bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant Lymphoepithelial Lesions of the Salivary Gland
Authors: Hsu Yao‐Chung , Lu Hsiao‐Feng , Huang Chao‐Cheng , Hsu Ruey‐Fen , Su Chih‐Ying
Published: March 2006

OBJECTIVES

To describe a relatively large series of patients with uncommon malignant lymphoepithelial lesions (MLEL) in the salivary glands, to present treatment‐outcome data to support therapeutic decision‐making, and to evaluate the incidence of cooccurrence of MLEL and Epstein‐Barr virus (EBV).

STUDY DESIGN AND SETTING

Ten patients with MLEL were treated between 1987 and 2002. All lesions were surgically removed, with or without neck dissection, and the patients treated with radiotherapy or radiotherapy and chemotherapy. Histopathology and in situ hybridization studies for EBV‐encoded RNA (EBER1) were performed.

RESULTS

With aggressive treatment, outcomes were good, regardless of the presenting stage, except when distal metastases were present. All 10 patients tested positive for EBV.

CONCLUSION AND SIGNIFICANCE

This and previous investigations support the use of aggressive surgical excision of the tumor and local metastases and radiotherapy or radiotherapy and chemotherapy, as optimal treatment for MLEL. The EBV finding may indicate a role for EBV in the pathogenesis of MLEL.
Detection of Fungi in the Sinus Mucosa using Polymerase Chain Reaction
Authors: Rao Arvin K. , Mathers Peter H. , Ramadan Hassan H.
Published: March 2006

OBJECTIVE

To compare the presence of fungi in the sinus mucosa of patients with and without chronic rhinosinusitis.

STUDY DESIGN AND SETTING

Prospective observational study using polymerase chain reaction and conventional culture to detect fungi in the sinus mucosa. Middle meatus mucosal samples were collected from 31 patients with chronic rhinosinusitis and 14 control subjects.

RESULTS

Fungi were detected in 6.5% of subjects with chronic rhinosinusitis and in none of the control subjects using polymerase chain reaction. Fungi were detected in 29% of subjects with the combination of inhalant allergies, nasal polyposis, and asthma. Fungi were detected in none of the subjects without the combination of these three comorbidities (P = 0.03).

CONCLUSION

Polymerase chain reaction assay appears to be able to detect fungi in chronic rhinosinusitis.

SIGNIFICANCE

Fungi may not be implicated in the pathogenesis of most chronic rhinosinusitis.
Acute Parotitis as a Complication of Fine‐Needle Aspiration in Warthin's Tumor. A Unique Finding of a 3‐Year Experience with Parotid Tumor Aspiration
Authors: Bahar Gideon , Dudkiewicz Mickey , Feinmesser Raphael , Joshua Ben‐Zion , Braslavsky Diana , Popovtzer Aharon , Galil Dora , Shpitzer Thomas
Published: March 2006

OBJECTIVE/HYPOTHESIS

Fine needle aspiration (FNA) is an accurate, cost‐effective tool for the study of salivary gland lesions. Although complications are extremely rare, salivary gland FNA can lead to hemorrhage, facial nerve injury, and cellulitis at the needle puncture site. Some studies suggest that FNA can cause infarction or metaplastic transformation of benign Warthin's tumors. We review our recent experience with FNA of the parotid gland, focusing on possible complications and pitfalls.

STUDY DESIGN AND SETTING

The medical records of all patients who underwent FNA of the parotid gland from 2000 to 2002 in the Department of Otolaryngology‐Head and Neck Surgery of a major tertiary‐care referral center were reviewed. Cytological results were compared to the histological diagnosis and complications were recorded.

RESULTS

Of the 256 lesions aspirated, 99 patients (39%), were cytologically diagnosed as benign tumors, including 31 (12%) Warthin's tumors, of which 16/17 resected and confirmed histologically. Five patients with Warthin's tumor had post‐FNA parotitis and were treated accordingly.

CONCLUSIONS

The combination of cystic spaces surrounded by oncocytic cells and a poor blood supply makes the tumor susceptible to infarction and inflammation. Our findings indicate that FNA is a strong and reliable tool in the investigation of the salivary glands. Nevertheless, when Warthin's tumor is clinically suspected on the basis of its location (tail of the parotid gland), cystic texture, patient sex (male) and age, one should consider parotitis as a possible complication.
Cytogenetic Analysis of Sinonasal Carcinomas
Authors: Gil Ziv , Orr‐Urtreger Avi , Voskoboinik Nadia , Trejo‐Leider Leonor , Spektor Sergey , Shomrat Ruth , Fliss Dan M.
Published: March 2006

BACKGROUND

Sinonasal carcinomas, including nonkeratinizing (NK) squamous cell carcinoma (SCC) and sinonasal undifferentiated carcinoma (SNUC), are uncommon malignant neoplasms arising from the Schneiderian respiratory epithelium of the nasal cavity and paranasal sinuses. Due to their low frequency, the cytogenetic data on these tumors is limited.

