bluuebunny/crossref_metadata_2025 huggingface dataset:
Management guidelines for improvement of otolaryngology referrals from primary care physicians
Authors: Benninger Michael S. , King Frances , Nichols Richard D.
Published: September 2022

OBJECTIVE AND DESIGN

A prospective evaluation of the effectiveness of otolaryngology evaluation, treatment, and referral guidelines developed collaboratively by otolaryngologists and primary care physicians on referrals and access to otolaryngology. Comparisons of appropriate to unnecessary referrals, the percentage of patients referred with disorders addressed to those without disorders addressed in the guidelines, access to otolaryngology, and questionnaire evaluations of primary care physician and patient satisfaction were measured before and after guideline implementation.

RESULTS

A significant decrease in appropriate to unnecessary referrals was seen, from 55% before to 12% after guidelines. The percentage of patients seen within 1 month of scheduling improved from 39% to 59%. Guideline‐addressed disorders decreased from 63% to 40%. The need for patients to see another physician for the referred symptom while waiting to see an otolaryngologist decreased from 31 % to 3%. Patient satisfaction with wait times improved. Eighty‐six percent of the primary care physicians used the guidelines, and 85% wanted to expand the guidelines to other specialty areas.

CONCLUSIONS

Management and referral guidelines are effective in improving patient access and the ratio of appropriate to unnecessary referrals. Such guidelines are well accepted and used by primary care practitioners in this setting.
Cerebrospinal fluid leak after translabyrinthine acoustic neuroma surgery
Authors: Celikkanat Serdar M. , Saleh Essam , Khashaba Ahmad , Taibah Abdelkader , Russo Alessandra , Mazzoni Antonio , Sanna Mario
Published: September 2022

Cerebrospinal fluid leakage is the most common complication of translabyrinthine acoustic neuroma surgery. This retrospective study reviews patients who had translabyrinthine acoustic neuroma surgery at the Gruppo Otologico, Piacenza, Italy, and ENT Department of Bergamo General Hospital, Bergamo, Italy, during the last 6 years. The incidence of postoperative cerebrospinal fluid leakage was 6.2%, and 75% of these patients underwent another surgery to control the cerebrospinal fluid leakage. A modification of translabyrinthine approach was used in patients with highly pneumatized temporal bones to prevent cerebrospinal fluid leakage in these high‐risk patients.
Therapy with Botulinum Toxin, by JosephJankovic and MarkHallet. 656 pages with illustrations. Marcel Dekker, Inc., New York, 1994. $195.00.
Authors: Eisele David W. , Flint Paul W.
Published: September 2022

Editors Note: The reviewers have rated the books on a scale of one to five stars. The highest ratings are given to books that fulfill their objectives and skillfully convey information to the chosen audience. Books are judged on appropriateness and completeness of detail for the targeted audience, quality of writing, editorial skill (especially multiauthored books), illustrations, and photography. It is hoped this code will aid the reader in selecting books for his or her permanent library. The rating scale is as follows: ∗∗∗∗∗ Outstanding, a classic, should be on the shelf of anyone interested in the subject; ∗∗∗∗ Strong, well‐written book with major contributions in some areas; ∗∗∗ Informative book that should be read, if not owned, by individuals with interest in the field; ∗∗ Some worthwhile information, but with deficiencies in writing style or completeness; ∗ Major shortcomings, not recommended.
Preoperative and postoperative auditory and facial nerve function in cerebellopontine angle meningiomas
Authors: Schaller Bernhard , Heilbronner Raoul , Pfaltz Carl R. , Probst Rudolf R. , Gratzl Otmar
Published: September 2022

Preoperative and postoperative facial nerve and auditory function were reviewed retrospectively in 13 cases of cerebellopontine angle meningiomas. According to their location within the posterior fossa and with special reference to the internal auditory canal, they were classified into a premeatal and a retromeatal group. All the tumors were removed by an otoneurosurgical team by use of a retrosigmoid approach. Postoperative results (1 year after operation) were compared within the two groups with respect to preservation of hearing (normal hearing in 31% and preservation of preoperative hearing in 69% of the cases) and facial nerve function (no or mild postoperative impairment in 69% of the cases). Both preoperative and postoperative impairment of facial nerve and auditory function prevailed in the premeatal group. For preservation of vital vascular and central nervous structures, subtotal resection with consecutive fractionated radiation therapy had to be performed in 30% of the cases. Our results provide substantial evidence that in cerebellopontine angle meningiomas a precise preoperative study of tumor location will assist in improving individual operative strategy and thus postoperative functional results.
Assessment of bone formation during osteoneogenesis: A canine model
Authors: Klotch Douglas W. , Ganey Timothy M. , Slater‐Haase Alicia , Sasse Joachim
Published: September 2022

