bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of endotoxaemia and carbohydrate overload on glucose and insulin dynamics and the development of laminitis in horses
Authors: TÓTH F. , FRANK N. , CHAMEROY K. A. , BOSTON R. C. 
Published: December 2009

SummaryReasons for performing study: Insulin resistance (IR) is a risk factor for pasture‐associated laminitis in equids and alimentary carbohydrate overload may trigger laminitis. Whether glucose metabolism responses to carbohydrate overload are more pronounced in insulin‐resistant horses requires further study.Hypothesis: Horses pretreated with endotoxin to alter insulin sensitivity differ significantly in their glucose and insulin responses to carbohydrate overload.Methods: Horses (n = 24) were divided into 3 groups. A lipopolysaccharide (LPS; n = 8) group that received endotoxin as an 8 h 7.5 ng/kg bwt/h i.v. continuous rate infusion, an oligofructose (OF; n = 8) group that received an infusion of saline followed by 5 g/kg bwt OF via nasogastric intubation, and a LPS/OF (n = 8) group that received LPS followed 16 h later by OF. Glucose and insulin dynamics were evaluated at ‐24 h and 48 h using the frequently sampled i.v. glucose tolerance test and minimal model analysis. Physical examinations and haematology were performed and the severity of laminitis assessed.Results: Horses receiving LPS developed leucopenia and both LPS and OF induced clinical signs consistent with systemic inflammation. Insulin sensitivity significantly decreased (P<0.001) over time, but responses did not differ significantly among groups. Time (P<0.001) and treatment × time (P = 0.038) effects were detected for the acute insulin response to glucose, with mean values significantly increasing in LPS and LPS/OF groups, but not the OF group. Five horses in the LPS/OF group developed clinical laminitis compared with 0 and 2 horses in the LPS and OF groups, respectively.Conclusions: Endotoxaemia and carbohydrate overload reduce insulin sensitivity in horses. Endotoxin pretreatment does not affect the alterations in glucose metabolism induced by carbohydrate overload.Potential relevance: Insulin sensitivity decreases after carbohydrate overload in horses, which may be relevant to the development of pasture‐associated laminitis.
Subchondral cyst‐like lesions in the talus of four horses
Authors: Montgomery L. J. , Juzwiak J. S. 
Published: December 2009

SummarySubchondral cyst‐like lesions (SCLs) of horses have been found in various locations, but SCLs of the talus have been reported rarely. In this report, we describe 4 horses affected with a SCL of the talus. Each SCL was identified using digital radiography, and each horse was treated by intralesional injection of triamcinolone acetonide. Case details, history, findings during clinical and radiographic examination, treatment, and outcome of each horse are discussed.
Advanced twin abdominal pregnancy: diagnostic and therapeutic challenges
Authors: DASSAH EDWARD TIERU , ODOI ALEXANDER TAWIAH , OPOKU BAAFUOR KOFI 
Published: December 2009

AbstractAbdominal pregnancy remains a diagnostic challenge despite the remarkable improvements and widespread availability of antenatal ultrasound. A case of advanced twin abdominal pregnancy that was diagnosed after failed induction of labor is presented highlighting the diagnostic and hemostatic challenges encountered. The role and limitations of antenatal ultrasound as well as the importance of adhering to basic ultrasound imaging principles are emphasized as a way of ensuring an early diagnosis and minimizing the devastating consequences associated with this rare variety of ectopic pregnancy.
Helicobacter pylori infection and hyperemesis gravidarum: a systematic review and meta‐analysis of case–control studies
Authors: SANDVEN IRENE , ABDELNOOR MICHAEL , NESHEIM BRITT–INGJERD , MELBY KJETIL K. 
Published: December 2009

