bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis of Palm Oil‐Based Diethanolamides
Authors: Lee C. S. , Ooi T. L. , Chuah C. H. , Ahmad S.
Published: August 2007

In this work, Epoxidized Palm Olein (EPOo) was blended with Refined Bleached Deodorized Palm Kernel Olein (RBDPKOo) in a range of 10–100% (w/w) to react with diethanolamine (DEA) with a 1:3 molar ratio to produce diethanolamides that retained some epoxides. The epoxidized diethanolamides are proposed as a new type of vegetable oil derived polyols for rigid polyurethane. The optimal reaction temperature is 110 °C for 5 h. In addition, the optimal amount of starting materials were determined to be 40% (w/w) of EPOo blended with 60% (w/w) of RBDPKOo. The diethanolamides appeared as non‐viscous liquid at room temperature with a viscosity of 990.08 cP at 25 °C and 427.09 cP at 40 °C, a cloud point of 21 °C, a pour point of 12 °C and 0.78% of retained oxirane oxygen contents (OOC). The hydroxyl and the amine values of the diethanolamides were determined as 351.85 mg KOH/g sample and 4.5 mg KOH/g sample, respectively. In addition, chemical elucidation of the diethanolamides with functional epoxides was carried out using Gas Chromatography (GC) and Gas Chromatography Mass Spectrometry (GCMS) for the purpose of process development and quality control.
Beware of ulnar nerve entrapment in flexion-type supracondylar humerus fractures
Authors: Steinman Suzanne , Bastrom Tracey P. , Newton Peter O. , Mubarak Scott J.
Published: August 2007

Purpose

A recent study reported a higher incidence of pre-operative ulnar nerve symptoms in patients with flexion-type supracondylar fractures than in those with the more common extension supracondylar fractures and a greater need for open reduction (Kocher in POSNA paper #49 2006). We have encountered a specific pattern of flexion supracondylar fractures that often require open reduction with internal fixation (ORIF) due to entrapment of the ulnar nerve within the fracture.

Methods

Medical records and X-rays from 1997 to 2005 at our children's hospital were examined to identify flexion supracondylar fractures that required open reduction. The operative reports were reviewed to identify cases that had the ulnar nerve blocking the reduction.

Results

During the 8 years examined, 1,650 supracondylar fractures had been treated by means of closed reduction and percutaneous pinning. Of these, only 1.8% or 30 cases could not be reduced closed and required open reduction internal fixation, excluding 11 open fractures. Of the 30 fractures requiring open reduction internal fixation, 24 were of the extension type needing ORIF because of interposed periosteum/muscle. The other 6 patients had flexion-type supracondylar fractures that failed closed reduction. All had a persistent medial gap at the fracture site. All 6 fractures had interposed periosteum or muscle, while in 3 cases the ulnar nerve was also entrapped within the fracture site (Figs. 1 , 2 )

Conclusion

Flexion-type supracondylar fractures remain a relatively uncommon variant (2–3%) of supracondylar fractures. Recent reports have noted that open treatment of these fractures is required more frequently than for extension fractures. In our series, 20% of the open cases were flexion-type fractures and in half of these the ulnar nerve was found to be entrapped in the fracture, preventing reduction.
Soft-tissue sarcomas of the extremities in patients of pediatric age
Authors: Casanova Michela , Meazza Cristina , Gronchi Alessandro , Fiore Marco , Zaffignani Elena , Podda Marta , Collini Paola , Gandola Lorenza , Ferrari Andrea
Published: August 2007

Purpose

The extremity site is a peculiar location for soft-tissue sarcomas (STS) of children and adolescents. Here we report the experience of the Pediatric Oncology Unit of the Istituto Nazionale Tumori of Milan, Italy, concerning 204 patients with STS of the limbs treated between 1977 and 2006.

Methods

The study series included 52 patients with rhabdomyosarcoma (RMS)(65% of which were of the alveolar subtype), nine with extraosseous Ewing sarcoma and 143 with non-rhabdomyosarcoma soft-tissue sarcomas (NRSTS), 38% of which were synovial sarcoma. Patients were treated with a multimodality approach including surgery, chemotherapy, and radiotherapy.

Results

For the RMS patients, the 5-year event-free survival (EFS) rate was 37.1%, with distant metastases being the main cause of treatment failure. The outcome was particularly poor for patients with large invasive tumors, hand/foot involvement and/or nodal or distant metastases, and for patients who were not given radiotherapy. For the extraosseous Ewing sarcoma cases, 5-year EFS was 74%. For the NRSTS cases, the 5-year EFS was 72.6%: tumor size and local invasiveness, tumor grade, malignant peripheral nerve sheath tumor (MPNST) histology, and distant metastases were the main prognostic factors.

Discussion

While the limbs are the most common sites of NRSTS and are often characterized by a more favorable prognosis than for axial tumors, the clinical features of extremity RMS often differ from those of RMS of other sites, with a higher incidence of unfavorable prognostic factors (e.g., alveolar subtype) and consequently unsatisfactory treatment results. The treatment of these patients is complex and necessarily multidisciplinary, and it demands not only adequate experience of treating children and adolescents in clinical trials, but also particular skills in the field of orthopedic surgery.
The association between television‐viewing behaviors and adolescent dating role attitudes and behaviors
Authors: Rivadeneyra Rocío , Lebo Melanie J.
Published: August 2007