METHODS

Seventeen patients who were operated on in our institution for extirpation of paranasal carcinomas were enrolled in this study. Fourteen pathologically confirmed samples of sinonasal carcinomas were cytogenetically analyzed using G‐banding techniques after short‐term culture. Three samples did not grow on culture.

RESULTS

Five of the 14 sinonasal carcinomas had an abnormal karyotype (36%). Of the 9 NK SCCs, 3 had abnormal karyotypes with numerical and structural chromosomal anomalies. Of the 5 patients with SNUC, 2 had an abnormal karyotype. One case of SNUC had a diploid complex karyotype. Another case of SNUC had a near triploid composite karyotype with 60–69 chromosomes. The chromosome arms that involved frequent breakpoint and rearrangements were: 1p, 6p, 7p, and 12q. We found that 3 of the 3 patients who died of disease displayed an abnormal karyotype, whereas 2 of the 11 patients who are alive displayed an abnormal karyotype (P = 0.027).

CONCLUSIONS

The study revealed that more than a third of the paranasal carcinomas carry an abnormal karyotype. No specific common aberrations were found in these tumors. To our knowledge this is the first attempt to investigate sinonasal squamous and undifferentiated carcinomas on a genetic level using G‐banding technique. Additional studies are required in order to determine whether cytogenetic data may serve as an adjunct to conventional pathology for the diagnosis and prognosis assessment of these rare and highly aggressive tumors.
Histology of the Nasal Septal Swell Body (Septal Turbinate)
Authors: Wexler David , Braverman Itzhak , Amar Mary
Published: March 2006

OBJECTIVE

To analyze the vascular and glandular elements of the nasal septal swell body (NSB) and quantitatively compare these to the inferior turbinate (IT) and non‐swell body portion of septum.

STUDY DESIGN

Fourteen healthy adults undergoing septoplasty and IT reduction were submitted to unilateral biopsies of the NSB, the adjacent inferior turbinate, and inferior septum. Photomicrography with morphometric analysis was used to determine the relative area proportions of each tissue type.

RESULTS

NSB was rich in seromucinous glands (49.9% ± 7.0%) compared to IT (19.9% ± 5.5%), P < 0.01. Conversely, IT mucosa demonstrated increased area proportion of venous sinusoids (28.3 ± 13.9) compared to NSB (10.0 ± 6.0), P < 0.01. Inferior septal mucosa had glandular and vascular elements similar in proportion to that of NSB.

CONCLUSIONS AND SIGNIFICANCE

NSB is a highly glandular structure of the anterior‐superior septum, with moderate proportion of venous sinusoids. Located at the distal valve segment, the NSB appears structured for secretory function and vasoactive airflow regulation.
The Impact of Atopy, Sinus Opacification, and Nasal Patency on Quality of Life in Patients with Severe Nasal Polyposis
Authors: Alobid Isam , Benítez Pedro , Valero Antonio , Berenguer Joan , Bernal‐Sprekelsen Manuel , Picado Cesar , Mullol Joaquim
Published: March 2006

OBJECTIVES

Nasal polyposis has a great impact on the quality of life. The aim of this study was to evaluate the association between quality of life and atopy, sinus opacification, and nasal patency in severe nasal polyposis.

METHODS

One hundred nine patients completed the Medical Outcome Study Short Form‐36 (SF‐36) survey. Symptoms, polyp size, atopy, nasal patency, and sinus opacification were also scored.

RESULTS

Patients showed worse scores in all SF‐36 domains, except for physical functioning, compared with Spanish population. Atopic patients had worse scores in role physical, body pain, vitality, and mental health than nonatopic patients. Atopic patients showed lower physical component summary (44.7 ± 1.1) and mental component summary (38.4 ± 1.0) than nonatopic patients (48.3 ± 1.6, 40.6 ± 1.3; P < 0.05), respectively. There were no correlations between quality of life and symptoms, polyp size, CT scan, nasal patency, and atopy.

CONCLUSION

Nasal polyposis has a considerable impact on quality of life and atopy worsens this impact.

EBM rating

C‐4
Multilevel Surgery for Obstructive Sleep Apnea: Short‐Term Results
Authors: Verse Thomas , Baisch Alexander , Maurer Joachim T. , Stuck Boris A. , Hörmann Karl
Published: March 2006

OBJECTIVE

To determine the efficacy of a new multilevel surgical protocol for obstructive sleep apnea (OSA).

STUDY DESIGN AND SETTING

Sixty patients with moderate to severe OSA because of multilevel pharyngeal obstruction were enrolled into this prospective, controlled clinical trial after clinical examination, endoscopy, and polysomnography. Surgery included uvulaflap, tonsillectomy, hyoid suspension, and radiofrequency treatment of the tongue base (group A). A second group did not receive hyoid suspension (group B). In both groups, nasal surgery was performed if necessary. Polysomnography and Epworth Sleepines Scale (ESS) were recorded at baseline and 2 to 15 months after surgery.