AbstractObjective. To summarize the evidence from epidemiological studies examining the association between Helicobacter pylori infection and hyperemesis gravidarum. Design. Systematic review and meta‐analysis of case–control studies. Material and methods. We searched the Medline/PubMed, Embase, Cinahl, ISI Web of Science and Biological Abstracts databases from 1966 to 17 June 2008 and finally Google Scholar. A total of 25 case–control studies were identified. Both fixed‐effect and random‐effect models were used to synthesize the results of individual studies. The Cochran Q, τ2 of between‐study variance and index of heterogeneity (I2) were used to evaluate heterogeneity. Heterogeneity between studies was examined by subgroup and random effect meta‐regression analyses. Publication bias was evaluated. Results. Publication bias was not observed. The random model pooled estimate was odds ratio = 3.32, 95 % confidence interval (CI): 2.25–4.90. A high heterogeneity was pinpointed (I2 = 80 %, 95 % CI: 65–89). Subgroup analysis and meta‐regression showed a weaker association in studies with a clear definition of hyperemesis gravidarum compared to studies without this condition, and weaker association in recent studies compared to earlier studies. Meta‐regression showed that these two study characteristics explained 40% of heterogeneity between studies. Conclusions. Exposure to H. pylori appears to be associated with an increased risk of hyperemesis gravidarum. The residual heterogeneity might have different reasons. Given the high prevalence of H. pylori, the public health consequence of H. pylori with regard to hyperemesis gravidarum may be important.
Predictors of term stillbirths in an inner‐city maternity hospital in Lagos, Nigeria
Authors: OLUSANYA BOLAJOKO O. , SOLANKE OLUMUYIWA A. 
Published: December 2009

AbstractObjective. To determine the rates, pattern and correlates of term/viable stillbirths (gestational age ≥ 37 weeks and fetal weight ≥ 2,500 g). Design. Unmatched case‐control, cross‐sectional study. Setting. Inner‐city maternity hospital, Lagos, Nigeria. Methods. About two‐thirds of all documented stillbirths from 2005 to 2007 were analyzed to determine factors that correlated with viability by comparing term stillbirths first with pre‐term stillbirths and then with term live births using multiple logistic regression. Main outcome measures. Prevalence rates and adjusted odds ratios at 95% confidence intervals (CIs). Results. Of the total 7,216 deliveries over the three year period, there were 917 qualifying stillbirths out of which 404 (44.1%) were macerated and 13 (1.4%) were identified with congenital anomalies. Over half (57.0%) of the mothers with stillbirths had no antenatal care. Compared with pre‐term stillbirths, term stillbirths were significantly associated with multiparity (odds ratio (OR) 0.69; 95% CI 0.48–0.99), antepartum hemorrhage (OR 0.54; 95% CI 0.35–0.83), premature rupture of membranes (OR 0.26; 95% CI 0.14–0.52), hypertensive conditions in pregnancy (OR 0.60; 95% CI 0.39–0.92), cesarean section (OR 1.71: 95% CI 1.13–2.60), cephalopelvic disproportion (OR 3.56; 95% CI 1.43–8.86), prolonged/obstructed labor (OR 1.94; 95% CI 1.22–3.07), and congenital abnormalities (OR 0.20; 95% CI 0.05–0.79). Young maternal age (OR 2.50; 95% CI 1.22–5.14), lack of antenatal care (OR 1.57; 95% CI 1.22‐3.07), cord accidents (OR 29.63; 95% CI 14.23–61.71), and fetal distress (OR 5.30; 95% CI 3.35–8.38) emerged as additional risk factors when compared with term live births. Conclusions. While the uptake of antenatal care was generally poor, most factors associated with the unacceptably high proportion of viable stillbirths in this resource‐poor setting were identical to risk factors for total stillbirths and can be effectively managed with improved maternal education and obstetric care.
Serum glycodelin pattern during the menstrual cycle in healthy young women
Authors: BERSINGER NICK A. , BIRKHÄUSER MARTIN H. , YARED MENGISTU , WUNDER DOROTHEA M. 
Published: December 2009

AbstractObjective. Glycodelin (PP14) is produced by the epithelium of the endometrium and its determination in the serum is used for functional evaluation of this tissue. Given the complex regulation and the combined contraceptive and immunosuppressive roles of glycodelin, the current lack of normal values for its serum concentration in the physiological menstrual cycle, derived from a large sample number, is a problem. We have therefore established reference values from over 600 sera. Design. Retrospective study using banked serum samples. Setting. University hospital. Methods. Measurement of blood samples daily or every second day during one full cycle. Main outcome measures. Serum concentrations of glycodelin and normal values for every such one‐ or two‐day interval were calculated. Late luteal phase glycodelin levels were compared with ovarian hormones. Follicular phase levels were compared with stimulated cycles from patients undergoing in vitro fertilization. Results. Glycodelin concentrations were low around ovulation. Highest levels were observed at the end of the luteal phase; the glycodelin serum peak was reached 6–8 days after the one for progesterone. Late luteal glycodelin levels correlated negatively with the body mass index and positively with the progesterone level earlier in the secretory (mid‐luteal) phase in the same woman. No associations with other ovarian hormones were observed. Follicular phase glycodelin levels were higher in the spontaneous than in the in vitro fertilization cycles. Conclusions. Normal values taken at two‐ or one‐day intervals demonstrate the very late appearance of high serum glycodelin levels during the physiological menstrual cycle and their correlation with progesterone occurring earlier in the cycle.
Artifact reduction of susceptibility-weighted imaging using a short-echo phase mask
Authors: Ishimori Y. , Monma M. , Kohno Y. 
Published: December 2009