Two hundred and fifteen ninth grade students were surveyed to examine the relationship between television use and gender role attitudes and behavior in dating situations. Findings indicate the existence of a relationship between watching “romantic” television programming and having more traditional gender role attitudes in dating situations. However, watching non‐romantic television dramas and thinking television was realistic, was related to having less traditional dating role attitudes. In addition, watching soap operas was related to a younger age of dating initiation and a greater number of dating partners. These results suggest that along with their own experiences in dating peers, adolescents may be learning from television programs that dating is a gendered process with prescribed roles for males and females, an attitude connected with greater sexual risk for young women.
Human TAO kinase 1 induces apoptosis in SH‐SY5Y cells
Authors: Wu Ming‐Fang , Wang Shyang‐Guang
Published: August 2007

The human TAO kinase 1 (hTAOK1) is a member of the Ste20 group of kinases with the kinase domain located at the N‐terminus. The rat homologue, originally named TAO1, has been demonstrated to be highly expressed in brain. In this study, the human TAO kinase 1 was transfected into human neuroblastoma SH‐SY5Y cells and its biological effects on the cell morphology were observed by co‐expressing the enhanced green fluorescent protein (EGFP). It was found that after 16 h of transfection the cells had shrunk, and finally became rounded when transfected with wild‐type or mutant K57A genes encoding either the kinase domain (residues 1–376) or the full‐length molecule (residues 1–1001). Thirty‐four hours after transfection, cells floated and apoptotic bodies were observed after nuclear staining with DAPI. On the other hand, the cells that were transfected with the gene encoding the C‐terminal regulatory region (residues 377–1001) of hTAOK1, appeared to remain unchanged. In order to know the signaling events involved in the above biological phenomena, caspase‐3‐like activities of the transfected cells were measured in the absence or presence of JNK inhibitor SP600125, in which caspase‐3 and JNK (C‐jun‐N‐terminal kinase) are both known to be critical components of the neuronal apoptosis. The results showed that the apoptotic cells exhibited elevated caspase‐3‐like activity, which could be reduced by SP600125 to some extent. It is concluded that human TAO kinase 1 induces apoptosis in SH‐SY5Y cells and the kinase domain is essential, but its catalytic activity seems to be dispensable in this case.
Increasing glucose levels and BMI predict future heart failure Experience from the Reykjavík Study
Authors: Thrainsdottir I.S. , Aspelund T. , Gudnason V. , Malmberg K. , Sigurdsson G. , Thorgeirsson G. , Hardarson T. , Rydén L.
Published: August 2007

Background:

Heart failure is common in diabetes and ischaemic heart disease is the most likely link. Still, it has been suggested that the relation extends beyond such disease.

Methods:

7060 subjects with two or more visits in the Reykjavík Study were followed–during 30years from 1967. All underwent oral glucose tolerance tests. Disease status was defined according to the glycaemic level and presence of heart failure. The incidence and predictive factors for these diseases were determined.

Findings:

Age and sex standardized incidence of heart failure was 5.3/1000/year, of diabetes 4.6/1000/year and abnormal glucose regulation 12.6/1000/year. Body mass index (BMI) and fasting glucose predicted the development of these conditions (p<0.001). Increasing fasting glucose by 1mmol/l increased the risk for heart failure by 14% (p=0.04) after adjusting for IHD, BMI and other risk factors for CVD. There was a strong association between diabetes and heart failure, OR 3.0 (2.3–4.0), and abnormal glucose regulation and heart failure, OR 1.8 (1.5–2.3). Diabetes and heart failure were, however, not independent predictors of each other.

Interpretation:

There was an independent relationship between increases in fasting glucose and development of heart failure. BMI was a strong predictor of heart failure. Although fasting glucose and BMI were significant risk factors for glucose disturbances and heart failure the conditions themselves did not independently predict each other.
Association study of catechol-O-methyltransferase Val158Met polymorphism with personality traits in japanese healthy volunteers
Authors: ishii Genki , Suzuki Akihito , Oshino Shingo , Shiraishi Hiroaki , Matsumoto Yoshihiko , Otani Koichi , Goto Kaoru
Published: August 2007

Catechol-O-methyltransferase (COMT) is one of the major enzymes for the degradation of catecholamines. It has been suggested that catecholaminergic neurotransmission is involved in characterization of personality. Previous studies on the association between the COMT Val158Met polymorphism and personality traits in healthy subjects have produced inconsistent results. Therefore, the relationship between this polymorphism and personality was re-examined in 478 Japanese healthy volunteers. Personality traits were assessed by the Temperament and Character inventory (TCI), and the COMT genotypes were determined by a PCR-RFLP method. in total, there were no significant differences among the Val/Val, Val/Met, and Met/Met genotypes in seven TCI dimension scores. Similarly, no significant relationship was found between the COMT genotypes and the TCI dimensions when males and females were analyzed separately. The present study thus suggests that the COMT Val158Met polymorphism is not associated with personality traits in Japanese healthy subjects.
Psychiatric diagnoses and personality traits associated with disadvantageous decision-making
Authors: Jollant F. , Guillaume S. , Jaussent I. , Bellivier F. , Leboyer M. , Castelnau D. , Malafosse A. , Courtet Ph.
Published: August 2007

Objective

Decision-making impairment is an important feature of psychiatric disorders. in a large comorbid psychiatric population, we explored the link between decision-making deficit and clinical variables.

Method

We used the Iowa Gambling Task to measure decision-making in 317 patients. Psychiatric diagnoses were made according to the DSM-IV criteria. Self-questionnaires were used to assess several personality traits. The last and most severe suicidal acts were characterized.

Results

(1) After controlling for age and medication intake, a past history of suicide attempt (OR = 2.0 [1.1–3.8]) and normothymic bipolar disorders (OR = 3.4 [1.1–10.5]) were significantly and independently associated with impaired decision-making. (2) Decision-making performance was significantly correlated with affective lability. (3) No association was found between decision-making skills and suicidal characteristics.