RESULTS

In group A, the mean apnea‐hypopnea index (AHI) decreased significantly after surgery (38.9 ± 20.0 vs 20.7 ± 20.6, P < 0.0001), whereas in group B the AHI did not. All secondary variables (minimal oxygen saturation, mean oxygen saturation, arousal index), and the ESS significantly improved in group A with only changes in arousal index and ESS reaching levels of significance in group B.

CONCLUSION

The presented protocol including the hyoid suspension proved to be effective in the treatment of OSA, whereas surgery without hyoid suspension was less successful.
Hearing Loss with Stapedotomy and Treated Otitis Media
Authors: Lo Teresa M. , Zhang Mei , Young Linda J. , Antonelli Patrick J.
Published: March 2006

OBJECTIVE

To determine if treated Pseudomonas aeruginosa otitis media (PA OM) increases the risk of sensorineural hearing loss (SNHL) with stapedotomy.

STUDY DESIGN AND SETTING

PA OM was induced in 28 guinea pigs. Half of the animals underwent unilateral stapedotomy before antibiotic therapy (untreated), and half underwent stapedotomy after treatment (treated). Control animals underwent saline injections followed by stapedotomy. Electrocochleographic thresholds were measured before and after stapedotomy. Temporal bones were analyzed histomorphologically.

RESULTS

Less SNHL was seen after stapedotomy in treated ears than in untreated ears (P = 0.0268). SNHL after stapedotomy in treated ears was similar to controls (P = 0.9370). Severe damage to cochlear outer hair cells was found in untreated ears.

CONCLUSIONS

Ears with PA OM treated previously are not at increased risk of SNHL with stapedotomy.

SIGNIFICANCE

Stapedotomy may be carried out with caution in the setting of inactive, chronic OM.
Repetitive Endoscopic Sinus Surgery Failure: A Role for Radical Surgery?
Authors: Videler Ward J. M. , Wreesmann Volkert B. , van der Meulen Freerk W. , Knegt Paul P. , Fokkens Wytske J.
Published: March 2006

OBJECTIVES

Endoscopic sinus surgery (ESS) is considered to be the golden standard for surgery in patients with chronic rhinosinusitis and nasal polyposis. However, there is still a small group of patients unresponsive despite repetitive surgery. Radical surgery aimed at reduction of the inflammatory burden and optimization of drainage of the sinuses has been suggested as a last resort for these patients.

STUDY DESIGN

A prospective, questionnaire‐based study was conducted in a group of 23 patients who underwent Denker's procedure for refractory chronic rhinosinusitis. Symptoms were evaluated before Denker's procedure and 12 months and 2 years after surgery.

RESULTS

Patients reported improvement of feelings of congestion in 74%, rhinorrhea in 70%, and nasal obstruction in 60% of the cases. The following postoperative improvements were statistically significant: rhinorrhea (P = 0.001), feelings of congestion (P = 0.02), and nasal obstruction (P = 0.03). Reduced olfactory perception and asthma did not improve.

CONCLUSION

Radical surgery may be a viable treatment option in case of recurrent ESS failure.
Chronic Cough: State‐of‐the‐Art Review
Authors: Simpson C. Blake , Amin Milan R.
Published: March 2006

Cough is the most common presenting complaint in adults seeking medical treatment in an ambulatory setting. Chronic cough (persisting greater than 3 weeks) can be associated with myriad diseases that may overlap multiple medical specialties. For this reason, a thorough assessment of the patient with chronic cough relies on a multidisciplinary approach and close cooperation between pulmonary medicine, gastroenterology, and otolaryngology. Despite this daunting task, success can be achieved in up to 90% of patients with chronic cough if a systematic and thorough approach is used. The purpose of this review is to summarize the state‐of‐the‐art in the diagnosis and treatment of chronic cough for the practicing otolaryngologist.
Analysis of Prognostic Factors of Nasopharyngeal Carcinoma: Impact of in Situ Hybridization for Epstein‐Barr Virus Encoded Small RNA 1
Authors: Nakao Kazunari , Mochiki Masato , Nibu Ken‐Ichi , Sugasawa Masashi , Uozaki Hiroshi
Published: March 2006

OBJECTIVES

To evaluate the impact of clinical, histopathological, and molecular biological parameters on the prognosis of nasopharyngeal carcinoma (NPC).

STUDY DESIGN AND SETTING

The clinical records of 48 patients with a diagnosis of NPC were retrospectively reviewed. In situ hybridization for Epstein‐Barr virus encoded small RNA 1 (EBER‐ISH) was applied for 30 paraffin‐embedded specimens available. Prognostic factors of NPC were meticulously analyzed.

RESULTS

The EBER‐ISH signal was shown to be highly significant as a favorable prognostic factor (P = 0.007). Although EBV was more commonly associated with Type III NPC, EBER‐ISH‐positive Type I‐II NPC had also significantly better survival rate than EBER‐ISH‐negative Type I‐II NPC (P = 0.036).

CONCLUSIONS

In addition to the WHO histopathological grade, the 1997 UICC staging, nodal status, and distant metastasis at presentation, the EBER‐ISH signal was shown to be significant as a prognostic factor.