Background: Susceptibility-weighted imaging (SWI) is utilized in magnetic resonance (MR) venography and other applications, but can include artifacts caused by the phase-masking process. Purpose: To demonstrate risks of filter processes used in making phase masks for SWI, and to propose a simple method for reducing artifacts. Material and Methods: Phase linearity related to echo time (TE) was evaluated for the original phase and high-pass-filtered phase using a CuSO4-doped water phantom. Effect of filter size of the Hanning window and background homogeneity were also evaluated in a phantom study. Use of a phase mask generated by data with differing magnitudes of TE was attempted in a human study. Shorter TE was used for making the phase mask, and the number of multiplications was increased. As short and long TEs were necessary simultaneously for phase mask and T2* contrast, a dual-echo technique was used. Results: Linearity of TE and phase value collapsed, and an unexpected negative phase appeared in the high-pass-filtered phase. Using a short-TE phase mask, phase-aliasing artifacts were reduced and visibility of deep veins was equivalent to that under conventional methods with an increased number of multiplications. Conclusion: Use of a short-echo phase mask in SWI is useful for reducing artifacts.
Breast magnetic resonance imaging findings in women treated with toremifene for premenstrual mastalgia
Authors: Oksa S. , Parkkola R. , Luukkaala T. , Mäenpää J. 
Published: December 2009

Background: Toremifene, a selective estrogen receptor modulator, has been shown to be effective in alleviating premenstrual breast pain. However, the exact mechanism by which toremifene and related compounds work in premenstrual mastalgia is poorly understood. Purpose: To find out if the effect of toremifene on breast would be detectable with dynamic magnetic resonance imaging (MRI). Material and Methods: This randomized, double-blind crossover study was performed on women suffering from marked premenstrual mastalgia. Ten women were randomized to receive either toremifene (20 mg) or placebo from cycle day 15 until next menstruation for three menstrual cycles. After a washout period, the treatment was crossed over for three additional cycles. The MRI evaluations were performed premenstrually at the end of each treatment phase. Breast pain and quality-of-life scores were collected from one baseline cycle and from all the treatment cycles. Results: Nine patients were evaluable for this analysis. Both the enhancement ratio and the maximum slope of enhancement tended to be smaller during the toremifene cycles as compared to placebo. On the left side, the difference in the maximum slope of enhancement between toremifene and placebo was statistically significant (median 5.150 [range 3.7–6.7] and 6.500 [range 4.9–9.5], respectively; P=0.047). T2 relaxation times as well as breast pain and quality-of-life scores were inconsistent. Conclusion: Use of toremifene is associated with measurable changes in dynamic breast MRI findings in women with cyclic breast pain.
Prostate cancer detection: the value of performing an MRI before a biopsy
Authors: Shimizu T. , Nishie A. , Ro T. , Tajima T. , Yamaguchi A. , Kono S. , Honda H. 
Published: December 2009