Discussion

A lack of statistical power may have masked associations with obsessive-compulsive disorder and anorexia nervosa. We did not control for other cognitive functions except attention.

Conclusion

This study supports the independent association of decision-making impairment with vulnerability to suicidal behaviour but not with substance abuse. Normothymic bipolar disorders, but not unipolar disorders, were also linked to low performance. At the dimensional level, impulsivity and decision-making abilities may be distinct processes. Affective regulation skills appear to be a major influence on decision-making performance and following a relevant therapeutic target.
Platelet monoamine oxidase activity in obsessive-compulsive disorder
Authors: Arrojo Manuel , Baca-Garcia Enrique , Perez-Rodriguez Maria Mercedes , Dolengevich-Segal Helen , Navio-Acosta Mercedes , Rodriguez-Salgado Beatriz , Saiz-Ruiz Jeronimo
Published: August 2007

Response to SSRIs suggests the implication of the serotonergic system in obsessive-compulsive disorder (OCD). However, biological studies on serotonergic function in OCD have yielded contradictory results. Platelet monoamine oxidase (MAO) activity has been proposed as an index of cerebral serotonin activity.

The aim of this study was to examine platelet MAO activity in 29 OCD patients and 29 healthy controls matched by age, sex and tobacco use. We also explored the relationship between platelet MAO activity and aggressive obsessions in OCD patients.

There were no differences in platelet MAO activity between OCD patients and healthy controls. We found a significant correlation between platelet MAO activity and Y-BOCS scores in the group of patients with Y-BOCS scores >15.

OCD patients with aggressive obsessions had significantly lower levels of platelet MAO activity than patients without aggressive obsessions.

Our results suggest that platelet MAO activity may be a marker of OCD severity, and that low platelet MAO activity may be associated with aggressive obsessions in OCD patients.
The whole hexapeptide repeats domain from avian PrP displays untypical hallmarks in aspect of the Cu2+ complexes formation
Authors: Stańczak Paweł , Juszczyk Paulina , Grzonka Zbigniew , Kozłowski Henryk
Published: August 2007

Prions, the infectious agents responsible for the transmissible spongiform encephalopathies (TSEs) have defied full characterization for decades. Although the interactions of Cu2+ ions with PrP both in vivo and in vitro are well documented, there are still a lot of ambiguities concerning the biological and chemical nature of these effects. In this work, we have investigated the interactions of Cu2+ ions with whole repeat region of the copper‐binding domain (hexapeptide repeats) of chicken PrP. Our results provide explanations for the structural and chemical basis of the specific interactions of Cu2+ ions with the hexapeptide repeat region. Furthermore, we show that SOD‐like activity depends on Cu2+ complexes.
Use of high density antibody arrays to validate and discover cancer serum biomarkers
Authors: Loch Christian M. , Ramirez Arturo B. , Liu Yan , Sather Cassandra L. , Delrow Jeffrey J. , Scholler Nathalie , Garvik Barbara M. , Urban Nicole D. , McIntosh Martin W. , Lampe Paul D.
Published: August 2007

Perhaps the greatest barrier to translation of serum biomarker discoveries is the inability to evaluate putative biomarkers in high throughput validation studies. Here we report on the development, production, and implementation of a high‐density antibody microarray used to evaluate large numbers of candidate ovarian cancer serum biomarkers. The platform was shown to be useful for evaluation of individual antibodies for comparative analysis, such as with disease classification, and biomarker validation and discovery. We demonstrate its performance by showing that known tumor markers behave as expected. We also identify several promising biomarkers from a candidate list and generate hypotheses to support new discovery studies.
Prospective, Randomized, Controlled Trial of a Hemostatic Sealant in Children Undergoing Adenotonsillectomy
Authors: Jo Stephen H. , Mathiasen Ronald A. , Gurushanthaiah Deepak
Published: August 2007

OBJECTIVES

To evaluate the efficacy of Floseal as a hemostatic sealant compared to traditional electrocautery hemostasis after cold knife adenotonsillectomy.

STUDY DESIGN

Prospective, randomized, controlled trial of 68 consecutive patients undergoing cold steel adenotonsillectomy. Patients were randomized to receive either Floseal (FS) or electrocautery (EC) for hemostasis.

RESULTS

FS patients had shorter operative times than EC patients (16 min vs 31.2 min, P < 0.0001) and less blood loss (49.2 mL vs 70.8 mL, P < 0.05). Four EC patients were crossed over to Floseal when adequate hemostasis could not be achieved in the adenoid bed. No Floseal patients were crossed over. FS patients had significantly less pain on postoperative days two through 11 (P < 0.05) and less use of narcotic pain medications over the first 10 postoperative days (P < 0.05). FS patients also had a faster return to regular diet (5.5 days vs 7.9 days, P < 0.01) and activity (5.3 days vs 7.8 days, P < 0.01) as compared to the EC patients. There were no significant complications in either group.

CONCLUSIONS

Floseal is safe and efficacious, and decreases postoperative morbidity as compared to electrocautery hemostasis after cold steel adenotonsillectomy.

SIGNIFICANCE

This study demonstrates the safety and efficacy of Floseal as a hemostatic method in children undergoing adenotonsillectomy.
Prospective Clinical Study of Bleeding Sites in Idiopathic Adult Posterior Epistaxis
Authors: Chiu Tor W. , McGarry Gerry W.
Published: August 2007

OBJECTIVES

The precise identification of the bleeding point is important to the efficient management of epistaxis. Our hypothesis was that the septum was the commonest bleeding site.

