bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contrast-enhanced Magnetic Resonance Imaging in Patients With Dropped Head Syndrome
Authors: Endo Kenji , Nishimura Hirosuke , Sawaji Yasunobu , Aihara Takato , Suzuki Hidekazu , Konishi Takamitsu , Nagayama Kyohei , Yamamoto Kengo 
Published: October 2023

Study Design.
This is a retrospective study of a consecutive case series of dropped head syndrome (DHS).

Objective.
To identify the characteristic features of contrast-enhanced magnetic resonance imaging (MRI) in DHS patients.

Summary of Background Data.
Isolated neck extensor myopathy DHS is thought to be caused by severe cervical extensor muscle weakness from age-related loss of elasticity. However, the MRI findings of the cervical extensor muscles in DHS patients have not yet been characterized.

Materials and Methods.
The subjects were 34 patients with isolated neck extensor myopathy DHS who underwent contrast-enhanced MRI within seven months after onset and 32 patients with age-matched cervical spondylosis or cervical soft-tissue tumor as controls. The presence of enhanced findings in the cervical extensor muscles, the involved cervical levels, and the characteristically enhanced shape of those muscles were evaluated using contrast-enhanced MRI.

Results.
In the DHS group, the contrast-enhanced MRI showed pronounced enhancement at splenius capitis in 34 cases, rhomboid in 23 cases, semispinalis cervicis in seven cases, and levator scapulae in three cases. In the non-DHS group, none of those extensor muscles were enhanced. The enhanced pattern was butterfly shaped in 29 cases (85.3%) and linear in five cases (14.7%). All were located at the spinous process attachment at C6 or C7 in the DHS group. In the non-DHS group, seven cases presented an enhanced image of the spinous process, with C5-6 in one case, C6 in five cases, and C7 in one case.

Conclusions.
In DHS, contrast-enhanced MRI showed intramuscular enhancement of the cervical extensor muscles, which was not present in non-DHS cases. The enhanced muscles included the splenius capitis muscle in all cases. These findings may be useful for developing a strategy for DHS treatment.
Decomposing the Black–White Racial Disparity in Severe Maternal Morbidity Risk: The Role of Hypertensive Disorders of Pregnancy
Authors: Labgold Katie , Howards Penelope P. , Drews-Botsch Carolyn , Dunlop Anne L. , Bryan J. Michael , Ruddock Tonia , Johnston Sabrina , Kramer Michael R. 
Published: October 2023

Background:
To our knowledge, no studies have explicitly studied the role of hypertensive disorders of pregnancy (HDP) in racial disparities in severe maternal morbidity (SMM).

Methods:
Using causal mediation models, we estimated the proportion of the non-Hispanic (NH) Black–White racial disparity in risk of SMM that is explained through the pathway of HDP. We linked 2006–2019 Georgia hospital discharge records with vital statistics birth and fetal death records for NH Black and NH White birthing persons. We used G-estimation of a structural nested mean model to decompose the absolute racial disparity in the incidence of SMM into pathways operating through HDP.

Results:
NH Black birthing people experienced an excess 56 SMM events (95% confidence interval [CI] = 52, 59) per 10,000 delivery hospitalizations compared with NH White birthing people. If counterfactual disparity measure estimation assumptions hold, the estimated absolute disparity remaining after blocking the causal pathways through HDP was 41 SMM events per 10,000 deliveries (95% CI = 38, 44), suggesting that 26% (95% CI = 12, 40) of the absolute racial disparity would be eliminated if there was no contribution of HDP to SMM risk.

Conclusion:
Our results are consistent with the hypothesis that intervening to prevent HDP is an important (yet incomplete) pathway for reducing the excess risk among NH Black pregnancies compared with NH White pregnancies.
Latest advances in immuno-oncology for endometrial cancer: single-agent and combination regimens
Authors: Richardson Michael , Chase Dana M. 
Published: October 2023

Purpose of review
The scope of immuno-oncology in endometrial cancer has changed rapidly in the last several years, requiring up-to-date knowledge for those who treat these patients.

Recent findings
This article will focus on molecular profiling, recent trials, and FDA approvals of targeted immuno-oncology medications in endometrial cancer. These include immune checkpoint inhibitors alone or with combination treatment.

