bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction and decision making using Bayesian hierarchical models
Authors: Stangl Dalene K.
Published: April 2007

This paper uses Bayesian hierarchical models to analyse multi‐centre clinical trial data where the outcome variable of interest is continuous, but not normally distributed, and where censoring has occurred. The goal of such an analysis is the same as for any subgroup analysis, to provide survival estimates for specific subgroups as well as for the population and to provide estimates of the degree of heterogeneity between subgroups. An analysis of the Collaborative Study of Long‐Term Maintenance Drug Therapy in Recurrent Affective Illness, a multi‐centre clinical trial funded by the National Institute for Mental Health's Pharmacologic Research Branch, serves to illustrate the proposed methodology. A feature of this data set is that one treatment group was withdrawn from medication at the time of randomization. The paper contains comparison of models, one that accounts for the drug washout period through the use of a changepoint model as well as a comparison of results across several choices of prior parameter values. In addition, the paper considers sensitivity to model choice and priors in a decision theory context.
Re‐evaluating design specifications of longitudinal clinical trials without unblinding when the key response is rate of change
Authors: Shih Weichung Joseph , Gould A. Lawrence
Published: April 2007

The design of clinical trials often requires knowledge of quantities such as between‐ and within subject variances about which only imprecise information exists. To provide assurance that the study has the desired power to detect a minimum clinically meaningful difference between treatment groups, Gould, Gould and Shih, and Shih have recommended obtaining relevant information from the trial at an interim stage without unblinding. Wittes and Brittain provided a similar recommendation, but viewed the portion up to the interim stage as an (internal) pilot study and required unblinding. This paper considers the problem of re‐evaluating the design specifications in longitudinal clinical trials when the key response is the rate of change (slope). The proposed method aims to re‐evaluate the sample size and study duration in a way that maintains the trial's blinding, using an EM algorithm. Simulation results show that the effect on type I error rate in negligible, but the potential gain in power can be substantial. The procedure is simple to use in practice, as it does not unblind patients treatment identifications, and, since it does not unveil the relative efficacy of treatments, it fulfils the requirement of a valid ‘administrative’ (interim) analysis.
Designing a cost‐effective clinical trial
Authors: Hornberger John C. , Brown Byron Wm. , Halpern Jerry
Published: April 2007

Researchers and administrators must decide which clinical trials are worth doing and how many subjects are needed for a trial. We calculated sample size considering the costs of implementing the results of the trial and the trial costs using (1) Neyman—Pearson methods and (2) a Bayesian cost—benefit method. We illustrate these methods in a clinical trial sponsored by the National Institutes of Health that compares two levels of blood urea nitrogen clearance by haemodialysis for patients with end‐stage renal disease. When applied to evaluations of research proposals, these methods may help researchers to decide whether to begin a study, and, if so, how many subjects to enrol in it. These methods should be especially useful for large studies intended to inform health policy.
Sample size determination for comparing more than two survival distributions
Authors: Ahnn Sang , Anderson Stewart J.
Published: April 2007

We examine the asymptotic properties of the Tarone and Ware and Harrington and Fleming classes of test statistics under alternative hypotheses when there are comparisons between more than two survival distributions in the presence of arbitrary right censoring. When we assume equal censoring distributions across treatment groups and proportional hazards, we derive the sample size formula for testing the equality ofk⩾ 2 survival distributions using the logrank test. This work extends Schoenfeld's derivation for comparing two survival distributions and also generalizes the results of Makuch and Simon. We also derive the sample size formula for testing monotone dose‐response using Tarone's trend test. We then investigate the practicality of the formula in various situations by presenting empirical power with use of Monte Carlo simulations. In addition, with stratification present, we derive the sample size formula for the stratified logrank test, which is an extension of Palta and Amini.
A class of tests for detecting ‘general’ and ‘focused’ clustering of rare diseases
Authors: Tango Toshiro
Published: April 2007

This paper proposes a class of tests applicable to the detection of two types of disease clustering: ‘focused’ and ‘general’ clustering. The former assesses the clustering of observed cases around the fixed point and the latter does not have any prior information on the centre of clustering. The proposed test for ‘general’ clustering is a generalization of the index for temporal clustering proposed by Tango in that it adjusts for differences in population densities and also in population distributions among categories of the counfounders such as age and sex. Simulation study shows that the proposed ‘general’ test outperformed the average distance method of Whittemore et al. in most of the cluster models considered.
Exploratory tools for disease mapping in geographical epidemiology
Authors: Cislaghi Cesare , Biggeri Annibale , Braga Mario , Lagazio Corrado , Marchi Marco
Published: April 2007

In the present paper a new shrinkage estimator of relative risk, useful in disease mapping, is compared with the empirical and full Bayes estimators, using death certificate data for lung cancer (males and females) and breast cancer (females) 1982–1988 in the Emilia—Romagna region (Italy). The estimates are obtained averaging the relative risks obtained from recursive partitioning of the set of observed values. The number of partitions is fixed in advance and behaves as a smoothing parameter, the lower the number the higher the degree of shrinkage toward the overall mean of the observed values.
Tests for directional space—time interaction in epidemiological data
Authors: Lawson Andrew B. , Viel Jean Francois
Published: April 2007