Distraction osteoneogenesis, callotasis, has been demonstrated to be an effective means of lengthening long bones. A variation of Ilizarov's technique produces a transport disk from one cut surface of bone within a defect and advances the disk to the opposite surface to close the defect. This process, previously described by Costantino et al. (Arch Otolaryngol Head Neck Surg 1990; 116:535‐45), demonstrated bone formation within the distraction site. The precise mechanism of bone formation has not yet been described for the mandible. Four conditioned beagles were studied, with one control dog maintained in neutral fixation and three dogs distracted at 0.25 mm every 8 hours. A two‐cm defect was closed, and dogs were kept in fixation for 1 week after closure, after which they were killed. Three sites were evaluated: (1) the distraction seam, (2) the interface of the cortical and distracted bone, and (3) the cortexes at the closed defect. Each site was bisected, and one half was decalcified for immunohistochemical and hematoxylin and eosin pathologic evaluation. The vascular basement membrane was labeled for laminin and type IV collagen. Both of these substances demonstrate the differentiation of the vascular matrix component predisposing primary bone formation. Labels were intense at the distraction seam where intense angiogenesis occurred. No hyalin cartilage was observed at the distraction site, which indicates that the fixation was stable and that ossification occurred primarily without intermediate callous formation. This model demonstrated that osteoclasts within the canine model produce bone through primary bone formation within an angiogenic matrix rich in basement membrane laminin and type IV collagen. Likewise, bone is species specific in mineral composition for dog mandible. Understanding the formation and composition of distracted bone is essential for understanding application of this technique within the clinical setting.
Electronic integration of glottic closure and cricopharyngeal relaxation for the control of aspiration: A canine study
Authors: Broniatowski Michael , Dessoffy Raymond , Azar Kouros , Davies Charles R. , Trott Martin S. , Miller Frank R. , Tucker Harvey M.
Published: September 2022

Aspiration can result from muscular weakness or paralysis of laryngopharyngeal muscles after lower motor neuron disorders (e.g., stroke) or unchecked gastroesophageal reflux. We submit that rehabilitation of the finely tuned swallowing mechanism should provide at least restoration of the normal dynamic relationships between glottic closure and cricopharyngeal relaxation. In three dogs under general endotracheal anesthesia, the recurrent laryngeal nerves and the pharyngeal musculature were exposed through a midline cervical incision. A tracheotomy was performed to allow unhindered laryngoscopic exposure of the vocal cords. A no. 9 endotracheal tube passed through the upper esophageal sphincter was used as a pressure transducer by saline inflation of its cuff and linked to an oscilloscope. The cricopharyngeus was placed under baseline tension with pulse trains administered by an intramuscular needle electrode with a circuit previously used for agonist/antagonist coupling of reinnervated facial musculature. A second output channel was linked to the contralateral recurrent laryngeal nerve by a bipolar electrode. As the pulse width of the current to the recurrent laryngeal nerve increased, that to the cricopharyngeus was reciprocally decreased, producing snug glottic closure and synchronous cricopharyngeal relaxation. Results were documented on videotape. These findings were highly reproducible. We believe that the novel approach proposed in the current model offers an attractive solution to long‐term aspiration problems resulting from an imbalance between vocal cord and cricopharyngeal activities.
Smoking and middle ear disease: Are they related? A review article
Authors: Harner Stephen G. , Blakey Brian W. , Blakey Joan E.
Published: September 2022

The relationship between passive smoking and middle ear disease was reviewed. The hypothesis that acute otitis media, serous otitis media, and related diseases in children are caused by inhalation of second‐hand smoke has been accepted by many. We reviewed the literature on this topic. There are many studies that do not support the hypothesis. There is no indication that the smokers themselves have a higher incidence of middle ear disease. Considering the difficulty of publishing negative studies, the need for academics to publish significant findings, and the poor foundation for some authors” conclusions in the literature, we find that the literature does not offer sufficient support for the hypothesis that second‐hand smoke causes middle ear disease to accept the hypothesis.
Earlens∗ Tympanic Contact Transducer: A New Method of Sound Transduction to the Human Ear
Authors: Perkins Rodney
Published: September 2022

This article is an initial report on a new method of transducing sound to the human ear. The report describes the shortcomings of conventional acoustic amplification devices, the potential advantages afforded by the Earlens system (ReSound Corp., Redwood City, Calif), a description of the system, and preliminary clinical results. The system is composed of two elements: a transducer that is composed of a magnet mounted on a thin, conical silicone platform and a device that generates a magnetic field which causes the Earlens to vibrate. The Earlens transducer is placed on the umbo area of the tympanic membrane and maintains its position there by floating on a droplet of mineral oil. Two configurations of the magnetic field device are described: one that is placed within the external auditory canal and another that is worn around the neck. This feasibility study was done in seven patients during a 3‐month period. All patients in the study maintained the position of the transducer for the duration of the study, and the tympanic membranes showed no evidence of inflammation or other problems. The presence of the transducer caused an average 5‐dB threshold depression in the speech frequencies. In the neck‐worn device, maximum mean functional gain was 25 dB at 2000 Hz. Variability in the functional gain at different frequencies was noted with poorer gain above 2000 Hz.
The History of Laryngology: A Centennial Celebration
Authors: Alberti Peter W.
Published: September 2022

In looking backward it is well to remember that the interior of the larynx was terra INVISA, if not completely INCOGNITA, until Garcia invented the laryngoscope in 1855 and Turk and Czermak had demonstrated its use in Medicine.
Allergic and Immunologic Aspects of Meniere's Disease
Authors: Derebery M. Jennifer
Published: September 2022

