bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Contrast Enhancement Pattern in Two Different T1-Weighted 3-D Sequences in MR Imaging of the Breast
Authors: Wiberg M. Kristoffersen , Boné B. , Bronge L. , Aspelin P. 
Published: October 2009

Purpose: Can a complementary 3-D T1-weighted sequence (MPRAGE) facilitate the evaluation of contrast enhancement in patients with widespread and early contrast enhancement in our standard 3-D T1-weighted FLASH sequence? Material and Methods: Twenty patients with 21 breast lesions were examined with both FLASH and MPRAGE sequences. the MR examinations were reviewed independently by three radiologists. Results: In both the FLASH and MPRAGE sequences, 11 lesions were true-positive. In the FLASH sequence alone, 3 lesions were true-negative and 13 false-positive in comparison to the MPRAGE sequence alone in which 10 lesions were true-negative and 6 false-positive. Seven lesions that were false-positive in the FLASH sequence were true-negative in the MPRAGE sequence: this shows that MPRAGE has the potential to downgrade the false-positive findings found in the FLASH sequence. Conclusion: Due to its higher sensitivity, FLASH is the sequence of first choice at routine examination. However, when atypical increased enhancement was found, the addition of the MPRAGE sequence improved the specificity of the MR investigation.
Embolotherapy for Pulmonary Arteriovenous Malformations in Patients with Hereditary Hemorrhagic Telangiectasia (Rendu-Osler-Weber Syndrome)
Authors: Andersen P. E. , Kjeldsen A. Drøhse , Oxhøj H. , Vase P. , White R. I. 
Published: October 2009

Purpose: To evaluate the clinical results of embolization of pulmonary arteriovenous malformations (PAVMs) in patients with hereditary hemorrhagic telangiectasia (HHT), the Rendu-Osler-Weber syndrome. Material and Methods: Twelve patients in the county of Fyn, Denmark, were treated with transcatheter embolization of 20 PAVMs using 12 detachable silicone balloons and 26 steel coils. Results: All PAVMs were completely occluded and we observed a significant rise in PaO2 after treatment and a significant decrease in right-to-left shunt estimated by contrast echocardiography. All patients experienced an improved functional level. One patient experienced severe pleurisy and another a rise in temperature following treatment, but otherwise no symptomatic complications were observed. Conclusion: Embolotherapy is a definitive treatment for PAVMs: it is very effective with a high success rate and few complications. Patients with HHT are at risk of PAVM and should be screened and treated for PAVMs when these reach a size that is associated with complications. In the detection of PAVMs, contrast echocardiography is a very sensitive method, and follow-up of these patients can be done with contrast echocardiography.
Diagnostic Quality in Hysterosalpingography
Authors: Lindequist S. , Rasmussen F. , Madsen H. H. Torp , Næser A. , Bjartveit K. , Kristoffersen D. T. , Klaveness A. J. 
Published: October 2009

Purpose: To compare the diagnostic quality and adverse events of the water-soluble, non-ionic, iso-osmolar, dimeric contrast media iodixanol and iotrolan in hysterosalpingography (HSG). Material and Methods: One hundred and twenty patients participated in a double-blind randomized parallel-group phase-III study. Questionnaires and patient interviews were used. Diagnostic quality was assessed using a visual analogue scale and the quality in specific regions was rated using a categorical scale. Results: Overall diagnostic quality was equal for the two groups. There was no statistically significant difference between the two groups in diagnostic quality in the specific regions of interest. No differences between the contrast media were found with regard to adverse events. Conclusion: Both contrast media provided images of high diagnostic quality in HSG.
CT Measurement of Lung Density
Authors: Kalef-Ezra J. , Karantanas A. , Tsekeris P. 
Published: October 2009

Purpose: The aim of this study was to obtain more accurate data on the electron density of the lungs in healthy subjects and to determine the factors that influence this value. Material and Methods: Single kVp quantitative CT was applied in 130 normal adults (61 men and 69 women) to study the electron density of the lung. Results: The electron density of the lung in men was lower than that in women. In contrast, the area designated as lung in men was larger than that in women. The mean electron density decreased with increasing age in men, but not in women. The following parameters were not found to influence lung electron density: body mass, body height, smoking habits, and right or left lung. The electron density of the lung medial to the thoracic wall and close to the breast was lower than the density in the entire lung parenchyma. Conclusion: Quantitative CT provided the means to study noninvasively the electron density of the lung and the factors that influence this value.
RARE-MR-Urography — A New Diagnostic Method in Autosomal Recessive Polycystic Kidney Disease
Authors: Kern S. , Zimmerhackl L.-B. , Hildebrandt F. , Uhl M. 
Published: October 2009