SIGNIFICANCE

This is the first report to describe the EBER‐ISH as an independent prognostic factor of NPC regardless of histopathology.
The Association between Positional Vertebral and Basilar Artery Flow Lesion and Prevalence of Vertigo in Patients with Cervical Spondylosis
Authors: Olszewski Jurek , Majak Joanna , Pietkiewicz Piotr , Luszcz Cezary , Repetowski Marcin
Published: March 2006

OBJECTIVE

The aim of our investigations was to characterize the relationship between basilar artery (BA) flow velocity in patients with cervical spondylosis and age, grade of radiological changes, prevalence of vertigo, and decreased blood flow velocity through vertebral arteries (VA) after head rotation.

STUDY DESIGN AND SETTING

A prospective, controlled study in academic neurotology was conducted. We examined 80 patients with radiological evidence of cervical spondylosis. Forty patients complained of positional vertigo lasting more than 6 months. Patients were examined by transcranial Doppler ultrasound with head rotations.

RESULTS

We showed significant association between velocity flow in basilar artery after neck rotation and age, prevalence of vertigo, grade of radiological changes, and positional vertebral artery flow lesion.

CONCLUSION

Spondylotic‐induced VA compression may be the reason for decreased blood flow velocity in the basilar artery during head rotation, which may be of particular importance for older patients, especially complaining of vertigo.

SIGNIFICANCE

Every patient with high‐grade cervical spondylosis, especially complaining of vertigo, should be examined by using TCD (transcranial Doppler) with head rotations. In case of positional blood flow reduction during head rotation, further angiographic examination should be undertaken so as to plan suitable treatment.
Incidence of Skull Base and Orbital Erosion in Allergic Fungal Rhinosinusitis (AFRS) and Non‐AFRS
Authors: Ghegan Mark D. , Lee Fu‐Shing , Schlosser Rodney J.
Published: March 2006

OBJECTIVE

To compare the incidence of bony erosion associated with allergic fungal rhinosinusitis (AFRS) with the incidence of bony erosion seen in other types of inflammatory sinusitis.

STUDY DESIGN

Retrospective review.

RESULTS

AFRS was diagnosed in 27 patients, and 15/27 (56%) had bony skull base or orbital erosion. Non‐AFRS chronic sinusitis required surgery in 158 patients, but only 8 (5%) had bony skull base or orbital erosion (P < 0.01). AFRS patients were 12.6 times (P < 0.01) more likely to have bony erosion than non‐AFRS patients. African American males were 15.0 times (P < 0.01) more likely to have bony erosion than whites and African American females combined.

CONCLUSION

Bony erosion with intracranial and intraorbital extension is much more common in AFRS than all other types of inflammatory sinusitis combined. African American males have a higher incidence of AFRS, as well as intracranial and intraorbital extension.
Soft Palate Implants for the Treatment of Mild to Moderate Obstructive Sleep Apnea
Authors: Nordgård Ståle , Stene Brit Kari , Skjøstad Ketil Wichman
Published: March 2006

OBJECTIVE

To evaluate the initial short‐term effectiveness of palatal implants in treating patients with mild to moderate obstructive sleep apnea (OSA). Previous published studies have focused on snoring without OSA.

STUDY DESIGN

A prospective, nonrandomized study of 25 previously untreated patients with an apnea‐hypopnea index (AHI) of 10 to 30 and a body mass index (BMI) of ≤30. Three permanent implants (Pillar; Restore Medical, St Paul, MN) were placed in the soft palate of each patient with a specially designed delivery tool in an office setting under local anesthesia after a formal polysomnography. A repeat polysomnography was obtained after 90 days.

RESULTS

The AHI was reduced from a mean of 16.2 to a mean of 12.1 (P < 0.05) for the study group. Twenty of 25 patients (80%) experienced a decrease in the AHI. Twelve of 25 patients (48%) showed a post‐90‐day implant AHI of 10 or less, a benchmark for the possible cessation of continuous positive airway pressure therapy. The Epworth Sleepiness Score decreased from 9.7 to 5.5 (P < 0.001) and the visual analog Scale of snoring intensity reported by bed partners decreased from 8.4 to 4.3 (P < 0.001).

CONCLUSION

The palatal implant method can significantly improve AHI and other sleep‐related parameters in patients with mild to moderate OSA and a BMI of ≤30. Short‐term results are comparative to those reported for uvulopalatopharyngoplasty but achieved in a low‐cost, single‐stage, outpatient office setting with low morbidity.
Incidence of Spontaneous Hearing Threshold Shifts during Modern Concert Performances
Authors: Opperman David A. , Reifman William , Schlauch Robert , Levine Samuel
Published: March 2006

OBJECTIVES

Concerts have long periods of intense sound with short break intervals. Hearing concerns are well known to performers; concertgoers largely ignore them. Preperformance and postperformance audiograms were compared to assess hearing threshold shifts with and without earplugs.