Meniere's disease, although idiopathic by definition, has been ascribed to a variety of causes, which more recently include autoimmune factors. Interest in the role of allergy in Meniere's disease has also increased. Studies from this institution and elsewhere provide evidence that allergy and immunologic factors play a role in Meniere's disease in at least some patients. The symptoms of Meniere's disease are thought to be produced by a sudden influx of fluid into the endolymphatic sac, producing a rupture of Reissner's membrane in the cochlea. The endolymphatic sac is capable of trapping antigen and generating its own immune response. It has a highly vascular subepithelial space containing numerous fenestrated blood vessels that are peripheral and “leaky.” At least three mechanisms by which allergy may play a role in the production of fluid in the endolymphatic sac are described: the endolymphatic sac itself might be a “target organ” of mediator released from systemic inhalant or food reactions; deposition of circulating immune complex may produce inflammation and interfere with the sac's filtering capability; and a predisposing viral infection in childhood that produces a mild impairment of endolymphatic sac function may interact with allergies in adulthood and cause the endolymphatic sac to decompensate, resulting in endolymphatic hydrops. The endolymphatic sac is the seat of immune reactivity in the inner ear. Repeated inflammatory reactions can produce sac dysfunction and eventual production of Meniere's disease.
Unique Nuclear Matrix Protein Alterations in Head and Neck Squamous Cell Carcinomas: Intermediate Biomarker Candidates
Authors: Donat Terry L. , Sakr Wael , Lehr Jeffrey E. , Pienta Kenneth J.
Published: September 2022

The progression of normal squamous epithelium to a malignant metastatic phenotype may depend on cellular genetic events and the failure of host mechanisms. Intermediate biomarkers are needed to more effectively identify and quantify malignant progression and develop the potential for specific treatments and prevention strategies. The nuclear matrix is the RNA‐protein scaffold of the nucleus, which controls in part nuclear shape, DNA organization, and DNA function. Nuclear matrix proteins in all previously studied cell types show a common set of nuclear matrix proteins and a subset of tissue‐ and cell type‐specific proteins. In every system studied to date, the nuclear matrix has been demonstrated to undergo quantifiable alterations in its protein composition with transformation to the malignant phenotype. The loss and gain of nuclear matrix proteins are being investigated as biomarkers for malignant transformation in breast, colon, and prostate carcinoma. We have investigated nuclear matrix protein composition in laryngeal and oral cavity primary squamous cell tumors and metastatic cervical lymph nodes. Laryngeal carcinoma demonstrated the gain of two specific nuclear matrix proteins in comparison with noncancerous squamous epithelium. Squamous cell carcinoma matrixes demonstrate greater heterogeneity than do previously studied adenocarcinoma matrixes, and yet they display specific matrix proteins that may represent important potential biomarkers.
Stoma Recurrence after Laryngectomy: An Analysis of Risk Factors
Authors: Zbären Peter , Greiner Richard , Kengelbacher Marc
Published: September 2022

Data from 130 patients who underwent total laryngectomy for squamous cell carcinoma of the larynx were reviewed. Patients were treated either by primary laryngectomy and planned postoperative radiotherapy or by primary radiotherapy and subsequent salvage laryngectomy. Patients with other treatment modalities and patients with positive margins of resection and laryngectomies for hypopharyngeal cancers were excluded from the study. The stomal recurrence rate with reference to several risk factors, such as primary tumor stage, location of tumor, lymph node metastases, timing of tracheotomy, and presence of a postoperative phairyngoperistomal fistula, was analyzed. The overall incidence of stomal recurrence was 10%. The treatment modality appeared to have an impact on subsequent stomal recurrence: stomal recurrence developed more often after salvage laryngectomy (18.4%) than after primary laryngectomy with planned postoperative radiation (4.8%). Advanced T stage, N stage, subglottic involvement, and preoperative tracheotomy are risk factors for stomal recurrence only in patients with a primary laryngectomy. Stomal recurrence developed in only four patients after primary laryngectomy with planned radiation. All four patients had more than one risk factor: primary tumor stage T4 (four times), subglottic involvement (three times), and preoperative tracheotomy (three times). The presence of a postoperative pharyngoperistomai fistula likewise may represent a risk factor for the development of a stomal recurrence.
Outpatient Biopsies of the Palatine Tonsil: Access to Lymphoid Tissue for Assessment of Human Immunodeficiency Virus RNA Titers
Authors: Faust Russell A. , Henry Keith , Dailey Peter , Melroe Holly , Sullivan Christopher , Erice Alejo , Haase Ashley T. , Boies Lawrence R.
Published: September 2022

OBJECTIVES

Our objective was to assess the feasibility of using tonsillar lymphoid biopsy specimens obtained on an outpatient basis to quantitate a patient's lymphoid human immunodeficiency virus (HIV) RNA titers.

DESIGN

A pilot cohort study was performed.

PATIENTS

We evaluated ten HIV‐seropositive patients who ranged in age from 26 to 48 years and had CD4+ cell counts ranging from 110 to 833 at enrollment.

MAIN OUTCOME MEASURES

The main outcome measures were tolerance and safety of outpatient tonsil biopsies and quantitation of HIV RNA titers in tonsillar lymphoid biopsy specimens, plasma, and peripheral blood mononuclear cells determined by a new method of HIV RNA signal amplification with branched DNA probes.