STUDY DESIGN AND SETTING

This was a prospective clinical study of 50 consecutive adult idiopathic posterior epistaxis patients carried out in a busy teaching hospital.

METHODS

The nasal cavity was inspected with endoscopy to identify the site of bleeding before any intervention. The location of bleeding sites was recorded on a proforma.

RESULTS

Of bleeding sites posterior to the piriform fossa, 94 percent were identifiable, with 70 percent arising from the septum.

CONCLUSIONS AND SIGNIFICANCE

This is the largest prospective study of the bleeding site in adult patients with posterior epistaxis and the only one with a well‐defined population. The vast majority of posterior bleeding sites can be identified by endoscopy without general anesthesia. The septum should be examined closely in cases of idiopathic bleeding.
Obliteration of the Persistently Discharging Mastoid Cavity using the Middle Temporal Artery Flap
Authors: Singh Vivian , Atlas Marcus
Published: August 2007

OBJECTIVE

To evaluate the surgical outcome of patients undergoing obliteration of a persistently discharging mastoid cavity with specific soft tissue vascular flaps for chronic otitis media or cholesteatoma.

STUDY DESIGN

A five‐year retrospective consecutive case review in a tertiary care referral center. Following mastoidectomy obliteration with a superiorly based middle temporal artery, axial periosteal flap and inferiorly based random pedicled musculoperi‐osteal flap was performed. The primary outcome was control of suppuration and the creation of a dry, low‐maintenance cavity as assessed by a semi‐quantitative scale.

RESULTS

A total of 51 consecutive patients undergoing revision mastoidectomy with obliteration were identified with a minimum follow‐up of 12 months; 43 (84%) had a small dry healthy mastoid cavity; three ears (6%) had occasional otorrhea that was relatively easily managed by topical therapy.

CONCLUSION

Obliteration using the middle temporal artery and inferior random flaps is an effective method to manage patients with pre‐existing cavities and also those not previously operated upon.
Incidence of Thyroid Carcinoma in Fluorodeoxyglucose Positron Emission Tomography‐Positive Thyroid Incidentalomas
Authors: King Deanne L. , Stack Brendan C. , Spring Paul M. , Walker Ronald , Bodenner Donald L.
Published: August 2007

OBJECTIVE

Fluorodeoxyglucose (FDG) whole body positron emission tomography (PET) scan may show clinically occult second lesions. Such lesions in the thyroid are increasingly common. There are several recent reports of a high probability of malignancy in these lesions ranging from 14% to 63%.

STUDY DESIGN AND SETTING

This is a retrospective review of 15,711 PET scans at a multi‐disciplinary thyroid clinic at a tertiary care university medical center. Twenty‐two patients were referred with thyroid PET “incidentalomas.” The review included 18 FDG‐PET scans, ultrasound guided fine needle aspiration biopsies, and thyroid surgery pathology. Aspiration cytology or pathology were the main outcome measures.

RESULTS

Three patients had malignancy of the PET‐positive thyroid lesions. Papillary thyroid micro carcinomas were detected in four of the specimens that showed a benign pathology of the dominant nodule.

CONCLUSION

Our experience shows a 14% malignancy rate for the dominant (imaged) nodule and a total malignancy rate of 32% when the incidental micro carcinomas are included. Both of these rates are significantly lower than results published previously.
Exclusively Endoscopic Surgery for Juvenile Nasopharyngeal Angiofibroma
Authors: Andrade Nilvano A. , Pinto José Antonio , de Oliveira Nóbrega Mônica , Aguiar José Estelita P. , Aguiar Tâmara Ferraro A.P. , Vinhaes Ériko S.A.
Published: August 2007

OBJECTIVE

To present the indications of nasal endoscopic surgery for treating juvenile nasopharyngeal angiofibroma (JNA).

STUDY DESIGN

Chart review.

MATERIALS AND METHODS

Twelve patients underwent nasal endoscopic surgery exclusively to resect JNA from January 2001 to June 2004. According to the classification of Andrews et al, eight patients were stage I and four patients were stage II.

RESULTS

The follow‐up was between five and 42 months, and no patient has shown a residual tumor or recurrence to date.

CONCLUSION

In JNA stages I and II, the endoscopic approach was effective without preoperative arterial embolization. There were no residual tumors or recurrence in this study.

SIGNIFICANCE

It seems to be appropriate to reevaluate the surgical limits of endoscopic surgery for resecting JNA.
Planned Neck Dissection after Definitive Radiotherapy or Chemoradiation for Base of Tongue Cancers
Authors: Hitchcock Ying J. , Bentz Brandon G. , Sharma Pramod K. , Fang Christine , Tward Jonathan D. , Pappas Lisa , Chen Jergin , Hayes John K. , Shrieve Dennis C.
Published: August 2007

OBJECTIVES

The study goal was to analyze the role of planned neck dissection for squamous cell carcinoma of the base of the tongue treated with definitive radiotherapy or chemoradiation.

STUDY DESIGN, SETTING

We conducted a retrospective study of patients with squamous cell carcinoma of the base of the tongue undergoing planned neck dissection after definitive radiotherapy or chemoradiation.

RESULTS

Twenty‐two of 41 (53.7%) patients had one to six positive residual lymph nodes after receiving definitive radiotherapy or chemoradiation. Neck control rates were 92.3% and 88.3% at two and five years, respectively. Three of 22 (13.6%) patients with pathological residual nodal disease had regional or locore‐gional failures, compared with 1 of 19 (5.3%) patients with a pathologically complete response (P = 0.39).

CONCLUSIONS

We observed a high incidence of pathologically residual lymph nodes after definitive radiotherapy or chemoradiation.

