bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser combined with radiotherapy for keloid treatment: a novel and efficient comprehensive therapy with a lower recurrence rate
Authors: Ma Qian-Yu , Yang Ya-Ting , Chen Zong-An , Xie Chun-Hui , Wang Wen-Bo , Lin Xiang , Xia Ling-Ling , Zhao Qiong , Gao Zhen , Wu Xiao-Li 
Published: March 2023

Background:
Keloid is a fibroproliferative skin disorder with a high recurrence rate. Combined therapies are most used in clinical treatments but relatively high risk of relapse remains a question, the various side effects, and the complexity of the treatment process therapies remain unknown for the current combination therapies.

Methods:
Totally 99 patients with keloids in 131 positions were included in this retrospective study. Fractional CO2 laser therapy was first applied (Alma Laser, Israel) with energy ranging from 360-1008mJ. Then the 6 Mev, 900 cGy electron beam irradiation was applied twice. The first pass was initiated within 24 hours after the laser therapy, and the second pass was performed on the 7th day after laser therapy. The patient and observer scar scale (POSAS) evaluated the lesions before the treatment and at 6-, 12-, 18-month post-treatment. At each follow-up visit, all the patients filled up a questionnaire of recurrence, side effects, and satisfaction.

Results:
We found a significant decrease in the total POSAS score (29[23, 39] versus 61.2±13.4, P＜0.001) at the 18-month follow-up compared to the baseline value (before the therapy). A total of 12.1% of the patients have recurrences during the 18-month follow-up period (11.1% for partial recurrence and 1.0% for complete recurrence). The total satisfaction rate was 97.0%. No severe adverse effects were observed during the follow-up period.

Conclusions:
CHN·Wu LCR is a new comprehensive therapy composed of ablative lasers and radiotherapy for keloids with excellent clinical efficacy, low recurrence rate and no serious adverse effects.
Surgical and Patient-Reported Outcomes of 694 Two-Stage Prepectoral vs. Subpectoral Breast Reconstructions
Authors: Asaad Malke , Yu Jessie Z. , Tran Jacquelynn P. , Liu Jun , O’Grady Brittney , Clemens Mark W. , Largo Rene D. , Mericli Alexander F. , Schaverien Mark , Shuck John , Mitchell Melissa P. , Butler Charles E. , Selber Jesse C. 
Published: March 2023

Introduction:
Opinion regarding the optimal plane for prosthetic device placement in breast reconstruction patients has evolved. The purpose of this study was to assess the differences in complication rates and patient satisfaction between patients who underwent prepectoral and subpectoral implant-based breast reconstruction (IBR).

Methods:
We conducted a retrospective cohort study of patients who underwent two-stage IBR at our institution in 2018-2019. Surgical and patient-reported outcomes were compared between patients who received a prepectoral versus a subpectoral tissue expander.

Results:
A total of 694 reconstructions in 481 patients were identified (83% prepectoral, 17% subpectoral). The mean body mass index was higher in the prepectoral group (27 vs. 25 kg/m 2, p=0.001), while postoperative radiotherapy was more common in the subpectoral group (26% vs 14%, p=0.001). The overall complication rate was very similar at 29.3% in the prepectoral and 28.9% in the subpectoral group (p=0.887). Rates of individual complications were also similar between the two groups. A multiple frailty model showed that device location was not associated with overall complications, infection, major complications, or device explantation. Mean scores for satisfaction with the breast, psychosocial well-being, and sexual well-being were similar between the two groups. Median time to permanent implant exchange was significantly longer in the subpectoral group(200 vs. 150 days, p<0.001).

Conclusion:
Prepectoral breast reconstruction results in similar surgical outcomes and patient satisfaction compared to subpectoral IBR.
Short Fasciotomy-Deep Inferior Epigastric Perforator Flap Harvest for Breast Reconstruction
Authors: Kim Jisu , Lee Kyeong-Tae , Mun Goo-Hyun 
Published: March 2023

Background:
Despite several technical modifications to further reduce donor invasiveness in harvesting deep inferior epigastric perforator (DIEP) flaps, techniques with general applicability and demonstrating clinical benefits are scarce. The present study aimed to introduce a short-fasciotomy technique and evaluate its reliability, efficacy, and applicability by comparing with those of conventional methods.

Methods:
A retrospective study was conducted with 304 consecutive patients who underwent DIEP flap-based breast reconstruction, consisting of 180 using the conventional technique between October 2015 and December 2018 (cohort 1) and 124 implementing short-fasciotomy technique between January 2019 and September 2021 (cohort 2). In the short-fasciotomy technique, the rectus fascia was incised as much as that overlay the intramuscular course of targeted perforators. After intramuscular dissection, pedicle dissection proceeded without additional fasciotomy. Postoperative complications and fasciotomy-saving benefit were compared.