METHODS

A prospective, randomized study in which 29 volunteers attended 3 concerts, encompassing 3 music genres. Audiograms, seating location, sound intensity, and earplug‐use data were collected. Data were analyzed to determine frequency test‐retest variability.

RESULTS

Sound levels averaged 99.8 dBA, and the maximum was 125.6 dBA. Sixty‐four percent (9/14) of participants without earplugs showed significant threshold shifts compared with 27% (4/15) of those using earplugs. No significant differences existed between music genres or seating location.

CONCLUSIONS

This study showed a high incidence of threshold shifts in unprotected concertgoers. Sound levels exceeded all Occupational Safety and Health Act rules despite standardized sound systems. A significant reduction in threshold shifts was seen with the use of earplugs.
Prevalence of Elevated Total IgE and Food Allergies in a Consecutive Series of ENT Pediatric Patients
Authors: Bhombal Shazia , Bothwell Marcella R. , Bauer S. M.
Published: March 2006

OBJECTIVE

Food allergies in childhood have been found to vary in frequency from 6% to 8% in the general population. Previous studies indicate milk allergy affects approximately 2.5% of infants and egg allergy has been estimated at 1.6% to 2.6%. Numerous allergists believe that the prevalence of food allergies is rising, similar to the rise in other atopic conditions. Prior studies have demonstrated that food‐specific IgE is a useful test for diagnosing symptomatic allergies to certain foods, including milk and eggs, and could decrease the need to perform cumbersome multiple double‐blind, placebo‐controlled food challenges in children based on history alone. The purpose of this study was to determine the prevalence of food allergies and elevated IgE in a consecutive series of pediatric otolaryngology patients.

STUDY DESIGN AND SETTING

ImmunoCap™ studies were drawn in a 2‐year series of children undergoing ENT procedures of bilateral myringotomy with tubes (BMT) with or without adenoidectomy or tonsillectomy or adenoidectomy alone between 2001 and 2003. Sera was analyzed for increased total IgE antibodies, as well as specific IgE antibodies to antigens, including milk, egg, beef, and environmental allergens. A positive patient history or family history of allergy were documented.

RESULTS

A total of 242 patients were assessed. Of the study population, milk allergy was found in 10.7%; egg white allergy was found in 5.0%. The prevalence of elevated IgE among participants was 11.2%. The overall food allergy prevalence was 14.5%.

CONCLUSIONS

Although we cannot imply causality, the study demonstrated an increased prevalence of food allergy in children undergoing ENT procedures, specifically milk and eggs, than in previous population studies.
Familial Aggregation of Sinonasal Polyps Correlates with Severity of Disease
Authors: Cohen Noam A. , Widelitz Jeffrey S. , Chiu Alexander G. , Palmer James N. , Kennedy David W.
Published: March 2006

OBJECTIVE

Investigate familial aggregation of sinonasal polyps (NP) and correlate the severity of chronic rhinosinusitis (CRS) with a family history of NP.

STUDY DESIGN AND SETTING

A questionnaire documenting NP, asthma, or aspirin intolerance was completed by 174 CRS patients. Severity of sinus disease was stratified as isolated NP, NP with concomitant asthma, and Samter's triad (polyps, asthma, and aspirin intolerance).

RESULTS

Compared to controls, CRS patients had a higher incidence of a family history of NP. Additionally, patients stratified with severe CRS had a higher incidence of relatives with NPs.

CONCLUSIONS

Familial aggregation of NP is demonstrated in CRS patients and correlates with disease severity.

EBM rating

B‐2b
Nasal Expiratory Sound Analysis in Healthy People
Authors: Tahamiler Rauf , Edizer Deniz Tuna , Canakcioglu Salih
Published: March 2006

OBJECTIVE

To evaluate the practicability of Odiosoft‐Rhino (OR), a new experimental method for assessing the nasal airflow and resistance, in normal subjects and to compare the results with acoustic rhinometry (AR) findings.

STUDY DESIGN AND SETTING

OR and AR were carried out in 72 healthy subjects. Their visual analogue scales of nasal obstruction, minimal cross sectional areas (MCA1 and MCA2), and nasal expiration sounds were analyzed and noted for both nasal cavities.

RESULTS

Statistically significant correlations (P < 0.05) were found between OR and AR in 2,000 to 4,000 Hz and 4,000 to 6,000 Hz with MCA1 and MCA2.

CONCLUSIONS

OR is a noninvasive and rapid test. It is easy to carry out and requires little patient cooperation. It seems that it may give compatible results with other reliable methods that assess nasal airflow.

SIGNIFICANCE

We assume that OR is a sensitive method for evaluating nasal airflow in normal subjects in an easy way.

EBM rating

A‐1b
Safety of Uvulopalatopharyngoplasty as Outpatient Surgery
Authors: Hathaway Bridget , Johnson Jonas T.
Published: March 2006

OBJECTIVE

Determine the admission rate and characterize the complications in uvulopalatopharyngoplasty (UPPP) patients scheduled to have outpatient surgery.