Spatial incidence of disease is often recorded with time of occurrence as an ordering label. This ordering can be used to provide distance based tests for joint clustering of cases in space and time. Two different tests are proposed: one where a control disease is available, and the other where only standardized rates within census regions are available.
Traffic accident mapping in Bangkok metropolis: A case study
Authors: Na Ayuthya Rampai Suksawasdi , Böhning Dankmar
Published: April 2007

Results from an analysis of traffic accidents from a study of the police records of four police stations in the Bangkok metropolis are presented. The main emphasis in this study was put on the development of a measure for traffic accident density. The traffic flow was estimated at the various study locations by trained experts. By relating the frequency of traffic accidents found in the police records to the independently estimated traffic flow, a measure for traffic accident occurrence, the traffic accident density, was constructed and estimated for the 47 areas in four study locations. The spatial risk structure was estimated and three risk groups were identified. Each areas was classified into its associated risk group, and traffic accident maps for the four study locations in the Bangkok metropolis are provided here. The implication for prevention strategies is discussed.
Incidence of leukaemia in young people around the La hague nuclear waste reprocessing plant: A sensitivity analysis
Authors: Viel Jean‐François , Pobel Dominique , Carré André
Published: April 2007

The objectives are to investigate the incidence of childhood leukaemia in young people around the French nuclear waste reprocessing plant (La Hague, Normandy) for the period 1978–1992, and to check the sensitivity of the results to the choice of disease clustering tests and reference rates. The performance of three statistical procedures are compared: a conventional approach; a Poisson maximum test, and an extraction mapping technique. On the whole, the results are in general agreement and demonstrate the apparent existence of a distinct cluster of childhood leukaemia, contiguous and south‐east of the La Hague nuclear facility.
MCMC methods for putative pollution source problems in environmental epidemiology
Authors: Lawson Andrew B.
Published: April 2007

This paper demonstrates the use of the Gibbs Sampler and other Markov Chain Monte Carlo (MCMC) methods in two applications in environmental epidemiology. The first example concerns the application of a Metropolis—Hastings/Gibbs sampler to a Cox process with a direction‐dependent cluster variance parameter. The second example consists of the estimation of the posterior (spatial) distribution of a putative location.
Multiple comparisons procedures for comparing several treatments with a control based on binary data
Authors: Chuang‐Stein Christy , Tong Donald M.
Published: April 2007

In this paper, we examine three approaches for comparing several treatments with a control with use of binary response data. The first approach relies on asymptotic theory applied to the Freeman—Tukey transformation of the observed proportions. The second finds an acceptance region based on the binomial distributions estimated under the joint null hypotheses. The third approach applies Dunnett's procedure to the binary data. We evaluated the actual overall type I error rates of the Freeman—Tukey test and Dunnett's procedure using both simulation and binomial calculations while we assessed those of the binomial approach using simulation. Based on their capability to preserve the desirable overall type I error rate, we provide recommendations regarding the choices among the three approaches for various occasions. In addition, we provide comments on the power of these three procedures.
Comparison of median survival times with adjustment for covariates
Authors: Karrison Theodore
Published: April 2007

Brookmeyer and Crowley derived a non‐parametric confidence interval for the median survival time of a homogeneous population by inverting a generalization of the sign test for censored data. The 1 – α confidence interval for the median is essentially the set of all valuestsuch that the Kaplan—Meier estimate of the survival curve at timetdoes not differ significantly from one‐half at the two‐sided α level. Su and Wei extended this approach to the two‐sample problem and derived a confidence interval for the difference in median survival times based on the Kaplan‐Meier estimates of the individual survival curves and a ‘minimum dispersion’ test statistic. Here, I incorporate covariates into the analysis by assuming a proportional hazards model for the covariate effects, while leaving the two underlying survival curves virtually unconstrained. I generate a simultaneous confidence region for the two median survival times, adjusted to any selected value,z, of the covariate vector using a test‐based approach analogous to Brookmeyer and Crowley's for the one‐sample case. This region is, in turn, used to derive a confidence interval for the difference in median survival times between the two treatment groups at the selected value ofz. Employment of a procedure suggested by Aitchison sets the level of the simultaneous region to a value that should yield, at least approximately, the desired confidence coefficient for the difference in medians. Simulation studies indicate that the method provides reasonably accurate coverage probabilities.
Linear rank tests for doubly censored data
Authors: Tang Ming‐Xin , Tsai Wei‐Yann , Marder Karen , Mayeux Richard
Published: April 2007

This paper establishes the asymptotic properties of the non‐parametric maximum likelihood estimator of the survival function based on data censored both from the left and the right. We show that the sample mean based on the survival estimator converges to a normal distribution, and we derive non‐parametric tests for the differences in survival functions. The methods are applied to a study of dementia associated with Parkinson's disease.
A program to implement a search method for identification of clinical subgroups
Authors: Marshall Roger J.
Published: April 2007

A procedure for identifying subgroups that are homogeneous with respect to an outcome variable is described. The method, search partition analysis (SPAN), is formulated in terms of a numeric outcome variable y and a set of predictors, explanatory variables or risk factors x = x1, x2, …, xp. The objective is to split observations into two groups by a binary partition, specified using Boolean expressions of the predictors, x, such that y is as homogeneous as possible in the resultant groups; uniformly ‘low’ in one and uniformly ‘high’ in the other. Subgroups within each of the two groups can be identified from the Boolean expressions. SPAN implements a search for the ‘best’ partition from among a class of regular Boolean expressions. Features of the method are described, including how to measure partition homogeneity, complexity penalizing, search strategies and subgroup definition and representation. The approach is illustrated with analyses of predictors of low birth weight and predictors of impaired glucose tolerance for screening purposes.
Non‐parametric methods for analysing recurrent complications of varying severity
Authors: Lancar RÉMi , Kramar Andrew , Haie‐Meder Christine
Published: April 2007