Background: In recent years, prostate-specific antigen (PSA) screening has been widely performed. As a result, patients who need to undergo a complete physical examination for an elevated PSA level have been rapidly increasing. Magnetic resonance imaging (MRI) examination has previously been reported to be effective for the detection of prostate cancer. Purpose: To evaluate the detectability of prostate cancer by performing MRI before biopsy, and to evaluate the relationship between detectability with MRI and cancer location, Gleason score (GS), and tumor size. Material and Methods: MRI was performed at 1.5 Tesla in 122 consecutive patients before biopsy. The detectability of prostate cancer, including sensitivity and positive predictive value (PPV) of transrectal ultrasonography (TRUS), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI) ( b=2000 s/mm2), apparent diffusion coefficient (ADC) map, and biopsy, was calculated using whole-mount section histopathology as a gold standard. In addition, the relationship between the detectability on each MRI sequence and factors such as cancer location (peripheral zone vs. transition zone), GS 5–10, short-axis diameter (≤4 mm, 5–9 mm, ≥10 mm), and long-axis diameter (≤9 mm, 10–19 mm, ≥20 mm) were also evaluated. Results: The sensitivities of TRUS, T2WI, DWI, ADC map, and biopsy were 26.9%, 41.2%, 56.7%, 57.7%, and 75.1%, respectively, and the PPVs of those modalities were 73.0%, 83.0%, 86.4%, 87.2%, and 91.5%, respectively. There was no correlation between the sensitivity of each MRI sequence and cancer location. The sensitivity of each MRI sequence increased as GS and short- and long-axis diameters of cancer lesions increased. Conclusion: MRI before a biopsy has a high detectability of prostate cancer, particularly with tumor size of more than 5 mm in short-axis diameter or 10 mm in long-axis diameter.
Magnetic resonance imaging of breast cancer and correlation with prognostic factors
Authors: Chang Yun-Woo , Kwon Kui Hyang , Choi Deuk Lin , Lee Dong Wha , Lee Min Hyuk , Lee Hye Kyung , Yang Seung Boo , Kim Yongbae , Seo Dae Young 
Published: December 2009

Background: Prognostic factors of breast cancer have been used for the prediction of clinical outcome or selection of patients for complementary treatment. Some of the imaging features of breast cancer, e.g. magnetic resonance imaging (MRI), are associated with these prognostic factors. Purpose: To evaluate the relationship between dynamic enhanced MR features and prognostic factors of clinical outcome of breast cancer. Material and Methods: A total of 136 patients with 151 breast cancers underwent 1.5T dynamic MR imaging with the use of a dynamic T1-weighted three-dimensional fast low-angle shot (FLASH) subtraction imaging technique. Morphological and kinetic analyses of MR features were evaluated using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon. Pathological prognostic factors were correlated with MR imaging characteristics, including tumor size, histological grade, lymph node status, expression of estrogen receptor (ER), expression of progesterone receptor (PR), expression of c-erbB2, determination of Ki-67 index, and microvascular density (MVD), using univariate and multivariate statistical analyses. Results: Based on univariate and multivariate analyses, spiculated tumor margins correlated significantly with lower histological grade (I–II) and positive PR expression. Rim enhancement was significantly correlated with high histological grade, presence of axillary lymph node metastasis, large tumor size, increased Ki-67 index, and increased MVD. Early peak enhancement, as seen on the first scan after contrast medium injection, was correlated with negative ER expression. Conclusion: The presence of a lesion with a spiculated margin may predict a relatively good prognosis, and the presence of a lesion with rim enhancement may predict a relatively poor prognosis.
Use of automatic tube current modulation with a standardized noise index in young children undergoing chest computed tomography scans with 64-slice multidetector computed tomography
Authors: Peng Yun , Li Jianying , Ma Daqing , Zhang Qifeng , Liu Yue , Zeng Jinjin , Sun Guoqiang 
Published: December 2009

Background: The automatic tube current modulation (ATCM) technique is available on multidetector computed tomography (MDCT) scanners, and its dose reduction benefits in clinical applications have been documented primarily in adult patients. Purpose: To evaluate the use of ATCM to reduce radiation dose while maintaining consistent image quality for young children undergoing 64-slice MDCT chest scans. Material and Methods: Chest scans (120 kV, small-scan field of view, 5-mm image slice thickness) were performed for 50 consecutive young children (0.2–3 years) using 64-slice volume computed tomography (VCT) with ATCM method and a noise index (NI) of either 8 or 9, depending on the patient's age. The scanner automatically selected the actual tube current based on NI values and patient attenuation as determined by scout scans for the study group. Image quality and volume-weighted CT dose index (CTDIvol) values (measured with small-scan field of view and 16-cm diameter CTDI phantom) were compared with images from a control group of 50 children acquired earlier using a standard protocol with fixed tube current. Two experienced pediatric radiologists assessed image quality, including resolution, noise, and artifacts, on a five-point scale. Scores greater than or equal to 3 were considered to be clinically acceptable. Results: The mean image quality score and CTDIvol for the study and control groups were 3.46 and 2.34±0.71 mGy, and 4.65 and 6.68±0.62 mGy, respectively. While there was a statistically significant decrease in image quality in the study group, all studies had acceptable image quality, and CTDIvol with ATCM was about 65% lower than that with fixed tube current. The average image noise for the control group was 4.78±0.58, versus 7.53±0.42 and 8.28±0.40 for children under and above 1 year of age, respectively, in the study group. Despite a higher average noise level, the study group with ATCM demonstrated a lower standard deviation of image noise. Conclusion: The z-axis ATCM method produces consistent image quality for young children undergoing 64-slice MDCT chest scans. With noise levels of NI=8 and 9 at 5-mm image slice thickness, one may obtain clinically acceptable images with significantly reduced radiation dose.
Spectrum of magnetic resonance imaging appearances of juvenile temporomandibular joints (tmj) in non-rheumatic children
Authors: Tzaribachev N. , Fritz J. , Horger M. 
Published: December 2009