Results:
The short-fasciotomy technique was successfully adapted for all patients in cohort 2 regardless of length of intramuscular course and number of harvested perforators, with no case requiring conversion to the conventional technique. The mean length of fasciotomy in cohort 2 was 6.6 cm, significantly shorter than that in cohort 1 (11.1cm). The mean length of the harvested pedicle in cohort 2 was 12.6cm. No flap loss occurred in either group. The rate of other perfusion-related complications did not differ between two groups. The rate of abdominal bulge/hernia was significantly lower in cohort 2.

Conclusions:
The short-fasciotomy technique allows for less invasive DIEP flap harvest regardless of anatomical variability and provides reliable outcomes with minimal functional donor morbidity.
Comparison of 3 CT Perfusion Software Packages in Estimation of Ischemic Lesions in Acute Ischemic Stroke Patients
Authors: Li Xiang , Zeng Chen , Li Yige , Liu Huan , Liu Ling , Zeng Wenbing , Yang Ran 
Published: March 2023

Objective
The aim of this study was to compare 3 computed tomography perfusion (CTP) software packages in the estimation of infarct core volumes, hypoperfusion volumes, and mismatch volumes.

Methods
Forty-three patients with large vessel occlusion in the anterior circulation who underwent CTP imaging were postprocessed by 3 software packages: RAPID, advantage workstation (AW), and NovoStroke Kit (NSK). Infarct core volumes and hypoperfusion volumes were generated by RAPID with default settings. The AW and NSK threshold settings were the following: infarct core (cerebral blood flow [CBF] <8 mL/min/100 g, CBF <10 mL/min/100 g, CBF <12 mL/min/100 g, and cerebral blood volume [CBV] <1 mL/100 g) and hypoperfusion (Tmax >6 seconds). Mismatch volumes were then obtained for all the combinations of the settings. Bland-Altman, intraclass correlation coefficient (ICC), and Spearman ρ or Pearson correlation coefficient were applied for statistical analysis.

Results
In the estimation of infarct core volumes, good agreement was observed between AW and RAPID when CBV <1 mL/100 g (ICC, 0.767; P < 0.001). For hypoperfusion volumes, good agreement (ICC, 0.811; P < 0.001) and strong correlation (r = 0.856; P < 0.001) were observed between NSK and RAPID. For mismatch volumes, the setting of CBF <10 mL/min/100 g combined with hypoperfusion with NSK resulted in moderate agreement (ICC, 0.699; P < 0.001) with RAPID, which was the best among all other settings.

Conclusions
The estimation results varied among different software packages. Advantage workstation had the best agreement with RAPID in the estimation of infarct core volumes when CBV <1 mL/100 g. NovoStroke Kit had better agreement and correlation with RAPID in the estimation of hypoperfusion volumes. NovoStroke Kit also had moderate agreement with RAPID in estimating mismatch volumes.
Effect of 320-Row Computed Tomography Acquisition Technology on Coronary Computed Tomography Angiography–Derived Fractional Flow Reserve Based on Machine Learning: Systolic and Diastolic Scan Acquisition
Authors: Yang Fengfeng , Shi Ke , Chen Yuhuan , Yin Youbing , Zhao Yang , Zhang Tong 
Published: March 2023

Background
The aim of the study is to investigate the performance of coronary computed tomography angiography (CCTA)–derived fractional flow reserve (CT-FFR) in the same patient evaluated by different systolic and diastolic scans, aiming to explore whether 320-slice CT scanning acquisition protocol has an impact on CT-FFR value.

Methods
One hundred forty-six patients with suspected coronary artery stenosis who underwent CCTA examination were included into the study. The prospective electrocardiogram gated trigger sequence scan was performed and electrocardiogram editors selected 2 optimal phases of systolic phase (preset collection trigger at 25% of R-R interval) and diastolic phase (preset collection trigger at 75% of R-R interval) for reconstruction. The lowest CT-FFR value (the CT-FFR value at the distal end of each vessel) and the lesion CT-FFR value (at 2 cm distal to the stenosis) after coronary artery stenosis were calculated for each vessel. The difference of CT-FFR values between the 2 scanning techniques was compared using paired Wilcoxon signed-rank test. Pearson correlation value and Bland-Altman were performed to evaluate the consistency of CT-FFR values.