SIGNIFICANCE

Planned neck dissection following definitive radiotherapy or chemoradiation is highly effective in achieving regional control of squamous cell carcinoma of the base of the tongue.
Neck Dissection Followed by Chemoradiotherapy for Stage IV (N+) Oropharynx Cancer
Authors: Cupino Andrew , Axelrod Rita , Anne P. Rani , Sidhu Kulbir , Lavarino Jorosali , Kung Brian , Rosen Marc , Keane William , Machtay Mitchell
Published: August 2007

PURPOSE

This study evaluated the strategy of performing neck dissection (ND) without primary tumor resection prior to definitive chemoradiotherapy (CRT) for N2+ oropharynx cancer.

METHODS

We analyzed records of 25 patients who underwent ND before concurrent CRT with weekly low‐dose concurrent paclitaxel and a platinum compound. The extent of ND was highly customized (1 to 39 nodes) and median radiotherapy dose was 70 Gy.

RESULTS

Median follow‐up was 36 months. Two‐year and 3‐year actuarial locoregional control rates were 95% and 88%. No patient had regional neck nodal failure. Two‐year rate of freedom from distant metastases was 91%. The 2‐ and 3‐year event‐free survival rates were 88% and 75%. Fifteen percent had Grade 3+ late toxicity; none had permanent gastrostomy tube dependence.

CONCLUSIONS

Neck dissection without primary tumor resection before definitive chemoradiotherapy for oropharynx cancer is a safe and effective management program and warrants further exploration.
Endoscopic Revision of External Dacryocystorhinostomy
Authors: Demarco Ricardo , Strose Alex , Araújo Marcos , Valera Fabiana Cardoso Pereira , Moribe Iracema , Anselmo‐Lima Wilma Terezinha
Published: August 2007

OBJECTIVES

To observe the benefit of endoscopic surgery for the treatment of lacrimal duct obstruction in revisional surgeries after external dacryocystorhinostomy.

STUDY DESIGN AND SETTING

Retrospective nonrandomized study. Eleven cases of recurrent lacrimal duct obstruction after external dacryocystorhinostomy were submitted to endoscopic dacryocystorhinostomy.

RESULTS

The rate of success after revisional surgery was 90.9%. The major causes of failure of the external approach were the presence of granulation tissue, septal deviations and synechiae near the opening of the fistula, inadequate removal of the bony wall adjuvant the lacrimal sac, technical error in the localization of the lacrimal sac, and excessive perioperative bleeding that impaired the surgical field.

CONCLUSION

Endoscopic dacryocystorhinostomy in revisional cases proved to be a safe technique of low morbidity, permitting effective resolution of the lacrimal obstructions.

SIGNIFICANCE

Endoscopic surgery allows greater visibility of the lacrimal sac and its neighbor anatomic alterations and leads to better results.
Quality of Perceived Sound after Stapedotomy
Authors: Tan Frédérique M.L. , Grolman Wilko , Tange Rinze A. , Fokkens Wytske J.
Published: August 2007

OBJECTIVE

To evaluate the quality of perceived sound in relation to the audiometric result after stapedotomy.

STUDY DESIGN

Ninety‐eight patients with otosclerosis, who underwent stapedotomy between 2004 and 2005, participated in this retrospective study. Audiometric data were obtained before and after stapedotomy. Patients filled out two questionnaires: the Amsterdam Post Operative Sound Evaluation and the Operation Benefit Profile, which is based on the Glasgow Hearing Aid Benefit Profile.

RESULTS

There were 83 responders and 15 nonresponders; 83% indicated that their hearing was now better compared to preoperatively. The sounds that gave the highest percentage of distortion were “high pitched sound” (15%) and “loud sound” (13%). The groups with an air‐bone gap of 0 to 10 dB and 10 to 20 dB report a relatively high number of patients who experience distortion. The audiometric data correlate well with the Operation Benefit Score.

CONCLUSIONS

Audiometric improvement does not necessarily mean an improvement in perceived sound and vice versa. But the audiometric outcome is significantly related to the patient's experienced handicap, benefit of the operation, residual difficulty, and overall satisfaction.
Eight Cases of Nasal Tuberculosis
Authors: Kim Yong Min , Kim Ah Young , Park Yong Ho , Kim Dong Hyun , Rha Ki‐Sang
Published: August 2007

OBJECTIVE

To elucidate the clinical characteristics of nasal tuberculosis and to discuss its diagnostic difficulties.

STUDY DESIGN

Retrospective clinical analysis.

RESULTS

A total of eight patients presented with nasal tuberculosis during the study period (from January 1989 through December 2006). Six were female and two were male. The patient age varied from 17 to 51 years, with a mean of 31 years. The most commonly involved site was the nasal septum (7 of 8). Perforation of the nasal septum was observed in three cases. Sinus invasion was observed in two cases and required sinus surgery. Six of the cases were a result of primary infections, while two were secondary disease manifestations. All patients were treated with anti‐tuberculosis medications, with subsequent improvement with regard to clinical symptoms and physical signs.

CONCLUSIONS

We present the largest number of nasal tuberculosis cases reported in the medical literature from a single institute. Diagnosing nasal tuberculosis requires a high index of suspicion and occasionally the use of experimental drug treatment options.
The Sensitivity of Preoperative Scanning in Regional Recurrence of Papillary Thyroid Cancer
Authors: Khafif Avi , Ben‐Yosef Rami , Kesler Ada , Trejo‐Laider Leonor , Landsberg Roee , Patchornik Hanna , Even‐Sapir Einat , Fliss Dan M.
Published: August 2007

BACKGROUND

The treatment of patients with regionally recurrent papillary carcinoma of the thyroid is a matter of controversy. Radioactive nodal picking was proposed as an alternative to neck dissection in these patients.