Non‐parametric methods have recently been proposed to take into account the recurrent nature of complications in clinical trials, by estimating the prevalence Q(t), defined as the probability of relapse‐free patients being in a complication state at time t. Recoveries are also considered. These methods have been adapted in this paper to take into consideration not only the recurrent nature of complications but also their severity through the interpretation of average weight functions. Results of a randomized trial comparing late complications following two alternative doses of pre‐operative internal brachytherapy in patients with localized stage cervix carcinoma are used to illustrate the methods.
Interval censored survival data and multistate compartmental models in the analysis of first appearance of Plasmodium falciparum parasites in infants
Authors: Gottschau Adam , Hogh Birthe
Published: April 2007

A statistical model for interval censored data is described. Assuming a piecewise constant incidence enables us to analyse very unbalanced data in a generalized linear model. The distribution of age at first appearance of P. falciparum parasites in infants in Liberia has been estimated. A new graphical method for presentation of test results on all children was developed. In an illness—death model it is described how the proportion of undetected and detected malaria parasitemias depends on parasite rates and testing frequency. The incidence of detectable malaria parasitemia was 0·14 per month in infants under 4 months of age, and 0·60 per month in children over 4 months (p < 0001). The congenital resistance to malaria in African infants living in a highly endemic area had largely disappeared by the age of 4 months; before this age children were partly protected.
S4W: a problem‐solving environment for wireless system design
Authors: Mishra Dhananjay , Shaffer Clifford A. , Ramakrishnan Naren , Watson Layne T. , Bae Kyung K. , He Jian , Verstak Alex A. , Tranter William H.
Published: May 2007

This work describes the Site‐Specific System Simulator for Wireless System Design (S4W), a problem‐solving environment (PSE) that integrates visualization and computational tools with a high‐level graphical user interface. S4W improves the ability of wireless system engineers to design an indoor wireless system by encouraging them to think in terms of designing the system for optimal performance. Issues of computation management, data management, and location of resources are hidden from the user. The complex nature of data sets in the domain of wireless simulations calls for a customized set of visualization tools. Therefore, a number ofad hocvisualizations were developed for S4W. A study comparing the integrated system with an earlier, unintegrated version is presented. This helps to demonstrate the productivity gains that a PSE provides. Copyright © 2007 John Wiley & Sons, Ltd.
Chemometrics‐based XAS characterization of titanium on titanium‐oxide‐modified chromatographic silica
Authors: Goraieb Karen , Collins Kenneth E. , Bueno Maria Izabel M. S.
Published: May 2007

Chemometric procedures (PCA and PLS) were applied to x‐ray absorption spectrometry (XAS) to characterize chromatographic silica modified with titanium oxide. The XAS spectra were obtained using 3‐Win DCM software and were analyzed with the traditional WinXAS 2.3 software to obtain Ti coordination numbers and bond lengths of TiO attached to silica. PCA applied to the XAS spectra allows unsupervised classifications with respect to silica type, shapes of the titanium oxide layer, TiO bond length and Ti coordination numbers. PLS applied to XAS spectra allows the calibration of Ti coordination numbers and the TiO bond lengths. Copyright © 2007 John Wiley & Sons, Ltd.
Reverse Radial Forearm Fascial Flap with Radial Artery Preservation
Authors: Hansen Adam J. , Duncan Scott F. M. , Smith Anthony A. , Shin Alexander Y. , Moran Steven L. , Bishop Allen T.
Published: May 2007

The reverse radial forearm fascial (RRFF) flap is widely used in soft-tissue reconstruction of the hand. The traditional RRFF flap incorporates the radial artery from the forearm and is perfused by retrograde flow through the palmar arch. In patients with an abnormal Allen test because of an incomplete palmar arch, the traditional RRFF flap is contraindicated unless a vein graft is used to reconstruct the radial artery. A simpler alternative approach for hand reconstruction in such patients is a distally based RRFF flap based on radial artery perforators, which preserves the radial artery. We used RRFF flaps based on radial artery perforators in five patients who had palmar or dorsal soft-tissue loss. All five recovered full hand function, and only one had any complications (full-thickness skin graft loss at recipient site). The RRFF flap based on distal radial artery perforators is suitable for thin coverage of soft-tissue defects in hands with either a complete or an incomplete palmar arch.
Characterization of Arabidopsis decapping proteins AtDCP1 and AtDCP2, which are essential for post‐embryonic development
Authors: Iwasaki Shintaro , Takeda Atsushi , Motose Hiroyasu , Watanabe Yuichiro
Published: May 2007

Although decapping is an important process in eukaryotic mRNA turnover, little is known about this process in plants. Here, we identified Arabidopsis thaliana decapping proteins AtDCP1 and AtDCP2 and showed that (I) AtDCP2 is an active decapping enzyme, (II) AtDCP1 interacts with itself, (III) AtDCP1 and AtDCP2 are localized to cytoplasmic foci (putative Arabidopsis processing body), and (IV) AtDCP1 and AtDCP2 are essential for post‐embryonic development. Our findings provide new insights into the role of decapping‐dependent mRNA turnover.
Analysis of an ascidian integrin provides new insight into early evolution of collagen recognition
Authors: Tulla Mira , Huhtala Mikko , Jäälinoja Juha , Käpylä Jarmo , Farndale Richard W. , Ala-Kokko Leena , Johnson Mark S. , Heino Jyrki
Published: May 2007