Results
A total of 366 coronary arteries from the remaining 122 patients were analyzed. There was no significant difference regarding the lowest CT-FFR values between systole phase and diastole phase across all vessels. In addition, there was no significant difference in the lesion CT-FFR value after coronary artery stenosis between systole phase and diastole phase across all vessels. The CT-FFR value between the 2 reconstruction techniques had excellent correlation and minimal bias in all groups. The correlation coefficient of the lesion CT-FFR values for left anterior descending branch, left circumflex branch, and right coronary artery were 0.86, 0.84, and 0.76, respectively.

Conclusions
Coronary computed tomography angiography–derived fractional flow reserve based on artificial intelligence deep learning neural network has stable performance, is not affected by the acquisition phase technology of 320-slice CT scan, and has high consistency with the evaluation of hemodynamics after coronary artery stenosis.
Myeloid Sarcoma: A Primer for Radiologists
Authors: Chiu Austin M. , Yoon Justin G. , Tirumani Sree H. , Ramaiya Nikhil H. , Smith Daniel A. 
Published: March 2023

Abstract
Myeloid sarcoma (MS) is a rare extramedullary neoplasm that can present in association with acute myeloid leukemia, most commonly in children younger than 15 years. This unique extramedullary malignancy may involve a variety of different organ systems and can present following, preceding, simultaneous with, or in insolation to acute myeloid leukemia. Common areas of extramedullary involvement include soft tissues, bones, lymph nodes, and the peritoneum. Imaging plays a critical role in the diagnosis and management of MS, with commonly used modalities including positron emission tomography-computed tomography, magnetic resonance imaging, computerized tomography, and ultrasound. The purpose of this review article is to provide radiologists with a comprehensive guide summarizing the relevant imaging and clinical features of MS, with emphasis on the role of imaging in the diagnosis, treatment, and follow-up of patients with MS. The relevant pathophysiology, epidemiology, clinical presentations, and differential diagnosis of MS will be reviewed. The relevance of different imaging modalities in diagnosis, monitoring of treatment response, and assessment of treatment-related complications will also be outlined. Through summarizing these topics, this review article aims to provide radiologists with a guide for understanding the existing knowledge of MS in the literature and the current role of imaging in the management of this unique malignancy.
How Do Cancer-Specific Computed Tomography Protocols Compare With the American College of Radiology Dose Index Registry? An Analysis of Computed Tomography Dose at 2 Cancer Centers
Authors: Szczykutowicz Timothy P. , Ahmad Moiz , Liu Xinming , Pozniak Myron A. , Lubner Meghan G. , Jensen Corey T. 
Published: March 2023

Background
Little guidance exists on how to stratify radiation dose according to diagnostic task. Changing dose for different cancer types is currently not informed by the American College of Radiology Dose Index Registry dose survey.

Methods
A total of 9602 patient examinations were pulled from 2 National Cancer Institute designated cancer centers. Computed tomography dose (CTDIvol) was extracted, and patient water equivalent diameter was calculated. N-way analysis of variance was used to compare the dose levels between 2 protocols used at site 1, and three protocols used at site 2.

Results
Sites 1 and 2 both independently stratified their doses according to cancer indications in similar ways. For example, both sites used lower doses (P < 0.001) for follow-up of testicular cancer, leukemia, and lymphoma. Median dose at median patient size from lowest to highest dose level for site 1 were 17.9 (17.7–18.0) mGy (mean [95% confidence interval]) and 26.8 (26.2–27.4) mGy. For site 2, they were 12.1 (10.6–13.7) mGy, 25.5 (25.2–25.7) mGy, and 34.2 (33.8–34.5) mGy. Both sites had higher doses (P < 0.001) between their routine and high-image-quality protocols, with an increase of 48% between these doses for site 1 and 25% for site 2. High-image-quality protocols were largely applied for detection of low-contrast liver lesions or subtle pelvic pathology.

Conclusions
We demonstrated that 2 cancer centers independently choose to stratify their cancer doses in similar ways. Sites 1 and 2 dose data were higher than the American College of Radiology Dose Index Registry dose survey data. We thus propose including a cancer-specific subset for the dose registry.
Computer-Aided Detection of Subsolid Nodules on Chest Computed Tomography: Assessment of Visualization on Vessel-Suppressed Images
Authors: Yoshida Kotaro , Takamatsu Atsushi , Toshima Fumihito , Kozaka Kazuto , Kitagawa Taichi , Kobayashi Takeshi , Gabata Toshifumi 
Published: March 2023

Objectives
This study aimed to clarify the performance of automatic detection of subsolid nodules by commercially available software on computed tomography (CT) images of various slice thicknesses and compare it with visualization on the accompanying vessel-suppression CT (VS-CT) images.