Purpose: To describe the appearance of autosomal recessive polycystic kidney disease (ARPKD) by using a new diagnostic method: RARE-MR-urography. Material and Methods: Eight children were evaluated using MR images from 0.23 T and 1.5 T MR units, using T1-weighted spin-echo and T2-weighted turbo spin-echo sequences and RARE-MR-urography. Signal intensities, morphological appearance of the affected kidneys and, specifically, the picture of the urinary tract in RARE-MR-urography, were evaluated. Results: All children showed enlargement, reniform but humpy kidney shape, homogeneous-grainy renal parenchyma, normal renal pelvis and calyces. Although ARPKD is always associated with some degree of congenital hepatic fibrosis, there was no bile duct dilatation or liver fibrosis at the time of examination. Signal intensity was hyperintense in T2-weighted images in all cases. In 5 cases, T1-weighted images were hypointense. In RARE-MR-urography, hyperintense, linear, radial patterns in cortex and medulla were seen, which represent microcystic dilatation of collecting ducts and are therefore characteristic of ARPKD. Four patients presented with a few circumscribed small subcapsular cysts. Conclusion: RARE-MR-urography is a noninvasive method which demonstrates the pathognomonic water-filled cystic structures throughout the kindeys in ARPKD.
Biventricular Diastolic Cardiac Function Assessed by MR flow Imaging using a Single Angulation
Authors: Kroft L. J. M. , de Roos A. 
Published: October 2009

Purpose: To evaluate whether one single angulation is reliable for biventricular diastolic MR flow measurements across both the mitral and tricuspid valves. Material and Methods: MR flow imaging was performed in 14 healthy volunteers and 14 patients with pulmonary fibrosis. Flow curve parameters were calculated from the mitral valve in mitral valve angulation, the tricuspid valve in tricuspid valve angulation, and also from the mitral valve in tricuspid valve angulation and the tricuspid valve in mitral valve angulation. Results: for flow through the mitral valve, there were no significant differences between angulation set parallel to the mitral valve and angulation set parallel to the tricuspid valve for the diastolic inflow volume, the E-peak and the E:A ratio as measured in healthy volunteers and patients. the tricuspid valve flow was imaged well when the angulation was set parallel to the tricuspid valve, but not when angulation was set parallel to the mitral valve. the results indicate that the inflow volumes, the E-peak, and the E:A peak ratios across the mitral valve and tricuspid valve can be obtained using one single angulation which is set parallel to the tricuspid valve. Conclusion: Biventricular diastolic flow measurements can be obtained using one single angulation set parallel to the tricuspid valve.
Motion Artifacts in Cardiac CT
Authors: Knollman F. D. , Halfmann R. , Regn J. , Loebe M. , Ewert R. , Hetzer R. , Felix R. 
Published: October 2009

Purpose: Cardiovascular applications of CT are primarily limited by temporal resolution of the scanner. Recent development in scanner technology has greatly increased temporal resolution. We here describe a standardized method of assessing temporal properties of various CT techniques. Material and Methods: the Novacor left ventricular assist device was mounted in a water-filled circulation phantom and scanned at different pump rates with a spiral CT unit and an electron beam unit. We also evaluated the use of ECG-triggered subsecond scanning on a spiral CT unit. Results: Using the fastest conventional scanning protocol, severe motion artifacts occurred. These artifacts could not be reproduced from image to image, even if the pump rate was adjusted to scan rate (1/s). Electron beam tomography (EBT) reproducibly yielded few artifacts at 100 ms and practically no artifacts at 50 ms scanning time. Even without ECG-triggering, pump motion could be reproduced as a cine-cycle. With the ECG-triggered partial scanning CT technique, limited motion artifacts could be reproduced during diastole at a heart rate of 70–80 beats/min. Conclusion: the Novacor ventricular assist device may serve as a benchmark test in the evaluation of new scanning techniques for cardiovascular CT. While EBT presently remains the only CT technique to freeze cardiac motion throughout its cycle, ECG-triggered subsecond scans may, under certain conditions, capture cardiac anatomy in diastole.
Reliability of Ultrasonography in the follow-up of Hip Dysplasia in Children above 2 Years of Age
Authors: Tegnander A. , Terjesen T. 
Published: October 2009