METHODS

We analyzed neck dissection specimens in 20 patients with PTC and compared the results to preoperative total‐body scan (TBS) following a therapeutic dose of I131 and ultra‐sonographic findings.

RESULTS

Eighteen patients underwent paratracheal neck dissection and 10 patients had a lateral neck dissection. Preoperative TBS detected the correct number of positive nodes in only 1 patient (5%) and the correct number of patients with positive nodes in 6/20 (30%) of the patients. US detected 32/98 positive nodes (36%) and 20/20 (100%) of the patients. Prediction of the number of positive nodes for both TBS and US was low (5% and 10%, respectively).

CONCLUSIONS

Preoperative TBS and/or US cannot satisfactorily predict metastatic lymph node involvement and cannot safely delineate limited surgery to replace formal neck dissection in patients with regionally recurrent PTC.
Harmonic Scalpel Tonsillectomy: A Systematic Review of Evidence for Postoperative Hemorrhage
Authors: Neumann Codruta , Street Ian , Lowe David , Sudhoff Holger
Published: August 2007

OBJECTIVE

To systematically review the literature on harmonic scalpel tonsillectomy with a view of comparing its postoperative hemorrhagic rate with the conventional methods for tonsillectomy.

DATA SOURCES

Cochrane Library, Medline, Embase, CINAHL, INAHTA, CRD (Centre for Review and Dissemination, York, UK), and related databases. The date of the last search was September 19, 2006; papers were considered irrespective of language of publication.

REVIEW METHODS

Inclusion and exclusion criteria were applied independently by two reviewers with a third reviewer available for adjudication. The papers were quality assessed using Chalmers' criteria. Eleven randomized controlled trials (RCT) were included in the final review with five RCTs comparing harmonic scalpel tonsillectomy with “cold steel” tonsillectomy and six RCTs comparing harmonic scalpel with “hot” tonsillectomy techniques.

RESULTS

All studies were underpowered to detect a significant difference in the postoperative hemorrhagic complication between harmonic scalpel and the comparator tonsillectomy techniques. The heterogeneity of studies made quantitative combination of results impossible.

CONCLUSION

The evidence reviewed is of low quality and does not support any significant difference in postoperative hemorrhage rates when harmonic scalpel is compared with other tonsillectomy techniques. As studies have numerous methodological flaws and incorporate biases and confounding factors, these results need to be interpreted with caution. Larger and better‐conducted studies would be needed in order to compare the safety of harmonic against conventional tonsillectomy methods. The need for a large sample size might make an RCT impractical; therefore a large, well‐controlled cohort study could be more suitable.
The Rising Incidence of Methicillin‐Resistant Staphylococcus Aureus in Pediatric Neck Abscesses
Authors: Thomason Timothy S. , Brenski Amy , McClay John , Ehmer Dale
Published: August 2007

OBJECTIVES

To examine the incidence of methicillin‐resistant Staphylococcus aureus (MRSA) in pediatric neck abscesses and compare these with abscesses caused by methicillin‐susceptible Staphylococcus aureus (MSSA) and other organisms (non‐SA).

STUDY DESIGN

Retrospective review of 245 children who underwent incision and drainage of neck abscesses from January 1, 2001, to December 1, 2005.

RESULTS

The yearly incidence of MRSA increased from 9 percent to 40 percent during the study period. Abscesses in medial locations were less common in the MRSA group (P < 0.01) and MSSA group (P < 0.001) compared with the non‐SA group. Average patient ages were MRSA 18.9 months, MSSA 18.7 months, and non‐SA 47.6 months. Complication rates were MRSA 8 percent, MSSA 5 percent, and non‐SA 5 percent.

CONCLUSIONS

The incidence of MRSA in pediatric neck abscesses is increasing dramatically. MRSA and MSSA usually infect younger patients in the lateral locations. Clinical courses were similar in all groups.
Lactobacilli: Important in Biofilm Formation on Voice Prostheses
Authors: Buijssen Kevin J.D.A. , Harmsen Hermie J.M. , van der Mei Henny C. , Busscher Henk J. , van der Laan Bernard F.A.M.
Published: August 2007

OBJECTIVE

We sought to identify bacterial strains responsible for biofilm formation on silicone rubber voice prostheses.

STUDY DESIGN

We conducted an analysis of the bacterial population in biofilms on used silicone rubber voice prostheses by using new microbiological methods.

METHODS

Two microbiological methods were used: polymerase chain reaction—denaturing gradient gel electrophoresis and fluorescence in situ hybridization. Twenty‐six Provox2 and eight Groningen Ultra Low Resistance voice prostheses that were removed because of leakage through the prosthesis or because of increased airflow resistance were used in this study.

RESULTS

The results showed that 33 of the 34 explanted voice prosthetic biofilms contained lactobacilli in close association with the Candida sp. present.

CONCLUSION

Lactobacilli are general colonizers of tracheoesophageal voice prostheses in vivo, growing intertwined with Candida. This knowledge may be important in the development of new pathways directed to prevent or to influence biofilm formation on tracheoesophageal voice prostheses and elongate their lifespan.
Transoral Laser Microsurgery for Untreated Glottic Carcinoma
Authors: Grant David G. , Salassa John R. , Hinni Michael L. , Pearson Bruce W. , Hayden Richard E. , Perry William C.
Published: August 2007

OBJECTIVES

To report the oncology and functional outcomes of transoral laser microsurgery (TLM) for untreated glottic carcinoma.