Methods
A total of 95 subsolid nodules from 84 CT examinations of 84 patients were included. The reconstructed CT image series of each case with 3-, 2-, and 1-mm slice thicknesses were loaded into a commercially available software application (ClearRead CT) for automatic detection of subsolid nodules and generation of VS-CT images. Automatic nodule detection sensitivity was assessed for 95 nodules on each series of images acquired at 3 slice thicknesses. Four radiologists subjectively evaluated visual assessment of the nodules on VS-CT.

Results
ClearRead CT automatically detected 69.5% (66/95 nodules), 68.4% (65/95 nodules), and 70.5% (67/95 nodules) of all subsolid nodules in 3-, 2-, and 1-mm slices, respectively. The detection rate was higher for part-solid nodules than for pure ground-glass nodules at all slice thicknesses. In the visualization assessment on VS-CT, 3 nodules at each slice thickness (3.2%) were judged as invisible, while 26 of 29 (89.7%), 27 of 30 (90.0%), and 25 of 28 (89.3%) nodules, which were missed by computer-aided detection, were judged as visible in 3-, 2-, and 1-mm slices, respectively.

Conclusions
The automatic detection rate of subsolid nodules by ClearRead CT was approximately 70% at all slice thicknesses. More than 95% of subsolid nodules were visualized on VS-CT, including nodules undetected by the automated software. Computed tomography acquisition at slices thinner than 3 mm did not confer any benefits.
Correlation Between Computed Tomography Findings and the Laboratory Test-Derived Severity Score in Patients With Severe Acute Alcoholic Hepatitis
Authors: Kim Hye Ri , Kim Seung Ho , Lee Yedaun , Son Jung Hee , Park Eun Joo , Ryu Ji Hwa 
Published: March 2023

Objective
This study aimed to compare computed tomography (CT) findings between patients with severe and nonsevere acute alcoholic hepatitis (AAH).

Methods
We included 96 patients diagnosed with AAH between January 2011 and October 2021 who underwent 4-phase liver CT and laboratory blood tests. Two radiologists reviewed the initial CT images with respect to distribution and grade of hepatic steatosis; transient parenchymal arterial enhancement (TPAE); and presence of cirrhosis, ascites, and hepatosplenomegaly. A Maddrey discriminant function score (4.6 × [patient's prothrombin time − control] + total bilirubin [mg/mL]) was used as cutoff indicator for severity, with a score of 32 or higher indicating severe disease. The image findings were compared between the severe (n = 24) and nonsevere (n = 72) groups using the χ2 test or Fisher exact test. After univariate analysis, the most significant factor was identified using a logistic regression analysis.

Results
In the univariate analysis, there were significant between-group differences in the TPAE, liver cirrhosis, splenomegaly, and ascites (P < 0.0001, P < 0.0001, P = 0.0002, and P = 0.0163, respectively). Among them, TPAE was the only significant factor for severe AAH (P < 0.0001; odds ratio, 48.1; 95% confidence interval, 8.3–280.6). Using this single indicator, the estimated accuracy, positive predictive, and negative predictive values were 86%, 67%, and 97%, respectively.

Conclusions
Transient parenchymal arterial enhancement was the only significant CT finding in severe AAH.
Real value of the oocytes with smooth endoplasmic reticulum aggregates in IVF/ICSI cycle: a retrospective cohort study
Authors: Zhang Zheng , Liu Xiao-Na , Wang Ying , Bai Xue-Yao , Tao Shang-Guan , Li Hong-Mei , Zhu Lin , Li Yu-Yan , He Wei 
Published: March 2023

Objective:
The management of oocytes affected by smooth endoplasmic reticulum aggregates (SERa) remains debatable. To understand how to manage SERa+ oocytes and cycles, we performed a retrospective cohort study and analyzed the impact of SERa+ cycles and oocytes on clinical and neonatal outcomes.

Methods:
We included 4856 cycles (149 SERa+ and 4707 SERa−) from 4201 women (age: 21–42 years) who received in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatments at the Center of Reproductive Medicine, First Affiliated Hospital of Army Military University, from 2016 to 2019. SERa+ cycles had at least one SERa oocyte in the oocyte cohort. All 1722 oocytes in the SERa+ cycle were divided into SERa+ (405) and SERa− (1317) oocytes.

Results:
The rates of two pronuclei (2PN) and high-quality embryos were lower in SERa+ cycles than in SERa− cycles, regardless of IVF or ICSI (P<0.05). As the proportion of SERa+ oocytes increased in the SERa+ cycles, the rate of high-quality embryos declined gradually (P<0.05). Furthermore, the rate of 2PN in SERa+ oocytes was significantly lower than that in SERa− oocytes (P<0.05). Regardless of whether IVF or ICSI insemination was performed, no significant differences in terms of clinical pregnancy rate and spontaneous abortion rate were observed between SERa+ and SERa− cycles or between SERa+ and SERa− oocytes (P>0.05).