Purpose: the aim of the present study was to assess whether ultrasonography (US) was reliable in the follow-up of children above 2 years of age who had previously been treated for congenital or developmental hip dislocation or dysplasia (HD). Material and Methods: As part of the routine follow-up, we examined 53 children (106 hips), aged 2–12 years (mean 6 years). Using US, the coverage of the femoral head was assessed by the distance from the lateral tangent of the ossified femoral head to the lateral bony acetabular rim (lateral head distance, LHD). the corresponding distance was measured on radiographs (LHDR). the radiographic femoral head coverage was assessed by the migration percentage (MP) and the center-edge (CE) angle. Results: We found a good accordance between sonographic LHD and the radiographic parameters MP and CE in all age groups, indicating that femoral head coverage was reliably assessed by US. There was also a high correlation between LHD and LHDR (r=0.85). All hips with subluxation were detected by US. In 11 hips that appeared normal on US, but with dysplasia or uncertain findings by radiography, the condition spontaneously normalized in 9 out of 9 examined hips with further follow-up. Conclusion: Because a reliable assessment of the hip is obtained, we recommend that US should be used as the primary imaging technique in the routine follow-up of children above 2 years of age with previous HD. Radiography should be omitted when US shows normal findings and is only needed when the US LHD is above the upper normal limit or the hip looks abnormal or suspicious by subjective evaluation.
Effect of Age, Sex, and Timing on Correction of Spastic Equinovarus following Cerebrovascular Accident
Authors: Namdari Surena , Park Min Jung , Baldwin Keith , Hosalkar Harish S. , Keenan Mary Ann 
Published: October 2009

Background: Spastic equinovarus (SEV) is the most common leg deformity after cerebrovascular accident (CVA). This study reviewed functional outcomes after surgical correction of SEV in a cohort of hemiplegic, post-CVA patients. Methods: Sixty-four consecutive post-CVA SEV patients who underwent surgical correction from January 2003 to January 2006 were included. Data parameters included age, sex, duration since CVA, preoperative orthotic and ambulatory requirements, and Viosca ambulation scores. There were 45 females and 19 males. Average age was 54 (range, 24 to 74) years. Average duration from CVA to surgery was 66 (range, 17 to 523) months. Mean followup was 50.1 (range, 12 to 168) weeks. Final outcomes included status of correction, bracing needs, use of assistive devices, and Viosca score. Univariate and multivariate statistical analyses were performed to determine if age, sex, and time from CVA to surgery affected outcome. Results: All feet were corrected to plantigrade position. Of the 48 patients who used orthoses preoperatively, 27 (56%) continued use while 11 (44%) were brace-free postoperatively. Of the 23 patients that used an ambulatory assistive device preoperatively, 12 (52%) continued use and 11 (47.8%) were free of assistive devices postoperatively. Median Viosca score improved from two (Independent Household Ambulation) to three (Independent Neighborhood Ambulation) ( p < 0.001). There was no statistical association between age, sex, CVA chronicity and outcome parameters. Conclusion: These results indicate that surgical correction of SEV is effective in post-CVA patients. Patients demonstrated improvement in ambulation score regardless of age, sex, or duration from CVA to surgery. Level of Evidence: IV, Retrospective Case Study
Evidence-Based Classification of Complications in Total Ankle Arthroplasty
Authors: Glazebrook Mark A. , Arsenault Kory , Dunbar Michael 
Published: October 2009

Background: Total ankle arthroplasty (TAA) has become a viable treatment for end-stage ankle arthrosis. Current literature on survival rates and complications of TAA consist of mostly retrospective Level IV papers that do not provide a system for classifying complications. The aim of the current review is to provide a summary of TAA implant survival and complication rates from current literature on outcomes of second or third generation ankle prostheses and subsequently propose a classification system. Methods: A literature review was used to identify articles reporting complications and failures of TAA ankle prostheses. Inclusion criteria included studies with at least 25 cases and a minimum of 24 months followup. Results: Twenty studies met the inclusion criteria. The percentage of failed TAA reported for the short- and intermediate-term followup in this review ranged from 1.3 to 32.3 % with an overall mean of 12.4 % failure at 64 months. Nine main complications of TAA were identified. Conclusion: Deep infection, aseptic loosening and implant failure should be considered “high-grade” complications since they will result in failure greater than 50% of the time. Technical error, subsidence and postoperative bone fracture should be considered “medium-grade”, while intra-op bone fractures and wound healing problems should be considered “low-grade”. We believe this review provides the groundwork for uniform complication reporting in TAA and allows the development of a classification system that will provide prognostic information that may serve to guide postoperative care of patients receiving TAA. Level of Evidence: III, Systematic Review of Level III and IV Studies
Effects of Custom and Semi-Custom Foot Orthotics on Second Metatarsal Bone Strain during Dynamic Gait Simulation
Authors: Meardon Stacey A. , Edwards W. Brent , Ward Erin , Derrick Timothy R. 
Published: October 2009