Summary
The publication of the TCGA has led to significant focus on molecular subgroupings into POLEm, MMRd, NSMP, and p53m groups. For those patients with MMRd vs. MMRp tumors, there are indications for single agent immune checkpoint inhibitors with dostarlimab or pembrolizumab. For those with MMRp tumors, the addition of lenvatinib to pembrolizumab has proven clinical benefit. The recent publication of the RUBY and NRG-GY018 trials have shown clinical benefit in both subgroups with addition of immune checkpoint inhibitor to platinum-based chemotherapy. Now there is approval for use of dostarlimab in frontline chemotherapy and maintenance for advanced stage or recurrent endometrial cancer. Several upcoming trials investigating molecular subgroups from the TCGA are eagerly anticipated.
Modified Preparatory Intravascular Stenting Technique in Super-microsurgical Lymphaticovenular Anastomosis for the Treatment of Lymphedema
Authors: Nuri Takashi , Asaka Akinori , Otsuki Yuki , Ueda Koichi 
Published: October 2023

Summary:
Clinical studies have reported that lymphaticovenular anastomosis (LVA) is more effective for early-stage lymphedema. However, the diameter of lymphatic vessels in early-stage lymphedema is thin (only about 0.3 mm). In this article, we report a modified preparatory intravascular stenting technique (PIST) for LVA with smaller lymphatic vessels and present the results of its application for the treatment of secondary lymphedema. In this technique, a 9-0 nylon thread is inserted into the target lymphatic vessel. Then, the thread is pulled until its tip has entered the lymphatic vessel. After that, the thread is allowed to proceed into the lumen by pushing it. Finally, with the nylon in place, the lymphatic vessel is transected and the lumen is secured. In this report, we investigated the surgical time for LVA between 10 patients who underwent LVA with modified PIST (group A) and another group of 10 patients who underwent LVA without the technique (group B). Lymphatic lumen was secured at all sites where indocyanine green lymphangiography confirmed lymphatic flow. The average outer diameter of lymphatic vessels in group A and B were 0.36 mm and 0.53 mm, respectively. The average surgical time for LVA in group A was 136 minutes, which was significantly shorter than the 187 minutes in group B. Our results indicated that modified PIST can help secure the lymphatic lumen even when the lymphatic vessels are thin. As a result, this technique can significantly reduce the surgical time for this procedure.
Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty
Authors: Wan Rou , Weissman Joshua P. , Williams Tokoya , Ullrich Peter J. , Joshi Chitang , Huffman Kristin , Galiano Robert D. 
Published: October 2023

Background:
There are different types of grafts for rhinoplasty, each with certain advantages and disadvantages. Fresh frozen cadaveric costal allograft (CCA) provides an alternative to rhinoplasties. The aim of this study was to compare the outcomes of fresh frozen CCA and traditional autologous costal cartilage in cosmetic and reconstructive rhinoplasty procedures.

Methods:
This is a prospective, single-center, nonrandomized, open-label clinical trial. Objective assessment to evaluate warping, resorption, and displacement of the cartilage was achieved by measuring the differences of standardized values (deviation angle, nasofrontal angle, total facial convexity, nasofacial angle, and nasolabial angle) obtained at 6-months and 12-months postoperative follow-up on standard two-dimensional photographs (Δ = ∣measurement6 − measurement12∣). Subjective assessment was measured by the FACE-Q assessment.

Results:
Fifty eligible patients between March 2017 and October 2020 were included. The average age was 43.9 ± 16.6 years and the mean follow-up period was 14.8 months. In the control group, the changes (Δ) in the deviation angle and nasolabial angle were greater than in the CCA group (P < 0.05). In the CCA group, the mean score of satisfaction with nose improved at 6 months and 1 year postoperatively (P < 0.05). The mean score of satisfaction with nostrils and overall facial appearance also increased in the CCA group at 6 months postoperatively (P < 0.05). Six patients from the CCA group and 10 patients from the control group experienced postoperative complications.