αI domain integrins have been found in the ascidian Ciona intestinalis. We produced Ciona α1I domain as a recombinant protein. It did not recognize fibril‐forming collagens or bind to GFOGER or other similar motifs in triple‐helical peptides. No GFOGER motifs were found in Ciona collagens. As Ciona α1I bound to collagen IX, we propose that before the emergence of GFOGER‐dependent collagen receptors in vertebrates, αI domain integrins might have been able to bind to collagen with alternative mechanisms.
Non‐genomic effects of ginsenoside‐Re in endothelial cells via glucocorticoid receptor
Authors: Leung Kar Wah , Leung Fung Ping , Huang Yu , Mak Nai Ki , Wong Ricky N.S.
Published: May 2007

We demonstrated that ginsenoside‐Re (Re), a pharmacological active component of ginseng, is a functional ligand of glucocorticoid receptor (GR) using competitive ligand‐binding assay (IC50
= 156.6 nM; K
d
= 49.7 nM) and reporter gene assay. Treatment with Re (1 μM) raises intracellular Ca2+ ([Ca2+]i) and nitric oxide (NO) levels in human umbilical vein endothelial cells as measured using fura‐2 and 4‐amino‐5‐methylamino‐2′,7′‐difluorofluorescein diacetate, respectively. Western blot analysis shows that Re increased phosphorylation of endothelial nitric oxide synthase. These effects were abolished by GR antagonist RU486, siRNA targeting GR, non‐selective cation channel blocker 2‐aminoethyldiphenylborate, or in the absence of extracellular Ca2+, indicating Re is indeed an agonistic ligand for the GR and the activated GR induces rapid Ca2+ influx and NO production in endothelial cells.
Identification and characterization of DUSP27, a novel dual‐specific protein phosphatase
Authors: Friedberg Ilan , Nika Konstantina , Tautz Lutz , Saito Kan , Cerignoli Fabio , Friedberg Iddo , Godzik Adam , Mustelin Tomas
Published: May 2007

A novel human dual‐specific protein phosphatase (DSP), designated DUSP27, is here described. The DUSP27 gene contains three exons, rather than the predicted 4–14 exons, and encodes a 220 amino acid protein. DUSP27 is structurally similar to other small DSPs, like VHR and DUSP13. The location of DUSP27 on chromosome 10q22, 50 kb upstream of DUSP13, suggests that these two genes arose by gene duplication. DUSP27 is an active enzyme, and its kinetic parameters and were determined. DUSP27 is a cytosolic enzyme, expressed in skeletal muscle, liver and adipose tissue, suggesting its possible role in energy metabolism.
Sialic acid is an essential moiety of mucin as a hydroxyl radical scavenger
Authors: Ogasawara Yuki , Namai Tomoyuki , Yoshino Fumihiko , Lee Masaichi-Chang-il , Ishii Kazuyuki
Published: May 2007

In this work, we examined the antioxidant role of mucin, a typical sialic acid containing high‐molecular weight glycoprotein. The function of mucin as a hydroxyl radical (OH) scavenger was characterized using bovine submaxillary gland mucin (BSM). Non‐treated BSM effectively protected DNA from the attack of OH; however, desialylated BSM lost this potential. Moreover, we estimated the scavenging effects of BSM against OH generated by UV irradiation of hydrogen peroxide using ESR analysis. Our results indicate that BSM has OH scavenging ability the and sialic acid in mucin is an essential moiety to scavenge OH.
Modified Cautery‐Assisted Palatal Stiffening Operation: New Method for Treating Snoring and Mild Obstructive Sleep Apnea
Authors: Pang Kenny P. , Terris David J.
Published: May 2007

OBJECTIVE

To assess a new method (modified cautery‐assisted palatal stiffening operation [CAPSO]) to treat snoring and mild obstructive sleep apnea (OSA).

DESIGN

A prospective, nonrandomized trial.

METHODS

Thirteen patients with simple snoring and mild OSA underwent the modified CAPSO under local anaesthesia. All patients had preoperative polysomnography and at 3 months postoperatively.

RESULTS

All patients were Friedman stage II and III, with tonsil size 0, 1, or 2. All patients had improvement in their snoring. Eighty‐four percent of the patients had improvement in the Epworth Sleepiness Scale, from 12.2 to 8.9. Objective success on the polysomnogram was noted in six out of the eight patients (75%) with mild OSA. The AHI improved from 12.3% to 5.2% (P < 0.05), and the LSAT improved from 88.3% to 92.5% (P < 0.05).

CONCLUSION

The modified CAPSO is a simple, low‐cost, and effective office‐based method to treat snoring and mild obstructive sleep apnea.
Dexamethasone does not Alter in Vitro Antibacterial Efficacy of Gentamicin
Authors: Drobbin Michael T. , Phelan Sean T. , Antonelli Patrick J.
Published: May 2007

OBJECTIVES

Aminoglycoside ototoxicity may be mitigated by administration of dexamethasone; however, dexamethasone could theoretically impair its antibacterial properties. The purpose of this experiment was to determine if dexamethasone decreases the antibacterial activity of gentamicin against Pseudomonas aeruginosa (PA) and Stapholococcus aureus (SA).