Background: Stress fractures of the lower extremity are common in military and running populations. Research on the effectiveness of orthotics in modifying bone strain is limited. Our hypothesis was that custom and semi-custom foot orthotics would equally decrease bone strain of the second metatarsal. Materials and Methods: Eight cadaver specimens were cast for two types of orthotics, a custom and semi-custom device, using neutral plaster casts. Cadaver specimens, mounted to a dynamic gait simulator, walked over a force platform while force and bone strain data were collected. Peak bone strains, strain rates and tendon forces during the stance phase for each condition were analyzed using repeated measures analysis of variance and effect sizes. Results: Condition effects were present for tension strain, shear strain, compression rate and shear rate. Specifically, custom orthotics significantly decreased the aforementioned bone strains and strain rates ( p ≤ 0.01 for all) and the semi-custom orthotic decreased tension strains and shear strain rates ( p = 0.05 and 0.03, respectively). The effect of custom and semi-custom devices only differed significantly for compression and shear strain ( p = 0.04 and 0.02, respectively) with custom orthotics having a greater effect. Conclusion: Both custom and semi-custom orthotics modified the second metatarsal bone strain and strain rate. The use of custom orthotics during simulated walking decreased second metatarsal bone strains and strain rates more effectively than semi-custom orthotics. Clinical Relevance: Orthotics may minimize the strain magnitudes and rates of the second metatarsal in walking and therefore are a feasible treatment option for the treatment and prevention of stress injury to the second metatarsal.
Castle Stopgap: Historical Reality, Literary Realism, and Oral Culture
Authors: O'Donnell Katherine 
Published: October 2009

Maria Edgeworth's Castle Rackrent (1800) relates the genealogy of the various Irish squires, and after reading this short novel King George iii reportedly said, “I know something now of my Irish subjects.” This article focuses on the issue of knowing, specifically knowing the Irish subject. I argue that knowledge and the processes of identification in the novel are ultimately made unintelligible by the gap between the different standards and practices of oral and literary cultures. To call the narrator Thady Quirk, the family retainer at Castle Rackrent, an unreliable narrator fails at marking how fundamentally his narration undermines every convention of the realist novel. Castle Rackrent is best understood as owing a profound debt to the virtuoso oral performance of Anglo-Gaelic culture.
Monocyte Derived Interleukin (IL)-23 Is an Important Determinant of Synovial IL-17A Expression in Rheumatoid Arthritis
Authors: STAMP LISA K. , EASSON ANDREA , PETTERSSON LINDA , HIGHTON JOHN , HESSIAN PAUL A. 
Published: October 2009

Objective.To demonstrate gene expression of interleukin (IL)-17A, IL-23, and IL-12 and to determine the proximity of IL-17A and IL-23 producing cells in rheumatoid synovial tissue.Methods.Total RNA was isolated from 25 synovial membranes obtained from 20 patients with rheumatoid arthritis (RA). Quantitative real-time polymerase chain reaction was used to measure IL-17A, IL-12p35, IL-23p19, p40, and GAPDH expression. Immunohistochemistry was utilized to determine cell type and proximity of IL-17A, IL-12, and IL-23 in rheumatoid synovium.Results.IL-17A was present in 13/25 synovia. IL-12p35 was present in all samples while IL-23p19 was present in 23/25. p40 was present in 23/25 samples. Of the 2 p40– samples both were IL-23p19 and IL-12p35 positive. Mean expression of IL-23p19 was significantly higher in the IL-17A+ versus IL-17A− synovia (0.10 ± 0.02 ng vs 0.05 ± 0.01 ng; p < 0.05). There was no difference in IL-12p35 expression between IL-17A+ and IL-17A− synovia (0.5 ± 0.21 ng vs 0.38 ± 0.24 ng; p = 0.2). All IL-17A+ cells were in the vicinity of IL-23+ cells. IL-12+ cells were both close to and removed from IL-17A+ cells. Only a proportion of CD3+T cells appeared to produce IL-17A.Conclusion.IL-17A gene expression occurs in only a subset of rheumatoid synovial membranes. IL-23 gene expression is higher in IL-17A+ versus IL-17A− membranes. In keeping with this, IL-17A+ and IL-23+ cells colocalize in synovial membranes. IL-17 is not an absolute requirement in RA but may be important in amplifying the inflammatory response. Anti-IL23 therapies may have a role in those patients with IL-17A expression.
Reactivation of Hepatitis B Viral Infection in Inactive HBsAg Carriers Following Anti-Tumor Necrosis Factor-α Therapy
Authors: CHUNG SOO-JIN , KIM JA KYUNG , PARK MIN-CHAN , PARK YONG-BEOM , LEE SOO-KON 
Published: October 2009

