distinct from other reported antibodies in pediatric patients with myositis.
Patients' Perceptions of Hip Resurfacing Arthroplasty
Authors: Murphy Todd P. , Trousdale Robert T. , Pagnano Mark W. , Mabry Tad M. , Sierra Rafael J. 
Published: October 2009

The purpose of this study was to understand patients' perceptions regarding hip resurfacing arthroplasty relative to conventional total hip arthroplasty (THA). A consecutive group of 139 patients being evaluated for hip symptoms were asked to complete a survey regarding hip resurfacing arthroplasty. Forty-one percent were aware of hip resurfacing arthroplasty, and 82% felt hip resurfacing arthroplasty was a safer procedure than THA. Seventy-nine percent felt there was less soft tissue damage associated with hip resurfacing arthroplasty, and 80% felt they would return to their activities more quickly. Eighty percent felt that their overall range of motion would be better following hip resurfacing arthroplasty.
Patients' perceptions of hip resurfacing arthroplasty are inconsistent with the known published advantages and disadvantages of the procedure when compared to conventional THA. Most of the patients received their information from sources other than an orthopedic surgeon.
Occipitocervical Fusion Using Contoured Rods and Medial Offset Connectors: Description of a New Technique
Authors: Garrido Ben J. , Puschak Thomas J. , Anderson Paul A. , Sasso Rick C. 
Published: October 2009

Stabilization of the occipitocervical junction and fixation of the occiput is challenging. Rigid fixation with plates and screws has reduced dependence on external immobilization and improved fusion rates. The strength of the occipital fixation can be compromised as plates constrain the ability to place occipital screws along the midline. Bilateral contoured rods with medial offset connectors allow placement of 6 occipital screws in the thickest and strongest bone along the midline, while easily connecting to screws in the cervical spine. The purpose of this study is to review complications and fusion rates in a patient series using this new technique to stabilize the occipitocervical junction.
A retrospective review was performed at 2 years of 20 patients who underwent occipitocervical fusion for instability using bilateral contoured rods with medial offset connectors. Six occipital screws were successfully placed in 17 patients. The caudal screw on one side was abandoned in 3 patients due to insufficient occipital thickness. Sixteen patients fused. Four patients died in the perioperative period secondary to polytrauma complications. There were no hardware-related complications nor failure of occipital fixation.
Bilateral rods with medial offset connectors allow parasagittal placement of 6 bicortical screws in the thickest and strongest bone along the occipital midline. The use of 6 occipital screws has been shown to be biomechanically advantageous. Using this technique, 6 occipital screws were easily placed in each of 17 patients, while 5 strong points of fixation were obtained in the other 3 patients. We experienced no failure of occipital fixation, and all surviving patients went on to fusion.
Pectoralis Major Insertional Ratio in Proximal Humerus Fractures: A Method to Reconstruct Humeral Head Height in Arthroplasty
Authors: Hasan S. Ashfaq , Rauls Russell B. , Cordell Cari L. , Heinzelmann Andrew D. , Siegel Eric R. 
Published: October 2009

A key factor for a successful outcome after hemiarthroplasty for a 4-part proximal humerus fracture is accurately restoring humeral length. Our hypothesis was that the pectoralis major insertion is not at a constant distance on the humerus, as has been previously suggested, but varies depending on the length of the humerus, and our goal was to determine if a consistent ratio exists for the insertion as it relates to total humeral length.
Thirty-eight cadaver arms were dissected to expose the pectoralis major insertion. Using a digital caliper, measurements were made from the top of the humeral head to the superior aspect of the pectoralis major insertion (HP), and from the pectoralis insertion to the lateral epicondyle (PL). The predictive ability of PL for HP was examined via regression, and the average prediction error was computed. The final predictive regression model had the following formula: pHP=0.2323×PL, where pHP is predicted HP. This equation had an average prediction error of 4.11 mm.
The PL can be measured intraoperatively during hemiarthroplasty for proximal humerus fractures. The proportionality relationship can then be used to predict HP with an average prediction error <5 mm. This relationship may facilitate accurate intraoperative reconstruction of prosthetic head height and enhance existing techniques for assessment of implant positioning.
Unilateral Carpal Tunnel Syndrome Caused by an Occult Palmar Lipoma
Authors: Bagatur A. Erdem , Yalcinkaya Merter 
Published: October 2009

Carpal tunnel syndrome usually presents bilaterally and space-occupying lesions should be suspected in patients with unilateral symptoms, especially with a long history and when the symptomatic hand shows severe neurophysiologic impairment, while the contralateral hand is neurophysiologically intact. Approximately half of patients with unilateral symptoms have positive electrodiagnostic test results in the asymptomatic, contralateral hand. Space-occupying lesions are known to cause carpal tunnel syndrome and the incidence of space-occupying lesions in unilateral carpal tunnel syndrome is higher than that of bilateral carpal tunnel syndrome. It is easy to detect a mass when it is palpable, but occult lesions may be overlooked easily.
Whenever a patient presents with unilateral symptoms and unilateral neurophysiologic impairment, the possibility of a space-occupying lesion compressing the median nerve should be kept in mind in the differential diagnosis. This article presents 2 cases of patients with occult deep palmar lipomas compressing the median nerve and causing unilateral symptoms of carpal tunnel syndrome. We stress the importance of imaging studies in patients with unilateral symptoms that are usually not used in carpal tunnel syndrome. While both patients' symptomatic hands showed severe neurophysiologic impairment, the contralateral hands were totally intact, which is contradictory with a long history. The reported patients were evaluated and magnetic resonance images revealed intra-tunnel lesions. Although lipomas are the most common soft tissue tumor in the body, <5% of the benign tumors of the hand are lipomas. Since the thick palmar fascia is strong, a deep lipoma may not be recognized although nerve compression symptoms may be gross.
Decompression, Correction, and Interbody Fusion for Lumbar Burst Fractures Using a Single Posterior Approach
Authors: Sasagawa Takeshi , Kawahara Norio , Murakami Hideki , Demura Satoru , Tomita Katsuro 
Published: October 2009

Burst fractures of the lumbar spine with instability or severe kyphosis are best served by surgical treatment. The question as to how these fractures should be approached and stabilized (anteriorly, posteriorly, or combined anteroposteriorly) is controversial. We performed decompression, correction, and interbody fusion using a single posterior approach for Denis type B or C lumbar burst fractures with severe kyphosis. The operative technique is as follows: after partial laminectomy, the bone fragment, which had migrated into the spinal canal, is impacted into the posterior wall of the vertebral body. After curetting the injured disk, bone chips and adapted lamina are inserted into the disk space for anterior support. Five Denis type B or C burst fractures demanding >20° kyphosis correction were treated by this procedure. Mean follow-up was 41 months. We evaluated neurologic assessment and localized kyphotic angle.
The neurologic function of all 5 patients improved by at least 1 grade, as measured by the Frankel grading scale. Mean values of localized kyphosis improved from a mean 23.0° before surgery to −3.0° after surgery. At follow-up examination, average regional kyphosis was −2.4°. No implant failure was observed at follow-up. Bony fusion was achieved in all patients.
The advantages of this operative procedure are it is safe for the neural structures and complete spinal canal decompression and kyphosis correction are achieved, while providing anterior support and posterior stabilization.