RESULTS

Outpatient tonsil biopsies were well tolerated and were performed without complications. Nine of 10 tonsil biopsies from the HIV‐seropositive patients examined were positive for significant concentrations of HIV RNA, ranging from 106 to 109 HIV RNA equivalents per gram of tissue. All of the HIV RNA‐positive tonsillar lymphoid specimens had HIV RNA titers that were 102 to 104 times greater than those recovered from plasma (per milliliter) of the same patient obtained at the time of biopsy.

CONCLUSIONS

Sufficient tonsillar tissue can be obtained in an outpatient clinic setting to quantitate lymphoid HIV titers by the new branched‐DNA signal amplification method with relative ease and without complication. The biopsy method described here affords ready access to the lymphoreticular system, which may help to advance our understanding of the pathogenesis of myriad immune diseases without the need for excisional node biopsies.
Extracapsular Spread in the Clinically Negative Neck (N0): Implications and Outcome
Authors: Alvi Aijaz , Johnson Jonas T.
Published: September 2022

Cervical metastasis is the most important prognostic factor in head and neck cancer patients. The prognostic significance of extracapsular spread of tumor in metastatic lymph nodes has also been documented. The presence of extracapsular spread further reduces the survival by 50% in those patients with cervical metastatic disease. Most patients with clinically negative necks (stage N0) have a good prognosis. However, some of these patients will have neck disease and distant metastasis and will eventually die. Because the presence of extracapsular spread is a predictor of poor outcome, we hypothesized that extracapsular spread may be a factor in the subset of patients with clinically negative necks who have poor outcomes. One hundred nine patients with clinically negative necks who had undergone neck dissection were identified. Occult metastasis was observed in 34% of patients. In this group, extracapsular spread was present in 18 (49%) patients. Overall, 103 patients were evaluable, of whom 70 (68%) remain free of disease 2 or more years after treatment. A subgroup of 68 patients had histologically negative nodes, of whom 56 (82%) are free of disease. Of patients with extracapsular spread, only 5 (31%) of 16 are free of disease. This is in contrast to patients with metastasis confined to the lymph node, of whom 9 (47%) of 19 are free of disease. Statistical analysis of these data shows that for this sample size this difference is significant. The addition of radiation therapy did not improve outcome in these patients. Extracapsular spread predicts a worse outcome in patients with subclinical cervical metastasis. Alternative modes of adjuvant therapy are suggested because of the poor results of postoperative radiation therapy in patients with extracapsular spread.
Triple Semicircular Canal Occlusion in the Guinea Pig
Authors: Antonelli Patrick J. , Bouchard Kenneth R. , Kartush Jack M. , Kubilis Paul S.
Published: September 2022

Hearing preservation is possible with translabyrinthine procedures, but the optimal means of sealing the remaining labyrinth has not been determined. The purpose of this study was to compare the effects of mechanical and nonmechanical (CO2 laser‐assisted) triple semicircular canal occlusion on hearing in the guinea pig. All three semicircular canals of 19 guinea pigs were treated with one of four techniques: fenestration without packing (control), fenestration with packing, CO2 laser coagulation of the membranous canal without packing, or laser coagulation with packing. Six weeks postoperatively, electrocochleographic thresholds were significantly elevated in one of five ears treated with packing alone, in one of five ears treated with laser and packing, in two of five ears treated with the laser alone, and in all four control ears. Thresholds were significantly elevated in control versus occluded ears (p < 0.05). There were no significant differences between the ears treated with laser or packing. These findings suggest that hearing can be preserved in triple canal occlusion by means of sealing the membranous labyrinth with either CO2 laser coagulation or mechanical packing. Further study on the feasibility of hearing preservation with complete labyrinthectomy is warranted.
Evaluation of Facial Palsy by Moiré Topography Index
Authors: Yuen Koji , Inokuchi Ikuo , Maeta Manabu , Kawakami Shin‐Ichiro , Masuda Yu
Published: September 2022

We investigated the usefulness of moiré topography for evaluating facial nerve function in 51 patients with facial palsy and 10 normal volunteers. This method visualizes the shape of objects in three dimensions. We devised three moiré indexes as a simple method of quantifying the severity of facial palsy: the nasolabial groove moiré index, the oral angle moiré index, and the inner canthus moiré index. We compared the results obtained by the moiré indexes with findings obtained using the House‐Brackmann grading system and found that they were highly correlated. These three moiré indexes included all the standard factors of the House‐Brackmann grading system, allowing us to develop the total moiré index.
The screening RAST: Is it a valid concept?
Authors: Lehr Andrew J. , Mabry Richard L. , Mabry Cynthia S.
Published: September 2022

Dr. William King in 1982 advocated the use of a “miniscreen” panel of six antigens to cost‐effectively initiate allergy testing. In a study of 100 consecutive patients, we found that a “midiscreen” of nine antigens was more sensitive and efficient and more accurately identified negative responders. However, the miniscreen was also effective if adjusted for regional antigen differences. (Otolaryngol Head Neck Surg 1997;117:54–5.)
Perioperative strategies in the management of carotid body tumors
Authors: Leonetti John P. , Donzelli Joseph J. , Littooy Fred N. , Farrell Brian P.
Published: September 2022