STUDY DESIGN

In vitro microbiological assay.

METHODS

Four separate trials of minimum inhibitory concentration (MIC) testing were performed for gentamicin against five PA strains and six SA strains, with and without the addition of high and low concentrations of dexamethasone.

RESULTS

MICs were not changed by more than one dilution with the addition of either high or low concentrations of dexamethasone for any of the PA and SA strains.

CONCLUSION

Dexamethasone does not impair the antibacterial efficacy of gentamicin for PA and SA. This supports the role of dexamethasone as an otoprotectant with aminoglycoside therapy.
Quantitative Three‐Dimensional Ultrasound Imaging of Partially Resected Tongues
Authors: Bressmann Tim , Ackloo Elizabeth , Heng Chiang‐Le , Irish Jonathan C.
Published: May 2007

OBJECTIVE

We sought to assess the impact of partial lateral glossectomies on tongue function and speech.

STUDY DESIGN AND SETTING

Tongue shapes of 12 patients with lateral tumors of the tongue were recorded with three‐dimensional ultrasound before their surgery and two months after. Twelve normal participants served as controls. Speech acceptability was also assessed.

RESULTS

Principal component analyses demonstrated that the flap reconstructions led to a stiffening of the operated side of the tongue. A concavity index and an asymmetry index demonstrated that the glossectomy patients exhibited decreased midsagittal grooving and increased lingual asymmetry. The change in midsagittal grooving correlated moderately with the decrease in speech acceptability.

CONCLUSION

A lateral partial glossectomy affects the tongue's intrinsic deformation, in particular midsagittal grooving and symmetry. This can have a detrimental effect for speech.

SIGNIFICANCE

A lateral resection affects the tongue's symmetry and midsagittal groove. The change in midsagittal grooving correlates with a decrease in speech acceptability.
Feasibility of Endoscopic Sentinel Node Biopsy in the Porcine Neck
Authors: Malloy Kelly M. , Cognetti David M. , Wildemore Bernadette M. , Cunnane Mary F. , Keane William M. , Pribitkin Edmund A. , Rosen David
Published: May 2007

OBJECTIVE

To assess the feasibility of endoscopic sentinel node biopsy (SNB) using a tracer dye in a pig model.

STUDY DESIGN AND SETTING

This was a prospective, nonrandomized experimental study in Yorkshire pigs. The posterolateral tongues of three animals were injected with a one‐to‐one solution of carbon dye to methylene blue dye. Endoscopic SNB was performed and stained lymph nodes identified and retrieved, followed by an open dissection to recover any remaining nodes. Specimens were analyzed by a pathologist for staining, size, and structural integrity.

RESULTS

Six unilateral endoscopic SNBs were performed without complications. During endoscopic dissection, gross blue‐staining of a sentinel node was noted in four of six dissections (66%). One of six sentinel nodes demonstrated histologic evidence of carbon staining. Structural integrity of all nodes was intact upon histological evaluation.

CONCLUSION/SIGNIFICANCE

Endoscopic cervical SNB in pigs is feasible but has limitations based on lymph node size and reliability of tracer dyes. Further study is warranted to perfect tracer dyes and retrieval methods to improve this technique.
Fusogenic Vesicular Stomatitis Virus for the Treatment of Head and Neck Squamous Carcinomas
Authors: Shin Edward J. , Chang Jaime I. , Choi Bryan , Wanna Georges , Ebert Oliver , Genden Eric M. , Woo Savio L.C.
Published: May 2007

OBJECTIVES

This study investigates the efficacy of recombinant fusogenic VSV [rVSV‐NDV/F(L289A) or rVSV‐F] in the treatment of head and neck squamous cell carcinoma (HNSCC).

STUDY DESIGN AND SETTING

The in vitro replication and cytotoxicity of rVSV‐F were studied in two human SCC cell lines, in one murine SCC cell line, and in human keratinocytes. The effects on tumor size and animal survival were investigated following in vivo rVSV‐F treatment of floor‐of‐mouth tumor model C3H/HeJ mice.

RESULTS

Recombinant VSV‐F preferentially induced rapid syncytia formation, and replicated in (P < 0.04) and killed (P < 1 × 10‐13) all three SCC lines tested. The virus had no observable effect on human keratinocytes. Tumor size was smaller (P < 0.03) and overall survival was better (P < 0.001) for treated animals than for control animals.

CONCLUSION/SIGNIFICANCE

Recombinant VSV‐F confers a modest survival benefit for HNSCC in this orthotopic murine model. This oncolytic virus holds promise as a novel cancer treatment for recurrent HNSCC.
Assessment of Chinese‐Version Voice Outcome Survey in Patients with Unilateral Vocal Cord Paralysis
Authors: Fang Tuan‐Jen , Li Hsueh‐Yu , Gliklich Richard E. , Chen Ya‐Hui , Wang Pa‐Chun
Published: May 2007

BACKGROUND

To develop a Mandarin Chinese outcome measure for the assessment of quality of life among unilateral vocal cord paralysis (UVCP) patients.

METHODS

Voice Outcome Survey (VOS) was translated into Mandarin Chinese using a parallel model. The Chinese (Taiwan) version of the VOS (CVOS) was administered to 48 patients with symptomatic UVCP in a prospective manner; the CVOS was validated according to established criteria for reliability, validity, and longitudinal sensitivity.