Background: Temporomandibular joints (TMJ) are frequently involved in children with juvenile idiopathic arthritis (JIA), and gadolinium-enhanced magnetic resonance imaging (MRI) is the only modality for an early diagnosis. However, only very few data exist on the appearance of contrast-enhanced MRI of normal juvenile TMJ. Purpose: To define the spectrum of normal MRI findings of juvenile TMJ, and to assess a possible overlap with findings typical for active synovitis in JIA. Material and Methods: 96 children (192 TMJ), 51 boys and 45 girls with a median age of 7.8 years (range 3–13 years), underwent a head MRI. The presence of autoimmune disease, including JIA, was excluded via chart history, available laboratory findings, and the absence of known typical pathological MRI changes (degree of synovial enhancement, hyperintense signal on T2-weighted images in the synovia or bone marrow, and morphologic changes of the mandibular condyle) of the TMJ affected by JIA. Results: In 90 (94%) children, the TMJ showed no MRI abnormalities compatible with arthritis. In three children (3%), the only abnormal MRI finding was a small bilateral joint effusion. A further three children (3%) had a mild synovial enhancement seen on both axial and coronal MR planes in one child and only in the axial plane in the other two children. Signal hyperintensity on T2-weighted images and other corresponding characteristics of TMJ inflammation were lacking in all these six patients. Conclusion: The vast majority of juvenile TMJ in non-rheumatic children shows no MRI abnormalities. Exceptions, including a discrete enhancement of the synovial membrane (3%) or small joint effusions (3%), can occur in a minority of patients, but none of them are accompanied by other signs of inflammation or morphological changes of the TMJ.
Congenital hydrocephalus and ventriculoperitoneal shunts: influence of etiology and programmable shunts on revisions
Authors: Notarianni Christina , Vannemreddy Prasad , Caldito Gloria , Bollam Papireddy , Wylen Esther , Willis Brian , Nanda Anil 
Published: December 2009

Object
Hydrocephalus is a notorious neurosurgical disease that carries the adage “once a shunt always a shunt.” This study was conducted to review the treatment results of pediatric hydrocephalus.

Methods
Pediatric patients who underwent ventriculoperitoneal shunt surgery over the past 14 years were reviewed for shunt revisions. Variables studied included age at shunt placement, revision, or replacement; programmable shunts; infection; obstruction; and diagnosis (congenital, posthemorrhagic, craniospinal dysraphism, and others including trauma, tumors, and infection). Multiple regression analysis methods were used to determine independent risk factors for shunt failure and the number of shunt revisions. The Kaplan-Meier method of survival analysis was used to compare etiologies on the 5-year survival (revision-free) rate and the median 5-year survival time.

Results
A total of 253 patients were studied with an almost equal sex distribution. There were 92 patients with congenital hydrocephalus, 69 with posthemorrhagic hydrocephalus, 48 with craniospinal dysraphism, and 44 with other causes. Programmable shunts were used in 73 patients (other types of shunts were used in 180 patients). A total of 197 patients (78%) underwent revision surgeries due to shunt failures. The mortality rate was 1.6%. Age at first revision, the 5-year survival rate, and the median 5-year survival time were significantly less for both posthemorrhagic and craniospinal dysraphism than for either the congenital or “other” group (p < 0.05). The failure rate and number of revisions were not significantly reduced with programmable shunts compared with either pressure-controlled or no-valve shunts (p > 0.5).

Conclusions
Posthemorrhagic hydrocephalus and craniospinal dysraphism hydrocephalus had significantly earlier revisions than congenital and other etiologies. Programmable systems did not reduce the failure rate or the average number of shunts revisions.