Despite the availability of noninvasive neuroradiographic techniques for the evaluation of head and neck neoplasms, paragangliomas of the carotid body often achieve substantial size before definitive diagnosis. Surgical “exploration” for the attempted resection of these lesions often results in significant blood loss, inadvertent cranial nerve injury, and procedure abandonment with partial tumor removal. Sixteen carotid body tumors were surgically resected at our institution between July 1988 and January 1995. Four of these patients had undergone cytologic examination by fine‐needle aspiration (FNA) and another 6 patients underwent failed attempted resection of their lesions as the result of intraoperative hemorrhage. Of the remaining 6 patients referred for the first time evaluation of a “neck mass,” the diagnosis was made by patient history, physical examination, magnetic resonance imaging, or magnetic resonance angiography. Complete tumor removal was accomplished in all 16 patients using a variety of lateral transcervical and skull base approaches. This article focuses on the clinicoradiographic diagnosis of carotid body tumors that do not need preoperative histologic confirmation. Specific intraoperative techniques for tumor removal, carotid artery management, and cranial nerve preservation are demonstrated through case presentations. Perioperative morbidity and overall results are detailed for this series of patients.
A Molecular, Clinical and Immunohistochemical Study of Vestibular Schwannoma
Authors: Irving Richard M. , Moffat David A. , Hardy David G. , Barton David E. , Xuereb John H. , Holland Fiona J. , Maher Eamonn R.
Published: September 2022

The molecular pathogenesis of vestibular schwannoma has been investigated by determining the extent of chromosome 22 loss of heterozygosity in 77 tumors and relating these findings to clinical and immunohistochemical indexes of tumor behavior. Loss of heterozygosity was looked for at eight chromosome 22q loci. Clinical details were obtained in all 77 cases, and a clinical growth index was calculated for each tumor. The proliferative index was estimated in all tumors by using a monoclonal antibody to the proliferating cell nuclear antigen and by calculating the labeling index. Forty percent (31 of 77) of the tumors showed allele loss, and in each case this loss involved the region of the neurofibromatosis type 2 gene. No evidence was found that the presence of chromosome 22 allele loss was associated with the clinical growth index. On the log scale, however, an association was seen between the clinical growth index and the proliferating cell nuclear antigen labeling index p = 0.001). These results suggest that chromsome 22 allele loss is a frequent event in vestibular schwannoma. Tumor behavior, however, appears to be independent of the chromosome 22 mutation. It is proposed that chromosome 22 allele loss and neurofibromatosis type 2 gene inactivation is an early event, possibly involved in the initiation of tumorigenesis in vestibular schwannoma. Tumor growth appears to be independent of this mutation and is likely to be determined by other as yet undefined factors.
Pediatric Sinusitis: A Literature Review with Emphasis on the Role of Allergy
Authors: Gungor Anil , Corey Jacquelynne P.
Published: September 2022

Evaluation and treatment of pediatric sinusitis is a challenging area that has been subject to many different opinions and options during the past decade. Sinusitis is among the most commonly encountered diseases of childhood and has been the major area of interest for many otolaryngologists, allergists, and pediatricians. We have searched the medical literature to review the many aspects of the problem and the opinions of various authors. The increasing importance of allergic diseases and their relationship to sinus disease have been evaluated through a review of relevant literature. The poorly understood variations of the presentation of sinusitis and its signs and symptoms in the pediatric age group have been reviewed. Recommendations concerning the method, duration, and timing of the therapeutic intervention or interventions are summarized. The natural course of pediatric sinusitis in association with related respiratory tract diseases is discussed. Allergies and viral upper respiratory infections are among the most common predisposing factors of sinus disease. Every child with sinusitis is a candidate for an allergy evaluation.
Pilot Study of the Oral Omeprazole Test for Reflux Laryngitis
Authors: Metz David C. , Childs Marcia L. , Ruiz Cesar , Weinstein Gregory S.
Published: September 2022

BACKGROUND: Gastroesophageal reflux disease occasionally presents with laryngeal symptoms. Such patients are often referred for a gastroenterology evaluation. This study was designed to determine whether an empiric trial of high‐dose omeprazole therapy could reliably identify patients with reflux laryngitis and thus obviate the need for a gastroenterology workup.

METHODS: Patients were evaluated with a history, physical examination, esophageal manometry, upper endoscopy, and 24‐hour pH‐metry for determination of the presence or absence of underlying gastroesophageal reflux disease and then received an empiric trial of oral omeprazole therapy (20 mg twice daily for 1 month). A positive omeprazole test result was defined as resolution of all laryngeal symptoms on completion of the empiric trial of therapy.

RESULTS: Two patients were classified as having no reflux, and eight were classified as having reflux. Omeprazole test results were positive in six patients. Five of six had reflux, but one patient had no evidence for reflux. Omeprazole test results were negative in four patients. Three of four had reflux, and one did not. Despite the absence of antisecretory therapy, laryngeal symptoms did not recur in either patient without reflux during follow‐up. Laryngeal symptoms were managed in two of the three patients with reflux who had negative omeprazole test results and who were using inhalers in combination with histamine H2 receptor antagonist therapy for their reflux disease. One patient with reflux who had a negative omeprazole test result responded to higher doses of omeprazole, and the five patients with reflux who had positive omeprazole test results all responded to continuation of omeprazole.