RESULTS

CVOS demonstrates moderate test‐retest reliability (r = 0.59, P < 0.001) and internal consistency (Cronbach's α = 0.63). CVOS significantly correlates with most of the subscales in the Mandarin Chinese (Taiwan) version of 36‐Item Short‐Form Health Survey (SF‐36) with only two exceptions (GH, general health; VT, vitality). The standardized response mean for the CVOS total score is 1.91, indicating excellent sensitivity to detect clinical changes.

CONCLUSIONS

Performance characteristics of the CVOS are equivalent to the English‐version VOS. CVOS is a valid tool to evaluate adults with UVCP‐related problems among Chinese‐speaking populations.
Age‐Related Changes in Human Laryngeal Nerves
Authors: Tiago Romualdo , Pontes Paulo , do Brasil Osíris Camponês
Published: May 2007

OBJECTIVES

We sought to perform a morphometric analysis of myelinated fibers from laryngeal nerves with the aim of verifying quantitative changes due to the aging process.

METHODS

A 1‐cm fragment was collected from the superior laryngeal nerves and recurrent laryngeal nerves from 12 cadavers during autopsy. The sample was divided in two groups: an adult group (aged <60 years) and an elderly group (aged ≥60 years).

RESULTS

The total number of myelinated fibers from the superior laryngeal nerves was similar in both groups (adult group = 9017 ± 1692, elderly group = 7918 ± 1624; P = 0.79). The adult group had a higher total number of myelinated fibers in the recurrent laryngeal nerves than that of the elderly group (adult group = 3276 ± 383, elderly group = 2381 ± 669; P = 0.005), as well as a higher total number of fibers in the laryngeal nerves (both superior and recurrent) than the elderly group (P = 0.02).

CONCLUSIONS

The adult group has a higher total number of myelinated fibers in the laryngeal nerves than the elderly group.
Urgent Awake Tracheotomy for Impending Airway Obstruction
Authors: Yuen Heng‐Wai , Heng‐Chian Andrew Loy , Johari Shirish
Published: May 2007

BACKGROUND/OBJECTIVE

Awake tracheotomy is performed for patients with impending airway obstruction. Few studies to date have addressed the issues surrounding awake tracheotomy. We sought to review the indications, complications, and outcome of awake tracheotomy for urgent airway control.

MATERIALS AND METHODS

We conducted a retrospective review of patients who underwent awake tracheotomy over a 4‐year period from 2001 to 2004 at an urban tertiary medical center. Data were obtained from inpatient records and operative charts.

RESULTS

We obtained data on 54 men and 19 women, with a mean age of 61 years. The majority of patients presented with hoarseness, dyspnea, and stridor. Twenty patients had obstruction from head and neck cancers. Nonmalignant causes included deep neck infections (n = 18), bilateral vocal cord paralysis (n = 17), trauma (n = 9), and laryngeal edema (n = 6). Other causes include laryngeal cyst, subglottic stenosis, and vocal cord granuloma. Six (8.2%) patients experienced complications, including postoperative hemorrhage, pneumothorax, and chest and wound infections. There were no long‐term complications or deaths.

CONCLUSION

Awake tracheotomy is efficacious and safe and has a low complication rate.

SIGNIFICANCE

Awake tracheotomy should be performed for impending airway obstruction and in a timely manner before complete obstruction occurs.
Health‐Related Quality of Life in Hereditary Hemorrhagic Telangiectasia
Authors: Geisthoff Urban W. , Heckmann Katinka , D'Amelio Roberto , Grünewald Stefan , Knöbber Dirk , Falkai Peter , König Jochem
Published: May 2007

OBJECTIVE

To assess and differentiate the health‐related quality of life (HR‐QoL) in patients with hereditary hemorrhagic telangiectasia (HHT).

STUDY DESIGN AND SETTING

A prospective, open, cross‐sectional questionnaire‐based study (including the Short Form‐36 Health Survey [SF‐36]) performed by a tertiary care center.

RESULTS

A total of 77 patients (36 females) were included. Except for one domain (bodily pain), the scores for all scales of the SF‐36 were significantly reduced in comparison with normative data. The duration of epistaxis, the presence of hepatic involvement and gastrointestinal bleeding, and the number of visible telangiectases correlated with lower scores on several scales of the SF‐36. Unexpectedly, the frequency of epistaxis did not correlate with any scale.

CONCLUSIONS

The duration of epistaxis, liver involvement, gastrointestinal bleeding, and the number of visible telangiectases have a major influence on the HR‐QoL in HHT whereby the frequency of epistaxis seems to play a minor role.