STUDY DESIGN AND SETTING

Retrospective review of patients undergoing UPPP between 2000 and 2004 in a tertiary care setting.

RESULTS

UPPP alone or in conjunction with tonsillectomy, septoplasty, or supraglottoplasty was carried out in 110 patients. Average preoperative respiratory disturbance index (RDI) was 35. Admission was required in 20 (18%) patients whereas 90 (82%) were discharged on the day of surgery. Admission due to desaturation was noted in 3 (3%) patients. The most common reasons for admission included pain and nausea. There were no major complications.

CONCLUSIONS

Careful preoperative selection of patients should permit many patients to undergo UPPP as outpatient surgery. Factors requiring admission may be assessed in the early postoperative period. The rate of respiratory events requiring postoperative admission after UPPP is low.

SIGNIFICANCE

UPPP can be carried out safely on an outpatient basis.
Clinicopathologic and Immunohistochemical Study of Intraoral Mucoepidermoid Carcinoma
Authors: Lopes Márcio Ajudarte , da Cruz Perez Danyel Elias , de Abreu Alves Fábio , de Almeida Oslei Paes , Kowalski Luiz Paulo
Published: March 2006

OBJECTIVE

The purpose of this study is to assess the clinicopathologic and immunohistochemical features of intraoral mucoepidermoid carcinomas and its relationship with the prognosis.

STUDY DESIGN AND SETTING

From 1953 to 1993, 27 patients with intraoral mucoepidermoid carcinomas surgically treated were selected for this study. Clinical data were obtained from the medical records, the microscopic slides were reviewed, the tumors were graded, and immunohistochemical analysis for p53, PCNA, cerbB‐2, and CEA were carried out.

RESULTS

The tumors were more frequent in patients between 40 and 60 years of age (40.7%), without gender predilection. Hard palate was the most common site with 13 cases (48%). T2 was the more frequent stage (48%) and 2 patients (7.4%) were staged as N +. Most tumors (48%) were classified as low grade of malignancy. The expression of PCNA was associated to high‐grade tumors (P =. 00610) and c‐erbB‐2 to low grade tumors (P =. 03958). No recurrence was noted in most of the cases (22 cases, 81.5%). Three cases (11.1%), however, showed local recurrence and 2 patients (7.4%) died because of the disease. The analysis of the overall survival rate showed that male patients (P =. 04249), stage N (P =. 05948), high grade of malignancy (P =. 0009), strong expression of PCNA (P =. 09128), and weak expression of c‐erbB‐2 (P =. 03334) had the lowest survival rates.

CONCLUSION

Our results showed that patients with intraoral mucoepidermoid carcinoma had a reduced survival expectation if they were of the male gender, with regional metastasis, high grade of malignancy, strong expression of PCNA and weak expression of c‐erbB‐2.
Histologic Evaluation of Intracordal Autologous Cartilage Injection in the Paralyzed Canine Vocal Fold at Two and Three Years
Authors: Lee Byung‐Joo , Wang Soo‐Geun , Goh Eui‐Kyung , Chon Kyong‐Myong , Lee Chang‐Hun , Lorenz Robert R.
Published: March 2006

OBJECTIVE

Intracordal injection for vocal fold augmentation is easy and simple and does not require a cervical skin incision. We reported previously on the 1‐year results of injected autologous auricular cartilage for volumetric augmentation in paralyzed canine vocal cord. This study evaluates the long‐term histomorphologic results of injected autologous auricular cartilage for the augmentation of the paralyzed canine vocal fold at 2 and 3 years.

STUDY DESIGN AND SETTING

A prospective trial of autologous cartilage augmentation of vocal cord in animal model. Five dogs were operated on. A piece of auricular cartilage was harvested from the ear and minced into tiny chips with a scalpel. Fat was harvested from inguinal area and minced with a scalpel. The minced cartilage and fat‐paste (0.2 ml) was injected using a pressure syringe into the paralyzed thyroarytenoid muscle using direct laryngoscopy. Three animals were sacrificed at 2 years, two at 3 years. Each subject underwent laryngectomy and serial coronal sections of paraffin blocks from the posterior vocal fold were made.

RESULTS

There was no significant complications perioperatively or postoperatively. The injected cartilage that seemed to have lost viability existed in the vocalis muscles until 36 months. Fibrotic change was exhibited in the surrounding injected cartilage. There were no differences between 2 and 3 years in histomorphologic results of the injected cartilage.