Conclusions:
Fresh frozen CCA is a safe and reliable source of rhinoplasty grafts. It is aseptic, readily available, and free of donor site complications.
Sleep Quality in Patients With Ocular Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Liao Yinglin , Li Jing , Yang Jing , Zhao Wenxin , Chen Ziyan , Wu Shaowen , Jin Ling , Huang Fen , Liang Lingyi 
Published: October 2023

Objectives:
To investigate the sleep quality in patients with ocular graft-versus-host disease (oGVHD) compared with patients without oGVHD after allogeneic hematopoietic stem cell transplantation (alloHCT) and healthy controls.

Methods:
This cross-sectional study analyzed 142 patients after alloHCT including 94 patients with oGVHD and 48 without. Fifty healthy controls were also enrolled. oGVHD was diagnosed according to International Chronic Ocular GVHD Consensus Group (ICOGCG) criteria. Sleep quality was assessed by the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleep quality was defined as CPQSI score greater than 6.

Results:
Patients after alloHCT demonstrated a significantly higher CPQSI score than those of controls {7.0 [interquartile range (IQR) 5.0-10.0] vs. 5.5 [IQR 4.8–7.0], P=0.002}, especially in the oGVHD subgroup (7.5 [IQR 5.0–11.0] vs. 6.0 [IQR 5.0–8.0], P=0.04) with nearly double prevalence of poor sleep quality (58 [62%] vs. 18 [37%], P=0.006). Poor sleep quality was strikingly correlated with oGVHD diagnosis (adjusted odds ratio [OR]=2.55, 95% confidence interval [CI]: 1.02–6.34, P=0.04) and systemic immunosuppressants (adjusted OR=2.61, 95% CI: 1.32–5.71, P=0.02). Among the ocular parameters, poor sleep quality was significantly associated with higher ICOGCG score (adjusted OR=1.20, 95% CI: 1.03–1.39, P=0.02) and lower tear film break-up time (adjusted OR=0.85, 95% CI: 0.74–0.99, P=0.05).

Conclusions:
Poor sleep quality was associated with an increased severity of oGVHD and tear film instability in the long-term alloHCT survivorship.
New-onset chronic inflammatory demyelinating polyradiculoneuropathy after COVID-19 infection: a case report
Authors: Abedi Samakoush Mohammad , Davoodi Lotfollah , Khademian Mojtaba , Kargar-soleimanabad Saeed , Abedini Mohammad-Ali 
Published: October 2023

Introduction and importance:
SARS-CoV-2 infection, besides respiratory symptoms, as cardinal manifestation, may present with neurological involvement. Immune-mediated polyradiculoneuropathy is one of the important neurological complications manifested by COVID-19 mainly includes Guillain–Barré syndrome (GBS), treatment-related fluctuation of GBS, and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Also, there are several reports of COVID-19 vaccine-related GBS and CIDP. According to possible severe manifestations of neuropathies like respiratory failure, considering these complications for early diagnosis and treatment is very important.

Case presentation:
The authors presented a 67-year-old woman with severe weakness in upper and lower extremities, the patient was diagnosed as case with CIDP initiated after COVID-19 virus infection and/or vaccination that experienced one relapse in 11 months. In both episodes, treatment with intravenous immunoglobulin started and the patient respond.

Clinical discussion:
To the best of our knowledge, this is one of the first reported cases with a typical chronic course of CIDP associated with COVID-19 virus infection and/or vaccination.

Conclusion:
Considering this complication and differentiation between GBS and CIDP, and then initiating maintenance therapy can prevent long-term disability.
Long-term patency of bypass to the right atrium as a last resort in two hemodialysis patients: case report
Authors: Banana Youssef , Boukabous Sara , El malki Hicham , Rezziki Abdellah , Belarbi Adam , Haddiya Intissar , Bentata Yassamine , Moutaouekkil El Mehdi , Benzirar Adnane , El Mahi Omar 
Published: October 2023

Introduction:
Central venous occlusion (CVO), which is caused by central venous catheters in haemodialysis patients , remains a challenge in vascular surgery.

Case presentation:
The authors report data evaluating bypass graft patency and complications of two patients with CVO who have benefited from a subclavian artery to right atrium bypass using polytetrafuloroetylene. The first patient , underwent three times an angioplasty of the atrio prothetic anastomosis , finally the graft failed at 12 month. The second one, presented a steal syndrome with ischaemia of the right upper limb immediately postoperatively. Three months after the procedure , she underwent an angiographic control that showed a stenosis of the protheto atrial junction.