SIGNIFICANCE

The data presented have an impact on therapeutic decisions, medical expert opinions, and research funding.
Executive Summary: Asthma and the Unified Airway
Authors: Krouse John H. , Veling Maria C. , Ryan Matthew W. , Pillsbury Harold C. , Krouse Helene J. , Joe Stephanie , Heller Andrew J. , Han Joseph K. , Fineman Stanley M. , Brown Randall W.
Published: May 2007

Asthma is a common comorbid disorder that will be seen by otolaryngologists in their treatment of patients with rhinitis, rhinosinusitis, and otitis media. Among otolaryngologists, however, a diagnosis of asthma is infrequently considered in this patient population. Otolaryngologists, however, may be in an important position to recognize this potential diagnosis and provide treatment or appropriate referral. To further develop this relationship among upper and lower airway inflammation, and to provide important information to otolaryngologists regarding this relationship, a multidisciplinary workgroup was impaneled by the American Academy of Otolaryngic Allergy in August 2006. The full report of this meeting is published separately as a Supplement to Otolaryngology‐Head and Neck Surgery. This Executive Summary provides a brief synopsis of that document, with a focus on comorbid respiratory inflammation for otolaryngologists. In the treatment of their patients with allergic rhinitis and rhinosinusitis, otolaryngologists must be aware of the possible presence of asthma so that appropriate treatment and/or referral can be initiated. The impact of this practice will allow more comprehensive treatment of patients with upper and lower airway disease, and will improve patient symptoms, function, and quality of life.
Phosphorus kinetics in lambs fed different levels of dicalcium phosphate
Authors: DIAS R. S. , KEBREAB E. , VITTI D. M. S. S. , PORTILHO F. P. , LOUVANDINI H. , FRANCE J.
Published: May 2007

The purpose of the current work was to study phosphorus (P) metabolism in growing sheep supplemented with different levels of dicalcium phosphate using an extant mathematical model. Twelve male non-castrated Santa Inês sheep, weighing 23 (±2·2) kg, received a basal diet unsupplemented or supplemented with dicalcium phosphate to provide 1·5, 3·0, 4·5 g of P/animal per day (treatments T1 to T4, respectively). After 3 weeks adaptation, 7·4 MBq of32P was injected into the jugular vein of each animal. Samples of blood, faeces and urine were collected every day during a 7-day period and thereafter the animals were sacrificed and samples from liver, kidney, heart, muscle and bone were collected for specific activity and inorganic P determinations. The flows between gut and plasma were similar for each treatment except for T1, which showed the lowest values for both flows (P<0·05). The amount of P accreted to soft tissue (F42) was different among treatments, however net tissue retention was similar for all treatments. Total P retained was highest for T4 and lowest as well as negative for T1 and T2. Phosphorus accreted to bone (F32) was different among treatments and contributed to the different net bone retentions. The highest value ofF32was reached by animals on T4, whilst the lowest values were found for animals on T1. Despite having the highest value ofF32, it should be noted that animals on T4 excreted the most P in faeces. Considering concerns about environmental P pollution, it is important to be aware that the treatment which provided the highest value for net bone P retention and forF42also led to the highest value of P excreted in faeces. Therefore, the current study suggests that T3 provided the best P level for this category of animal since P accreted to bone and tissue indicated that P absorption was adequate to attend to P requirements.
Evaluation of plasma fibronectine level as a probable indicator for tympanosclerosis
Authors: Görür K , Görüroğlu Öztürk Ö , Polat G , Vayisoğlu Y , Talas D Ü , Güner N , Özcan C
Published: May 2007

Objectives:

Wound healing, epithelial regrowth and collagen synthesis are very important factors in the repair of the traumatised tympanic membrane. The aim of the present study was to determine the role of plasma fibronectine in the aetiopathogenesis of tympanosclerosis.

Methods:

This prospective study included 58 patients with and 49 without tympanosclerosis. No inflammation or trauma was noted in either patient group. All patients underwent otoscopic and otomicroscopic examination, and the degree of tympanosclerosis was graded from mild (stage I) to severe (stage III). Following otological examination, blood samples were taken for plasma fibronectine measurement.

Results:

Following otoscopic and otomicroscopic examinations, patients' tympanosclerosis was graded as follows: 18 patients were stage I; 29 were stage II; and 11 were stage III. Statistical analyses revealed that the plasma fibronectine concentrations were significantly lower in the study group compared with the control group (p = 0.031). In addition, fibronectine levels were lowest in the patients with severest tympanosclerosis (p = 0.0001 in each comparison).

Conclusion:

The results of the present study show that serum fibronectine is important in the development and severity of tympanosclerosis.
What is the short term effect of perfumes on olfactory thresholds?
Authors: Robinson A M , Gaskin J A , Philpott C M , Goodenough P C , Elloy M , Clark A , Murty G E
Published: May 2007

Objectives:

Body sprays and perfumes are commonly worn by patients attending ENT out-patients clinics. Their effect on performance in olfactory testing is unknown. The aim of this study was to determine whether olfactory thresholds are altered by the presence of such fragrances.

Materials and methods:

One hundred and sixty healthy volunteers, aged 18 to 65 years, underwent olfactory thresholds testing. Each was then exposed to one of four strong perfumes, applied in a facemask for two minutes, and the thresholds were retested.

Results and analysis:

All olfactory thresholds worsened after being exposed to the strong perfumes of LynxTM and ImpulseTM body sprays, with the strongest effect being on olfactory detection of phenylethyl alcohol (p<0.001).

Conclusions:

Strong perfumes can have a negative effect on olfactory thresholds.

Significance:

Patients attending olfactory threshold testing need to be advised not to wear body sprays or perfumes.
Laryngeal squamous cell carcinoma presenting as a prelaryngeal, air-filled structure (pseudolaryngocoele)
Authors: Korampalli T S , Belloso A , Hans P S , Irion K , Sheppard I J
Published: May 2007

Objective:

We report a unique case of a squamous cell carcinoma of the larynx presenting as a large pseudolaryngocoele, arising through a thyroid cartilage defect.