CONCLUSIONS: The omeprazole test may be useful in confirming the suspicion of reflux laryngitis in patients suspected of having this disease after an otolaryngology evaluation. However, there is a potential for false‐positive and false‐negative test results. A gastroenterology evaluation may aid in the identification of false‐positive test results by documenting the absence of reflux in certain responders.
Spindle Cell Carcinoma of the Larynx and Hypopharynx
Authors: Olsen Kerry D. , Lewis Jean E. , Suman Vera J.
Published: September 2022

We reviewed the clinical records of 34 patients with laryngeal (25) and hypopharyngeal (9) spindle cell carcinomas who were treated at our institution between 1960 and 1990. All the spindle ceil carcinomas were studied using paraffin section immunostains, and we performed ploidy analysis of the sarcomatoid component in 31 patients. Of the 31 patients who underwent their initial treatment at our institution, 25 were men and 6 were women (median age at presentation, 64.6 years). A T1 glottic tumor, usually seen as an exophytic firm mass, was the most common type of tumor observed (16 cases). The spindle cells were nondiploid in 86% of the carcinomas, with positive keratin imrnunostains in 74%. The median follow‐up time was 3.7 years. Recurrence of the tumor after partial or total laryngectomy or pharyngectomy occurred in 10 patients. Eight patients died of their disease. The Kaplan‐Meier estimate of surviving at least 3 years after initial treatment was 56.8%. Keratin positivity adversely affected the overall survival rate (p < 0.02). The survival rate of patients with hypopharyngeal tumors was worse than that of patients with laryngeal lesions (p < 0.001). The presence of keratin positivity and nondiploid DNA content in the spindle cell population supports the neoplastic epithelial origin of these tumors (sarcomatoid carcinoma). The overall tumor behavior and surgical therapy appeared to be comparable with those of squamous cell carcinomas at a similar stage.
Molecules, Motion, and Man
Authors: Wackym Phillip A. , Balaban Carey D.
Published: September 2022

The application of cell and molecular biology techniques to vestibular research is resulting in rapid changes in our understanding of the fundamental mechanisms of vestibular function. The clinical problems encountered in space travel together with the acute and chronic vestibular dysfunction affecting many of the patients otolaryngologists care for have driven this research at a rapid pace. A review of these methods and highlights of the major advances are discussed. (Otolaryngol Head Neck Surg 1998;118:S16‐S24.)
UAV swarm collaborative coverage control using GV division and planning algorithm
Authors: Liu H. Y. , Chen J. , Huang K. H. , Cheng G. Q. , Wang R.
Published: September 2022

Unmanned aerial vehicle (UAV) swarm coverage is one of the key technologies for multi-UAV cooperation, which plays an important role in collaborative investigation, detection, rescue and other applications. Aiming at the coverage optimisation problem of UAV in the target area, a collaborative visual coverage control method under positioning uncertainty is presented. First, the visual perception area with imprecise localisation, UAV model and sensor model are created based on the given task environment. Second, a regional division algorithm for the target task area is designed based on the principle of Guaranteed Voronoi (GV) diagram. Then a visual area coverage planning algorithm is designed, in which the task area is allocated to the UAV according to the corresponding weight coefficient of each area, and the input control law is adjusted by the expected state information of the UAV, so that the optimal coverage quality target value and the maximum coverage of the target area can be achieved. Finally, three task scenarios for regional division and coverage planning are simulated respectively, the results show that the proposed area coverage planning algorithm can realise the optimal regional distribution and can obtain more than 90% coverage in different scenarios.
The Böckenförde Dictum, Aristotle’s Koinōnia, and the Debate on the Future of Europe -
Discussed: Religion, Law, and Democracy: Selected Writings. By Ernst-Wolfgang Böckenförde. Edited by Mirjam Künkler and Tine Stein. Translated by Thomas Dunlap. Oxford: Oxford University Press, 2020. Pp. 480. $65.00 (cloth); Oxford Scholarship Online by subscription (digital). ISBN: 9780198818632. DOI: https://doi.org/10.1093/oso/9780198818632.001.0001.
Authors: McDonagh Philip
Published: September 2022

As a former diplomat currently engaged in praxis-oriented research and teaching, I examine Böckenförde’s importance in the broad context of the debate on the future of Europe. First, I trace some of Böckenförde’s specific thoughts on the development of the European Union, notably concerning trends that impact on the shared “sense of belonging” that underpins deliberative democracy. Second, accepting Böckenförde’s crucial distinction between the granular provisions of the law and an underlying ethos or sense of direction, I argue that the Böckenförde paradox is strongly supported at the roots of our culture by ancient Greek political thought, in ways that can help us develop our thinking in new directions—involving Aristotelian conceptions of orientation, community (koinōnia), and discernment. Finally, I address the challenges currently facing the European Union, taking as my point of departure President Emmanuel Macron’s evocation of the “contribution which a living Europe can bring to civilisation.” The political thought of Ernst-Wolfgang Böckenförde, illuminated by conceptions of orientation, community, and discernment, can help to prepare us for a future intercultural dialogue in the service of peace.
RECOGNISING REE GROUPS USING THE CODEGREE SET
Authors: GUAN HAIYAN , ZHANG XUNING , YANG YONG
Published: September 2022

The codegree of an irreducible character
$\chi $
of a finite group G is
$|G : \ker \chi |/\chi (1)$
. We show that the Ree group
${}^2G_2(q)$
, where
$q = 3^{2f+1}$
, is determined up to isomorphism by its set of codegrees.
Initiatives for Early Medical Student Engagement with the Field of Otolaryngology – Head and Neck Surgery
Authors: Shah H P , Sheth A H , Abdou H , Lerner M Z
Published: September 2022

Objective

Early exposure and mentorship in surgical specialties like otolaryngology – head and neck surgery are critical for medical students. This paper presents initiatives implemented at our institution to engage early-career medical students with the field.