Objective.To investigate whether anti-tumor necrosis factor-α (TNF-α) therapy can influence the reactivation of hepatitis B virus (HBV) infection in inactive HBsAg carriers.Methods.The medical records of 103 patients [59 with ankylosing spondylitis (AS), 41 with rheumatoid arthritis (RA), 2 with juvenile RA, and 1 with psoriatic arthritis] who had been treated with anti-TNF-α therapy were reviewed retrospectively. Data on seropositivity of HBV, HBV load, and serum aminotransferases prior to and after initiation of anti-TNF-α therapy were obtained.Results.Eight patients were inactive HBsAg carriers, and all of them had normal liver function and undetectable HBV load prior to anti-TNF-α therapy. Reactivation of hepatitis B occurred in 1 patient during the course of anti-TNF-α therapy. After the third infusion of infliximab 5 mg/kg at Week 6, a blood test showed that the patient had normal liver function. When the patient returned for the fourth infusion of infliximab at Week 14, a blood test showed markedly elevated aspartate aminotransferase (AST)/alanine aminotransferase (ALT) levels (457 and 1054 IU/l, respectively) and increased viral DNA by HBV polymerase chain reaction (PCR). The fourth infliximab infusion was canceled, and entecavir 0.5 mg/day was prescribed. Then AST/ALT levels began to decrease and returned to normal range after 3 months. Followup HBV PCR showed negative results.Conclusion.We found 1 HBV reactivation case among 8 inactive HBsAg carriers following anti-TNF-α therapy. This finding supports the prophylactic use of antiviral agents in HBV carriers, even if they have normal liver function or an undetectable viral load.
Proinflammatory Cytokines Synergistically Enhance the Production of Chemokine Ligand 20 (CCL20) from Rheumatoid Fibroblast-like Synovial Cells in vitro and Serum CCL20 Is Reduced in vivo by Biologic Disease-modifying Antirheumatic Drugs
Authors: KAWASHIRI SHIN-YA , KAWAKAMI ATSUSHI , IWAMOTO NAOKI , FUJIKAWA KEITA , ARAMAKI TOSHIYUKI , TAMAI MAMI , ARIMA KAZUHIKO , KAMACHI MAKOTO , YAMASAKI SATOSHI , NAKAMURA HIDEKI , TSURUMOTO TOSHIYUKI , KONO MASAFUMI , SHINDO HIROYUKI , IDA HIROAKI , ORIGUCHI TOMOKI , EGUCHI KATSUMI 
Published: October 2009

Objective.Chemokine ligand 20 (CCL20) is a selective ligand for chemokine receptor 6 (CCR6). We investigated, both in vitro and in vivo, whether CCL20 is critically involved in the disease process of rheumatoid arthritis (RA).Methods.In vitro study investigated the effect of proinflammatory cytokines and biologic disease-modifying antirheumatic drugs (DMARD) on the production of CCL20 by rheumatoid fibroblast-like synovial cells (FLS). The in vivo role of CCL20 was studied by screening for serum CCL20 concentration in patients with RA during the therapeutic course of biologic DMARD, i.e., infliximab, etanercept, and tocilizumab.Results.Spontaneous CCL20 production from rheumatoid FLS was minimal; however, its production was significantly stimulated by interleukin 1ß (IL-1ß), tumor necrosis factor-α (TNF-α), or IL-17. IL-1ß was the most potent for stimulating the production of CCL20. CCL20 production was synergistically augmented by a combination of IL-1ß, TNF-α, and IL-17. In contrast, interferon-γ suppressed IL-1ß-induced CCL20 production. IL-6, in combination with soluble IL-6 receptor (sIL-6R), did not modulate CCL20 production, whereas IL-1ß-induced, TNF-α-induced, and IL-17-induced production were increased by IL-6. These production levels were clearly suppressed by biologic DMARD in vitro. Serum CCL20 was significantly higher in RA than in control subjects, and was clearly decreased by the treatment with infliximab, etanercept, and tocilizumab.Conclusion.Proinflammatory cytokines modulate the production of CCL20 from FLS. Our data suggest that therapeutic efficacy of biologic DMARD may result from the inhibition of CCL20 production in rheumatoid synovium.