CONCLUSION

The autologous auricular cartilage graft is well tolerated and may be a very effective material for long‐term volumetric augmentation in the paralyzed vocal cord.
Aldehyde dehydrogenase is essential for both adult and larval ethanol resistance in Drosophila melanogaster
Authors: FRY JAMES D. , SAWEIKIS MOLLY
Published: March 2006

The enzyme aldehyde dehydrogenase (ALDH) is essential for ethanol metabolism in mammals, converting the highly toxic intermediate acetaldehyde to acetate. The role of ALDH in Drosophila has been debated, with some authors arguing that, at least in larvae, acetaldehyde detoxification is carried out mainly by alcohol dehydrogenase (ADH), the enzyme responsible for converting ethanol to acetaldehyde. Here, we report the creation and characterization of four null mutants of Aldh, the putative structural locus for ALDH. Aldh null larvae and adults are poisoned by ethanol concentrations easily tolerated by wild-types; their ethanol sensitivity is in fact comparable to that of Adh nulls. The results refute the view that ALDH plays only a minor role in ethanol detoxification in larvae, and suggest that Aldh and Adh may be equally important players in the evolution of ethanol resistance in fruit-breeding Drosophila.
DETERMINANTS OF CHRONIC MALNUTRITION AMONG PRESCHOOL CHILDREN IN BANGLADESH
Authors: RAHMAN AZIZUR , CHOWDHURY SOMA
Published: March 2006

This study investigated the impact of some socioeconomic, demographic and health and community factors on chronic malnutrition or stunting in Bangladeshi children aged less than 5 years. The analysis revealed that the overall prevalence of stunting was 44%, of which 18% of children were severely stunted, and the demographic characteristics appeared to be the most significant factors for chronic malnutrition. Multinomial logistic regression analysis showed that parents’ education, household economic status, media exposure, number of under-5 children, place of delivery, child’s age, birth order, months of breast-feeding, birth size, mother’s BMI, mother’s height, age of household head, measles vaccine, supplementation of diet with liquids and regional differentials were significantly associated with severe as well as moderate stunting.
Organophosphorus pesticides residues in Italian raw milk
Authors: Pagliuca Giampiero , Serraino Andrea , Gazzotti Teresa , Zironi Elisa , Borsari Andrea , Rosmini Roberto
Published: March 2006

Organophosphorus pesticides (OPPs), widely used in agriculture, can cause toxic effects to humans and animals. The main purpose of the present work was to determine the contamination in raw milk by the main organophosphorus pesticides used in Italy and to evaluate the opportunity to start specific procedures of risk management along the milk production chain. The samples, collected in 4 Italian dairy plants directly from the tank trucks during the delivering, were representative of 920 tonnes of raw milk. The isolation of the OPPs (acephate, chlorpyriphos, chlorpyriphos-methyl, diazinon, methamidophos, methidathion, phorate, pirimiphos-methyl) was performed by liquid partition followed by clean-up with solid phase extraction. The analyses were carried out by dual column gas chromatography using two nitrogen-phosphorus detectors. Among the 135 samples analysed, 37 were positive in traces and 10 showed an OPP contamination ranging from 5 to 18 μg/kg. The higher results were recorded in the samples collected during the autumn-winter period. The main pollutants detected were acephate and chlorpyriphos. In every positive sample found, the OPP contamination was lower than the maximum residue level (MRL) fixed by the European Commission.
Camel (Camelus dromedarius) immunoglobulin G, α-lactalbumin, serum albumin and lactoferrin in colostrum and milk during the early post partum period
Authors: El-Hatmi Halima , Levieux Annie , Levieux Didier
Published: March 2006

Colostrum and milk samples from twelve Tunisian camels were analysed for concentration of immunoglobulin G (IgG), α-lactalbumin (α-la), serum albumin (CSA) and lactoferrin throughout the first 14 milkings post partum (7 days of lactation) using single radial immunodiffusion assay. Concentrations (mg/ml, means±SD) at first milking were IgG, 100·7±60·4; α-la, 2·2±0·7; CSA, 8·5±3·6 and lactoferrin, 1·2±0·3. Large variations were recorded for IgG and CSA concentrations (11·8–211·1 mg/ml and 2·9–13·8 mg/ml respectively) Concentrations of IgG and CSA dropped abruptly in the subsequent milkings while α-la concentration increased until milking 5 and then decreased slowly. Lactoferrin dropped only from milking 7. Mean IgG concentrations were 3·6 and 2·5 mg/ml at milking 9 and 13 respectively. However, IgG concentration did not differ significantly, at the 1% level, from milkings 11 to 14. The contribution of CSA to the increase in whey proteins in early milks was greater than that described in the bovine and caprine species.
Survival of thermophilic spore-forming bacteria in a 90+ year old milk powder from Ernest Shackelton's Cape Royds Hut in Antarctica
Authors: Ronimus Ron S , Rueckert Andreas , Morgan Hugh W
Published: March 2006

Milk powder taken to Antarctica on Shackelton's British Antarctic Expedition in 1907 was produced in New Zealand by a roller drying process in the first factory in the world dedicated to this process. Thermophilic bacilli are the dominant contaminants of modern spray-dried milk powders and the 1907 milk powder allows a comparison to be made of contaminating strains in roller-dried and spray-dried powders. Samples of milk powder obtained from Shackelton's Hut at Cape Royds had low levels of thermophilic contamination (<500 cfu ml−1) but the two dominant strains (Bacillus licheniformis strain F and Bacillus subtilis) were typical of those found in spray-dried powders. Soil samples from the floor of the hut also contained these strains, whereas soils distant from the hut did not. Differences in the RAPD profiles of isolates from the milk powder and the soils suggest that contamination of the milk from the soil was unlikely. It is significant that the most commonly encountered contaminant strain in modern spray-dried milk (Anoxybacillus flavithermus strain C) was not detected in the 1907 sample.
Experiments on two-dimensional flow over a normal wall
Authors: Arie Mikio , Rouse Hunter
Published: March 2006