Methods

A hands-on laryngoscope workshop was organised, and a centralised online platform was created for research and mentorship opportunities using a collaborative project management tool. Both measures were advertised via e-mail to student interest groups and campus diversity groups. At the end of the workshop, participating students completed an online distributed survey.

Results

Students’ perception of their knowledge of airway anatomy and related clinical scenarios significantly improved after the laryngoscopy workshop (p = 0.001 and p = 0.002, respectively). All attendees indicated that the workshop increased their comfort level with procedures and that they would recommend the workshop to colleagues. Nearly half of participants reported becoming ‘very interested’ in exploring otolaryngology – head and neck surgery through future elective courses.

Conclusion

Implementation of such initiatives at other institutions can generate medical student interest and may improve diversity in otolaryngology – head and neck surgery.
Effects of psychosis-associated genetic markers on brain volumetry: a systematic review of replicated findings and an independent validation
Authors: Vouga Ribeiro Nuno , Tavares Vânia , Bramon Elvira , Toulopoulou Timothea , Valli Isabel , Shergill Sukhi , Murray Robin , Prata Diana
Published: September 2022

Background

Given psychotic illnesses' high heritability and associations with brain structure, numerous neuroimaging-genetics findings have been reported in the last two decades. However, few findings have been replicated. In the present independent sample we aimed to replicate any psychosis-implicated SNPs (single nucleotide polymorphisms), which had previously shown at least two main effects on brain volume.

Methods

A systematic review for SNPs showing a replicated effect on brain volume yielded 25 studies implicating seven SNPs in five genes. Their effect was then tested in 113 subjects with either schizophrenia, bipolar disorder, ‘at risk mental state’ or healthy state, for whole-brain and region-of-interest (ROI) associations with grey and white matter volume changes, using voxel-based morphometry.

Results

We found FWER-corrected (Family-wise error rate) (i.e. statistically significant) associations of: (1) CACNA1C-rs769087-A with larger bilateral hippocampus and thalamus white matter, across the whole brain; and (2) CACNA1C-rs769087-A with larger superior frontal gyrus, as ROI. Higher replication concordance with existing literature was found, in decreasing order, for: (1) CACNA1C-rs769087-A, with larger dorsolateral-prefrontal/superior frontal gyrus and hippocampi (both with anatomical and directional concordance); (2) ZNF804A-rs11681373-A, with smaller angular gyrus grey matter and rectus gyri white matter (both with anatomical and directional concordance); and (3) BDNF-rs6265-T with superior frontal and middle cingulate gyri volume change (with anatomical and allelic concordance).

Conclusions

Most literature findings were not herein replicated. Nevertheless, high degree/likelihood of replication was found for two genome-wide association studies- and one candidate-implicated SNPs, supporting their involvement in psychosis and brain structure.
Epistemic fusion: Passenger Information Units and the making of international security
Authors: Glouftsios Georgios , Leese Matthias
Published: September 2022

This article focuses on the control of international mobility through the gathering, processing, and sharing of air travellers’ data. While a lot has been written about pre-emptive rationalities of security translated into the functionalities of IT systems used for border controls, we take a step further and investigate how these rationalities are operationalised through data transfer, screening, validation, discarding, profiling, contextualisation, calibration, and adjustment practices. These practices may seem banal and technical; however, we demonstrate how they matter politically as they underpin the making of international security. We do so by analysing the work of Passenger Information Units (PIUs) and retracing how they turn Passenger Name Record (PNR) data into actionable intelligence for counterterrorism and the fight against serious crime. To better understand the work of PIUs, we introduce and unpack the concept of ‘epistemic fusion’. This explicates how security intelligence comes into being through practices that pertain to cross-domain data frictions, the contextualisation of data-driven knowledge through its synthesis with more traditional forms of investigatory knowledge and expertise, and the adjustment of the intelligence produced to make it actionable on the ground.
Right ventricle-dependent coronary circulation diagnosed by non-invasive ferumoxytol-enhanced 4D cardiac magnetic resonance angiography in pulmonary atresia with intact ventricular septum
Authors: Rezkalla Joshua , Raymundo Stephanie A. , Renella Pierangelo
Published: September 2022

Pulmonary atresia with intact ventricular septum is a complex cyanotic congenital heart lesion with the potential for myocardial ischaemia due to the presence of coronary artery anomalies. We present a case of a two-day-old baby with postnatal diagnosis of pulmonary atresia with intact ventricular septum in whom non-invasive ferumoxytol-enhanced 4D cardiac magnetic resonance angiography was used for the assessment of coronary artery anatomy.
End-of-life care for Filipino patients with cancer
Authors: Guarin Geneva E. , Dee Edward Christopher , Robredo Janine Patricia G. , Eala Michelle Ann B. , Medina Manuel F. , Tanco Kimberson C.
Published: September 2022