STUDY DESIGN

A 2 center prospective case series analysis.

SETTING

Academic, tertiary referral centers.

RESULTS

Seventy‐six patients underwent TLM. Pathologic T stages were: T1, 45 (59%); T2, 21 (28%); T3, 5 (7%); and T4, 5 (7%). Five (7%) patients had neck dissections. Five (7%) patients received adjuvant radiotherapy. Mean follow‐up was 42 months. Respective T1 and T2 5‐year Kaplan‐Meier estimates were: local control, 90% and 93%; loco‐regional control, 90% and 93%; disease specific survival, 90% and 93%; and overall survival, 94% and 93%. The average hospital stay was 2 days. Two (3%) patients experienced major complications. The overall laryngeal preservation rate was 95% (72 of 76).

CONCLUSIONS

TLM is a safe and effective treatment in select carcinoma of the glottic larynx. Low morbidity and mortality and short periods of hospitalization make TLM an attractive therapeutic option.

SIGNIFICANCE

TLM is an emerging strategy in the treatment of laryngeal cancer.
Parliamentary elites as a democratic thermometer: Estonia, Lithuania and Moldova compared
Authors: Crowther William E. , Matonyte Irmina
Published: August 2007

This article assesses how the character of emerging legislative elites conforms to the broader patterns of post-communist social transformation by comparing Estonia, Lithuania and Moldova. We argue that the pace and direction of change among MPs has been significantly shaped by the nature of regime change in each country. We first address the issue of pace and scope of elite replacement. Second, we examine whether and to what extent, over time, changes occurred in the parliamentary representation of major social categories (in particular, ethnic minorities, women, age groups). Third, we examine the dynamics of political professionalization.
The impact of nutritional status on the outcome of Indian patients undergoing neurosurgical shunt surgery
Authors: Jain Gaurav , Mukerji Gaurav , Dixit Anupam , Manshani Novin , Yadav Y. R.
Published: August 2007

Undernutrition is common in surgical patients, is frequently unrecognised and is strongly associated with adverse outcomes such as high rates of complications and mortality, worsening functional status and prolonged hospitalisation. Owing to the associated infection and symptoms such as repeated vomiting, a high prevalence of undernutrition is expected in hydrocephalus patients, which may contribute to their poor surgical outcomes. The aim of this study was to evaluate the influence of preoperative nutritional status on the outcome of Indian patients with hydrocephalus undergoing neurosurgical shunt surgery. One hundred and twenty-four consecutive patients undergoing scheduled hydrocephalus shunt surgery were studied prospectively. All patients underwent nutritional screening according to different parameters prior to surgery. The patients were classified into normally nourished and undernourished groups. The undernourished group was further subdivided into moderately and severely undernourished. The surgical outcome was compared between these groups. A high prevalence (53 %) of undernutrition was observed in these patients. Postoperative complications such as shunt infection (P = 0·0023), shunt revision (P = 0·0074) and mortality (P = 0·0003) were significantly more common in undernourished patients compared with normally nourished patients. Serum albumin emerged as the most significant independent predictor of postoperative mortality. The present study demonstrated a high prevalence of undernutrition in hydrocephalus patients in India and its adverse influence on the outcome of shunt surgery. Early preoperative nutritional status screening and its optimisation may decrease the morbidity and mortality of shunt surgery for hydrocephalus.
Decreased levels of uric acid after oral glucose challenge is associated with triacylglycerol levels and degree of insulin resistance
Authors: Tinahones F. J. , Cardona F. , Rojo-Martínez G. , Almaraz M. C. , Cardona I. , Vázquez-Mellado J. , Garrido-Sánchez L. , Collantes E. , Soriguer F.
Published: August 2007

Hyperuricaemia is one of the components of metabolic syndrome. Both oxidative stress and hyperinsulinism are important variables in the genesis of this syndrome and have a close association with uric acid (UA). We evaluated the effect of an oral glucose challenge on UA concentrations. The study included 656 persons aged 18 to 65 years. Glycaemia, insulin, UA and plasma proteins were measured at baseline and 120 min after an oral glucose tolerance test (OGTT). The baseline sample also included measurements of total cholesterol, triacylglycerol (TAG) and HDL-cholesterol. Insulin resistance was calculated with the homeostasis model assessment. UA levels were significantly lower after the OGTT (281·93 (sd92·19)v. 267·48 (sd90·40) μmol/l;P < 0·0001). Subjects with a drop in UA concentrations >40·86 μmol/l (>75th percentile) had higher plasma TAG levels (P = 0·0001), baseline insulin (P = 0·02) and greater insulin resistance (P = 0·034). Women with a difference in plasma concentrations of UA above the 75th percentile had higher baseline insulin levels (P = 0·019), concentration of plasma TAG (P = 0·0001) and a greater insulin resistance index (P = 0·029), whereas the only significant difference in men was the level of TAG. Multiple regression analysis showed that the basal TAG levels, insulin at 120 min, glycaemia at 120 min and waist:hip ratio significantly predicted the variance in the UA difference (r20·077). Levels of UA were significantly lower after the OGTT and the individuals with the greatest decrease in UA levels are those who have greater insulin resistance and higher TAG levels.
Whole-grain wheat breakfast cereal has a prebiotic effect on the human gut microbiota: a double-blind, placebo-controlled, crossover study
Authors: Costabile Adele , Klinder Annett , Fava Francesca , Napolitano Aurora , Fogliano Vincenzo , Leonard Clare , Gibson Glenn R. , Tuohy Kieran M.
Published: August 2007