Conclusion:
Normal fertilization with SERa+ cycles and oocytes was substantially reduced, regardless of the insemination method. Embryos originating from SERa+ oocytes can be transferred when there are no other options, but fully informed consent and strict follow-up of fetal development are mandatory.
Effectiveness of An Intraoperative Lagophthalmos Formula for Levator Resection in Patients With Congenital Ptosis
Authors: Han Ye Eun , Kim Gye Jung , Kim Hwa Jung , Kang Julia Y. , Sa Ho-Seok 
Published: March 2023

Purpose:
To evaluate the effectiveness of an intraoperative lagophthalmos formula (IOLF) for levator resection in congenital ptosis and investigate the optimal preoperative conditions for IOLF application.

Methods:
This retrospective interventional cohort study evaluated 30 eyelids of 22 patients with congenital ptosis who underwent levator resection using the IOLF to calculate the extent of surgical correction under general anesthesia. Surgical success was defined as margin reflex distance-1 (MRD1)≥3 mm in each eye and a difference of MRD1

1 mm between the eyes at 6 months postoperatively. Logistic regression was performed to investigate the preoperative conditions associated with surgical success.

Results:
Among 30 eyelids, 19 had good-to-fair levator function (LF) (≥5 mm) and 11 had poor LF (

4 mm). The overall success rate was 90.0% (n=27/30), whereas the under-correction rate was 10.0% (n=3/30). The surgical success rate was 100% (n=19/19) in eyelids with LF ≥5 mm and 72.7% (n=8/11) in eyelids with LF

4 mm. Patients with preoperative MRD1≥0 mm (versus MRD1<0 mm, odds ratio=34.5, P=0.0098) or a combination of preoperative MRD1≥0 mm and LF≥5 mm (versus MRD1<0 mm and LF

4 mm, odds ratio=48.0, P=0.0124) more likely had successful surgical outcomes.

Conclusions:
Levator resection using the IOLF can provide satisfactory results for congenital ptosis regardless of LF. Preoperative MRD1≥0 mm may be suitable for IOLF application, and the combination of preoperative MRD≥0 mm and LF≥5 mm may be the optimal preoperative condition for IOLF application.
Infantile Cranial Fasciitis: A Clinicopathologic Evaluation
Authors: Cao Juan , Yang Guocheng , Chen Yongxian , Wang Yue , Shan Yingying , Xu Shoujun , Liu Yuecheng , Feng Xia , Liu Shuguang 
Published: March 2023

Objective:
To investigate the clinicopathologic features, immunophenotype, molecular genetic changes, and differential diagnosis of cranial fasciitis (CF).

Methods:
The clinical manifestations, imaging, surgical technique, pathologic characteristics, special staining, and immunophenotype, as well as break-apart fluorescence in situ hybridization assay for USP6 of 19 CF cases were analyzed, retrospectively.

Results:
The patients were 11 boys and 8 girls, aged 5 to 144 months, with a median age of 29 months. There were 5 cases (26.31%) in the temporal bone, 4 cases (21.05%) in the parietal bone, 3 cases (15.78%) in the occipital bone, 3 cases (15.78%) in the frontotemporal bone, 2 cases (10.52%) in the frontal bone, 1 case (5.26%) in the mastoid of middle ear, and 1 case (5.26%) in the external auditory canal. The main clinical manifestations were painless, with the presentation of masses that grew rapidly and frequently eroded the skull. There was no recurrence and no metastasis after the operation. Histologically, the lesion consists of spindle fibroblasts/myofibroblasts arranged in bundles, braided or atypical spokes. Mitotic figures could be seen, but not atypical forms. Immunohistochemical studies showed diffuse strong positive SMA and Vimentin in all CFs. These cells were negative for Calponin, Desmin, β-catenin, S-100, and CD34. The ki-67 proliferation index was 5% to 10%. Ocin blue-PH2.5 staining showed blue-stained mucinous features in the stroma. The positive rate of USP6 gene rearrangement detected by fluorescence in situ hybridization assay was about 10.52%, and the positive rate was not related to age. All patients were observed for 2 to 124 months and showed no signs of recurrence or metastasis.

Conclusions:
In summary, CF was a benign pseudosarcomatous fasciitis that occurs in the skull of infants. Preoperative diagnosis and differential diagnosis were difficult. Computed tomography typing might be beneficial for imaging diagnosis, and pathologic examination might be the most reliable way to diagnose CF.