Clinical discussion:
Central venous occlusion in patients with end-stage kidney disease is most often due to central venous catheters. Although the endovascular therapy is the first-line approach to the treatment of CVO, the surgical bypass to the right atrium is often the last resort to preserve adequate vascular access in haemodialysis patients, with CVO. The autologous vein and bovine arterial bypass remains better than polytetrafuloroetylene grafts in terms of long-term patency. Only few cases have been reported un the literature , besides no long-term outcome data has been previously reported.

Conclusion:
Long-term secondary patency of bypass to the right atrium can be achieved, but requires strict follow-up, and multiple endovascular procedures to maintain the bypass access.
Aneurysmal bone cyst of the mandible: a rare case report and literature review
Authors: Yahaya James J. , Morgan Emmanuel D. , Abraham Zephania S. , Othieno Emmanuel 
Published: October 2023

Introduction and importance:
Aneurysmal bone cysts (ABCs) are benign, non-neoplastic cystic lesions composed of multiple blood-filled cavities, which are separated by connective tissue septa and they constitute ~6 and 1.5% of all cases of the skull and jaws lesions, respectively.

Case presentation:
Herein, the case of an 80-year-old male with a histologically confirmed diagnosis of ABC involving the body of the left mandible was presented. The patient underwent partial mandiblectomy after confirmation of the diagnosis using orthopantomography, a computed tomography scan, and a tissue biopsy. The patient was free from pain after 1-year of follow-up, and the control orthopantomography showed no evidence of recurrence. This was followed by reconstruction of the healed part of the bone with titanium plates and a piece of bone from the lateral two-thirds of the left femur and thereafter he was cosmetically well.

Clinical discussion:
Patients with ABCs present with expansile and radiolucent bone lesions, which may be associated with displacement and loss of teeth due to alveolar bone erosion. Complete excision of the lesions is mandatory for the prevention of recurrence and increased morbidity.

Conclusion:
ABCs that involve the jaws are extremely rare and are more likely to pose a diagnostic challenge as they are more likely to be confused clinically with other expansile radiolucent bone lesions such as ameloblastoma, osteoblastoma, and giant cell tumor among many others. Also, those with extensive bone matrix formation may sometimes be confused histologically with other bone forming tumors including osteosarcoma. Recurrence is common but it can be avoided or minimized by complete resection of the lesion.
Clips closure versus endoloop ligation in laparoscopic appendectomy: a systematic review and meta-analysis of comparative studies
Authors: Poon Samuel Ho Ting , Law Sui Yuen , Lai Alex Ting Yeung 
Published: October 2023

Introduction:
Appendiceal stump closure (ASC) is a key step in performing laparoscopic appendicectomy. Currently, there is no gold standard method to achieve this goal. The ideal method should be safe, easily available, and have a short learning curve. Out of all those appendiceal stump closure methods, the use of hem-o-Lok demonstrates its feasibility in replacing the traditionally used endoloop. In this systematic review and meta-analysis, the authors aim to review the currently available evidence addressing the topic of interest.

Method:
The PubMed and Embase databases were searched with the paired search terms appendicitis, clip, and endoloop by two authors separately. The quality of the randomized controlled trials was assessed with the Cochrane risk of bias tool, and the quality of the observational studies was assessed with the Newcastle-Ottawa scale. Meta-analysis was conducted with Cochrane Review Manager version 5.4.

Result:
Eighteen studies were included for quantitative analysis. The appendiceal stump closure time was shortened by 2 min 7 s using a hem-o-lok with 95% CI 1 min 48 s–2 min 26 s, p less than 0.00001. The pooled results of 6 randomized controlled trials demonstrated a statistically significant reduction in operative time of 5.15 min from adopting the hem-o-lok approach (p=0.001, 95% CI −2.05 to −8.24 min). Both endoloop and hem-o-lok demonstrated a comparable postoperative hospital stay and infective complication profile.