Epidemiological studies have shown an inverse association between dietary intake of whole grains and the risk of chronic disease. This may be related to the ability to mediate a prebiotic modulation of gut microbiota. However, no studies have been conducted on the microbiota modulatory capability of whole-grain (WG) cereals. In the present study, the impact of WG wheat on the human intestinal microbiota compared to wheat bran (WB) was determined. A double-blind, randomised, crossover study was carried out in thirty-one volunteers who were randomised into two groups and consumed daily 48 g breakfast cereals, either WG or WB, in two 3-week study periods, separated by a 2-week washout period. Numbers of faecal bifidobacteria and lactobacilli (the target genera for prebiotic intake), were significantly higher upon WG ingestion compared with WB. Ingestion of both breakfast cereals resulted in a significant increase in ferulic acid concentrations in blood but no discernible difference in faeces or urine. No significant differences in faecal SCFA, fasting blood glucose, insulin, total cholesterol (TC), TAG or HDL-cholesterol were observed upon ingestion of WG compared with WB. However, a significant reduction in TC was observed in volunteers in the top quartile of TC concentrations upon ingestion of either cereal. No adverse intestinal symptoms were reported and WB ingestion increased stool frequency. Daily consumption of WG wheat exerted a pronounced prebiotic effect on the human gut microbiota composition. This prebiotic activity may contribute towards the beneficial physiological effects of WG wheat.
Decreased expression of carbonic anhydrase isozyme II, rather than of isozyme VI, in submandibular glands in long-term zinc-deficient rats
Authors: Goto Tomoko , Shirakawa Hitoshi , Furukawa Yuji , Komai Michio
Published: August 2007

We previously reported that in rats, long-term Zn deficiency significantly reduced taste sensitivity and total carbonic anhydrase (CA) activity in the submandibular gland. We therefore investigated the effects of Zn deficiency on salivary secretion and the expressions of CA isozymes (II and VI) in the rat submandibular gland, since those isozymes are thought to be related to taste sensation and salivary secretion. Male Sprague–Dawley rats, age 4 weeks, were divided into three groups (Zn-def, low-Zn and pair-fed, that were fed a diet containing 2·2, 4·1 or 33·7 mg Zn/kg, respectively, for 42 d). Northern blot analysis indicated that Zn deficiency reduced CA II mRNA expression in the submandibular gland without reducing CA VI mRNA expression. In Western blot analysis, Zn deficiency significantly reduced CA II (erythrocyte CA) protein expression in the submandibular gland without reducing CA VI protein expression. Salivary secretion was lower in the Zn-def group than in the pair-fed group. These results suggest that decreased CA isozyme II expression underlies the decreased CA activity previously reported in the submandibular gland in Zn-def rats, and this may reduce regular salivary secretion.
Prevalence in the eligibility for weight loss treatment in a Mediterranean population
Authors: Schröder Helmut , Elosua Roberto , Vila Juan , Martí Helena , Covas Maria-Isabel , Marrugat Jaume
Published: August 2007

The aim of the present study was to analyse the prevalence and time trends of the subjects in a Mediterranean population meeting the criteria for weight loss treatment according to the National Institutes of Health (US) treatment algorithm proposed by the National Heart, Lung and Blood Institute's Obesity Education Initiative Expert Panel. A random sample of the 25–74 year old population (n 4908) of Gerona, Spain, was examined in 1994–1995 and 1999–2000 in two independent population-based cross-sectional surveys. Cardiovascular risk factors, lifestyle measures and anthropometric variables were analysed. The prevalence of subjects meeting the criteria for weight loss treatment according to the National Institutes of Health algorithm significantly increased from 46·4 to 52·9 % in men and from 35·1 to 40·4 % in women from 1995 to 2000. Stratifying this analysis for age groups revealed a significant increase among women aged 25 to 39 years and the older age group (60 to 74 years) of both genders. This increase was mainly observed in men and women with primary school education. The high prevalence of subjects meeting the criteria for weight loss treatment and the increasing secular trend is an important issue for health policy. This trend is more pronounced in older age groups and among the population with a basic educational level.
The red clover (Trifolium pratense) isoflavone biochanin A inhibits aromatase activity and expression
Authors: Wang Yun , Man Gho Wai , Chan Franky L. , Chen Shiuan , Leung Lai K.
Published: August 2007

Biochanin A is an isoflavone isolated from red clover (Trifolium pratense), and is a commercially available nutraceutical for women suffering from postmenopausal symptoms. Isoflavones resemble the structure of oestrogen, and display agonistic and antagonistic interactions with the oestrogen receptor. Overexposure of oestrogen is a major contributing factor in the development of breast cancer, and cytochrome P450 (CYP) 19 enzyme, or aromatase, catalyses the reaction converting androgen to oestrogen. In the present study the effect of biochanin A on the gene regulation and enzyme activity of aromatase was investigated. By assaying MCF-7 cells stably transfected withCYP19, biochanin A inhibited aromatase activity and hampered cell growth attributing to the enzyme activity. In addition, 25 μm-biochanin A significantly reduced CYP19 mRNA abundance in the oestrogen receptor-negative breast cancer cells SK-BR-3. The transcriptional control of theCYP19gene is exon-specific, and promoter regions I.3 and II have been shown to be responsible forCYP19expression in SK-BR-3 cells. Luciferase reporter gene assays also revealed that biochanin A could repress the transcriptional control dictated by the promoter regulation. Interestingly, genistein did not inhibit aromatase but it might down regulate promoter I.3 and II transactivation. Since genistein is a major metabolite of biochanin A, it might contribute to biochanin A's suppressive effect on CYP19 expression. The present study illustrated that biochanin A inhibited CYP19 activity and gene expression.