Method:

Case report and review of the literature.

Case report:

A 47-year-old man presented with a two-month history of hoarseness and a large, midline neck swelling. Endoscopic examination revealed a transglottic carcinoma involving the anterior commissure. Fine needle aspiration of the neck mass showed it to be an air-filled structure which transiently collapsed but refilled within minutes. Subsequent computed tomography scanning and histopathological examination revealed that the air-filled mass was created by a defect in the thyroid cartilage, with formation of a pseudolaryngocoele.

Conclusions:

The anatomy of the anterior commissure region and its effect on the spread of laryngeal carcinoma is reviewed in order to explain the pathophysiology of this unusual presentation. We highlight the need for a high index of suspicion of malignancy if a laryngocoele or pseudolaryngocoele is detected clinically.
Evaluation of mucosal surface reduction after ethmoidal surgery in nasal polyposis
Authors: Bonfils P , Avan P , Palimi P , Malinvaud D
Published: May 2007

Objectives: To assess the reduction of mucosal surface after total sphenoethmoidectomy.

Study design: Prospective study.

Methods: Twelve normal, consecutive computed tomography scans were used. Computed tomography measurements were made at two different levels: the cribriform plate, and the upper level of the maxillary antrum. The length of the lateral wall of the ethmoid sinus and the perimeter of each ethmoid cell were measured at each level and on each side. The whole perimeter of the ethmoid sinus was evaluated for each CT scan level. For each side and each level, the ratio between the ethmoid sinus perimeter and the lateral ethmoid wall length was calculated.

Results: The mean length of the lateral ethmoid sinus wall was 61.7±1.3 mm and 59.9±1.6 mm at the upper and lower parts of the ethmoid sinus, respectively. The mean ethmoid sinus perimeter was 263.2±11.5 mm and 250.4±11.1 mm at the upper and lower parts of the ethmoid sinus, respectively. No significant statistical difference was observed between measurements as a function of side (right or left) or level (upper or lower). The mean ratio between the ethmoid sinus perimeter and the lateral ethmoid wall length was 4.2.

Conclusion: After total sphenoethmoidectomy, the mucosal surface of the ethmoid sinuses is reduced by a factor of 4.2; about 76 per cent of the mucosa is removed during total sphenoethmoidectomy.
Acute orbital complications of sinusitis: the benefits of magnetic resonance imaging
Authors: McIntosh D , Mahadevan M
Published: May 2007

Introduction:

Acute sinusitis is a relatively common condition, which usually responds to medical therapy. In most cases, there are no sequelae or complications subsequent to this infection. However, like many acute illnesses, there are well documented complications of acute sinusitis, and in particular these include peri-orbital and intracranial spread.

Objective:

The purpose of this paper is to highlight the importance of vigilance regarding both peri-orbital involvement of sinusitis and the limitations of imaging techniques such as computed tomography. An illustrative case is presented to demonstrate this.

Conclusion:

Magnetic resonance imaging is a valuable modality in assessing complex presentations of peri-orbital complications of acute sinusitis.
Two-hundred-year seed survival of Leucospermum and two other woody species from the Cape Floristic region, South Africa
Authors: Daws Matthew I. , Davies Jennifer , Vaes Elly , van Gelder Roelof , Pritchard Hugh W.
Published: May 2007

The ability of orthodox seeds to survive long-term dry storage is a key prerequisite for ex situ seed conservation in genebanks. However, only a few credible observations of seed survival for ≥ 200 years have been reported. In this paper, seed survival is shown for three species under suboptimal storage conditions for a documented time of ≥ 203 years and carbon dated at 218–270 years. Two species that germinated are in the Fabaceae (Liparia sp. and Acacia sp.). A water-impermeable seed coat, and hence an inability to equilibrate with ambient relative humidity, may contribute to long-term survival of these species. The third species that germinated (Leucospermum sp.) does not have a water-impermeable seed coat, and long-term survival may be linked to an oxygen-impermeable barrier in the seed. These results for species from the Cape Floristic Region, South Africa, suggest adaptation for extreme longevity in seeds of species of seasonally dry, Mediterranean environments.
Diaspore morphology and the potential for attachment to animal coats in Mediterranean species: an experiment with sheep and cattle coats
Authors: de Pablos Isabel , Peco Begoña
Published: May 2007

Morphological traits of diaspores that can predict their potential attachment to animal coats may help to model epizoochory in plant populations and communities. The present study tested the role of seed mass, shape and the presence of dispersal structures in the attachment potential of a sample of 14 abundant species in Mediterranean grassland and shrubland, using sheep and cattle coats that were shaken mechanically using a standardized protocol. We also tested recently proposed predictive models for the attachment potential of diaspores. Attachment potential measured on cattle hide was low in comparison with sheep wool for all types of diaspores. Differences between vertically and horizontally positioned coats were significant only for cattle, in which attachment potential was higher in vertically positioned coats. Seed weight was highly significant to predict attachment potential in sheep coats, but yielded significant results only in the case of vertically positioned cattle coats. In both cases, light seeds were best retained. Shape yielded marginally significant results only in the case of horizontally positioned cattle coats. In this case, elongated seeds seemed to be best retained. The presence of appendages in diaspores was significant only for sheep, in which attachment potential was higher for seeds with appendages. Recently proposed predictive models for the attachment potential were found to be highly robust for predicting this parameter in sheep coats, and thus support their generalization for this type of coat.