Conclusion:
The application of Hem-o-Lok demonstrates a comparable to endoloop ligation in terms of operative time and a potential benefit on the complication. When considering financial and technical aspects, it serves as an alternative to endoloop.
Reconstructive surgery and adjuvant radiotherapy for the multimodal approach in oral cancer: a single cancer centre experience
Authors: Bernaola-Paredes Wilber Edison , Rodrigues Monica Lucia , Carvalho Henrique Perez , dos Santos Bitencourt Fernando , Coutinho Marcelo Carvalho , D’Almeida Costa Felipe , Vallejo-Rosero Kleber Arturo , Marquez-Zambrano Jose Agustin , Pellizzon Antonio Cassio Assis 
Published: October 2023

Introduction and importance:
Ablative surgery for oral cancer, irrespective of the histological subtype, causes large tissue defects, functional and aesthetic damage. Microsurgical free flaps have been widely used in reconstruction after resection, with satisfactory success rates in conjunction with adjuvant radiotherapy (RT). This study aims to describe our clinical institutional experience based on the multimodal treatment performed in four cases diagnosed with oral squamous cell carcinoma with the use of different microvascular free flaps and RT.

Case series presentation:
Four patients underwent reconstructive microsurgery after surgical resection of oral cancer, using three types of free flap: radial forearm fasciocutaneous, osteomyocutaneous fibular, and anterolateral thigh musculocutaneous flaps; RT was performed in Case 2 and Case 3. In the period of 3 years after microsurgical reconstruction and RT, flaps remain clinically stable without failure signs in full patients submitted to multimodal treatment.

Clinical discussion:
After resection of oral carcinomas, extensive tissue defects can be successfully treated with reconstructive microsurgery using different types of microvascular free flaps. RT for locoregional control is a feasible option and did not seem to interfere with the survival of flaps.

Conclusion:
An enhance long-term follow-up to assess overall and disease-free survival rates and quality of life must be carried out; however, cohort studies would be necessary for better understanding of the role of each treatment in the multimodal scheme.
Bone Echinococcosis Mimicking Malignancy on FDG PET
Authors: Takenaka Junki , Hirata Kenji , Watanabe Shiro , Takahata Masahiko , Kudo Kohsuke 
Published: October 2023

Abstract
MRI revealed a thoracic vertebrae lesion in a 40-year-old woman with back pain. She was referred to our institution; MRI demonstrated a mass from the second to the fifth thoracic vertebra and compression fractures. CT revealed a splenic mass, multiple pulmonary nodules, and low-density masses in the liver. 18F-FDG PET/CT showed increased uptake (SUVmax, 10.6) in the peripheral rim of the thoracic vertebra mass, with central parts showing lower uptake than the peripheral rim. The splenic mass exhibited increased accumulation (SUVmax, 4.8). The thoracic spine lesion was fixed; a biopsy was performed. Alveolar echinococcosis was confirmed immunologically. Alveolar echinococcosis can present with bone lesions. It must be differentiated from malignancy.
Whipple Disease Misdiagnosed as Lymphoma by 18F-FDG PET/CT: A Case Study
Authors: Cheng You , Lu Kai-yu , Shao Dan 
Published: October 2023

Abstract
Whipple disease is a rare disorder caused by infection with the gram-positive bacterium Tropheryma whipplei. It can invade various organs and systems of the whole body. This case report describes a patient with invasion of multiple lymph nodes throughout the body misdiagnosed as lymphoma by PET/CT.
Cerebral Microvascular Imaging in Infants
Authors: Hwang Misun 
Published: October 2023

Abstract
Brain ultrasound in infants, although widely utilized, provides limited functional insights into the brain. Although color and power Doppler ultrasounds have allowed quantitative assessment of cerebral macrovascular flow dynamics, there is no standardized tool integrated into the current neurosonography protocol that allows cerebral microvascular flow assessment. The evaluation of anatomic and functional changes in cerebral microvessels is important, as microvascular alterations have been shown to precede macrovascular and tissue injury in a variety of neurologic diseases of infancy. In this regard, the cerebral microvascular imaging technique is a commercially available, advanced Doppler technique in which slow flow of cerebral microvessels can be detected via a static noise suppression algorithm. This article therefore shares the basic scan technique and clinical examples of the integrated use of microvascular imaging in neurosonography for infants, setting the stage for future clinical integration of the technique.