Providing end-of-life care within the cultural context of a Filipino patient in the United States is a complex process for clinicians, patients, and their families. An inclusive approach is crucial, especially because a significant proportion of patients belong to minority groups such as Filipinos, who represent the fourth largest group of immigrants in the United States as of data available in 2019. The case provided in this paper highlights the importance of family, religion, and finances in guiding the best possible way of providing end-of-life care for Filipino patients with cancer. At the end of this review, we discuss concrete action points that may give a non-Filipino physician a deeper understanding of end-of-life care for Filipinos.
The Bullet That Ended Chivalry: Voltaire's Histoire de Charles Xii As A Celebration Of The Implausible
Authors: Moraes Ferreira Caio
Published: September 2022

Voltaire's first historical work (History of Charles XII, 1731) is frequently read as a piece of literary satire designed to ridicule the tradition of military heroes and warmongering monarchs. I offer a contrasting perspective and make the case that the book grapples with a problem both epistemic and poetic: how to narrate and make sense of an implausible or unbelievable past. In shedding light on this issue, this article questions widely held assumptions about the relationship between truth, plausibility, and history in the seventeenth and eighteenth centuries. It pushes back against the notion that Voltaire, like other neoclassical historians, had a rigid and naive understanding of the implausible as “fabulous” or “unhistorical.” Instead, I make the case that the implausible to Voltaire often pointed to a necessary and meaningful aspect of histories as narratives of the grand, the extraordinary, and the grotesque.
Eczema and related atopic diseases are associated with increased symptom severity in children with autism spectrum disorder
Authors: Jameson C. , Boulton K. A. , Silove N. , Guastella A. J.
Published: September 2022

Growing evidence indicates that autism spectrum disorder (ASD) has diverse genetic, neurological, and environmental factors that contribute to its neurodevelopmental course. Interestingly, childhood ASD is often accompanied by skin disorders, such as eczema, and other related atopic manifestations. This link may be due to the shared embryonic origin of epidermal and neural tissue. Accordingly, we consider the potential influence of a skin-brain co-vulnerability and ensuing atopic cascade on ASD symptomatology by investigating whether atopic disorders (asthma, allergies, eczema and hay fever) are associated with increased symptom severity in children with ASD. Overall, 45 atopic and 93 non-atopic children with ASD were assessed using the ADOS-2 on scores of total, social and non-social symptoms. Differences in ASD symptom severity were further evaluated as a function of atopic disease type. Atopic children displayed greater symptom severity overall and in the social domain, relative to non-atopic participants. Atopic children were 2.4 times more likely to experience overall impairments classified within the ADOS-2 highest-level severity bracket and 2.7 times more likely to show social difficulties in this range. Moreover, those reporting comorbid eczema displayed increased symptom severity relative to both their non-atopic peers and those reporting asthma and allergies. Taken together, findings indicate that atopic disorders, and particularly comorbid eczema, are associated with increases in ASD symptom severity. Findings provide grounds for future investigations into this link between childhood skin diseases and ASD symptom severity to advance our understanding of neurodevelopment and to develop targeted assessment and intervention opportunities.
A key role of miR-132-5p in the prefrontal cortex for persistent prophylactic actions of (R)-ketamine in mice
Authors: Ma Li , Wang Long , Chang Lijia , Shan Jiajing , Qu Youge , Wang Xingming , Wan Xiayun , Fujita Yuko , Hashimoto Kenji
Published: September 2022

(R,S)-ketamine is known to elicit persistent prophylactic effects in rodent models of depression. However, the precise molecular mechanisms underlying its action remain elusive. Using RNA-sequencing analysis, we searched for novel molecular target(s) that contribute to the prophylactic effects of (R)-ketamine, a more potent enantiomer of (R,S)-ketamine in chronic restraint stress (CRS) model. Pretreatment with (R)-ketamine (10 mg/kg, 1 day before CRS) significantly ameliorated body weight loss, increased immobility time of forced swimming test, and decreased sucrose preference of sucrose preference test in CRS-exposed mice. RNA-sequencing analysis of prefrontal cortex (PFC) revealed that several miRNAs such as miR-132-5p might contribute to sustained prophylactic effects of (R)-ketamine. Methyl CpG binding protein 2 (MeCP2) is known to regulate brain-derived neurotrophic factor (BDNF) expression. Quantitative RT-PCR confirmed that (R)-ketamine significantly attenuated altered expression of miR-132-5p and its regulated genes (Bdnf, Mecp2, Tgfb1, Tgfbr2) in the PFC of CRS-exposed mice. Furthermore, (R)-ketamine significantly attenuated altered expression of BDNF, MeCP2, TGF-β1 (transforming growth factor β1), and synaptic proteins (PSD-95, and GluA1) in the PFC of CRS-exposed mice. Administration of agomiR-132-5p decreased the expression of Bdnf and Tgfb1 in the PFC, resulting in depression-like behaviors. In contrast, administration of antagomiR-132-5p blocked the increased expression of miR-132-5p and decreased expression of Bdnf in the PFC of CRS-exposed mice, resulting in antidepressant-like effects. In conclusion, our data show a novel role of miR-132-5p in the PFC underlying depression-like phenotypes in CRS model and the sustained prophylactic effects of (R)-ketamine.