Measurements of the velocity, pressure, and turbulence behind a series of normal plates in the uniform test section of an air tunnel are described, the oscillation of the wake being prevented in all but one test through use of symmetrically located tail plates. By a combination of experimental and computational techniques, details of the pattern of flow over a wall on a plane boundary in an infinite fluid are closely approximated. A significant difference is indicated between the characteristics of such a flow and those of the flow past an isolated plate with oscillating wake.
The displacement effect of a sphere in a two-dimensional shear flow
Authors: Hall I. M.
Published: March 2006

This paper contains a theoretical investigation of the displacement effect of a pitot tube in a shear flow. Viscosity is neglected throughout so that the vorticity field alone is considered.

It is first shown that a two-dimensional approach does not produce a large enough displacement effect because it does not include the stretching of vortex tubes that takes place around a three-dimensional pitot tube. Then the three-dimensional problem is considered. A solution is obtained in the plane of symmetry for a sphere in a shear flow. This solution is found by making an assumption about the rate of stetching of vortex tubes perpendicular to the plane of symmetry and then considering the shear flow as a small perturbation of a uniform flow. A solution in the plane of symmetry is sufficient to obtain the displacement effect, which is found to be of the same order as the experimental result obtained by Young & Maas (1936) for a conventional pitot tube. The sphere may be considered to represent a conventional pitot tube (of slightly smaller diameter), so it is concluded that a large part of the displacement effect of a pitot tube may be accounted for without the inclusion of viscosity, i.e. by consideration of the vorticity field alone.

To a first approximation, the vorticity in the plane of symmetry is found to depend only on the distance from the centre of the sphere.

An outline of shear flows past some two-dimensional bodies is given in an appendix. The bodies considered are a circular cylinder and a two-dimensional ‘pitot-tube’ consisting of two parallel semi-infinite plates.
The law of the wake in the turbulent boundary layer
Authors: Coles Donald
Published: March 2006

After an extensive survey of mean-velocity profile measurements in various two-dimensional incompressible turbulent boundary-layer flows, it is proposed to represent the profile by a linear combination of two universal functions. One is the well-known law of the wall. The other, called the law of the wake, is characterized by the profile at a point of separation or reattachment. These functions are considered to be established empirically, by a study of the mean-velocity profile, without reference to any hypothetical mechanism of turbulence. Using the resulting complete analytic representation for the mean-velocity field, the shearing-stress field for several flows is computed from the boundary-layer equations and compared with experimental data.

The development of a turbulent boundary layer is ultimately interpreted in terms of an equivalent wake profile, which supposedly represents the large-eddy structure and is a consequence of the constraint provided by inertia. This equivalent wake profile is modified by the presence of a wall, at which a further constraint is provided by viscosity. The wall constraint, although it penetrates the entire boundary layer, is manifested chiefly in the sublayer flow and in the logarithmic profile near the wall.

Finally, it is suggested that yawed or three-dimensional flows may be usefully represented by the same two universal functions, considered as vector rather than scalar quantities. If the wall component is defined to be in the direction of the surface shearing stress, then the wake component, at least in the few cases studied, is found to be very nearly parallel to the gradient of the pressure.
On the propagation of weak shock waves
Authors: Whitham G. B.
Published: March 2006

A method is presented for treating problems of the propagation and ultimate decay of the shocks produced by explosions and by bodies in supersonic flight. The theory is restricted to weak shocks, but is of quite general application within that limitation. In the author's earlier work on this subject (Whitham 1952), only problems having directional symmetry were considered; thus, steady supersonic flow past an axisymmetrical body was a typical example. The present paper extends the method to problems lacking such symmetry. The main step required in the extension is described in the introduction and the general theory is completed in §2; the remainder of the paper is devoted to applications of the theory in specific cases.

First, in §3, the problem of the outward propagation of spherical shocks is reconsidered since it provides the simplest illustration of the ideas developed in §2. Then, in §4, the theory is applied to a model of an unsymmetrical explosion. In §5, a brief outline is given of the theory developed by Rao (1956) for the application to a supersonic projectile moving with varying speed and direction. Examples of steady supersonic flow past unsymmetrical bodies are discussed in §6 and 7. The first is the flow past a flat plate delta wing at small incidence to the stream, with leading edges swept inside the Mach cone; the results agree with those previously found by Lighthill (1949) in his work on shocks in cone field problems, and this provides a valuable check on the theory. The second application in steady supersonic flow is to the problem of a thin wing having a finite curved leading edge. It is found that in any given direction the shock from the leading edge ultimately decays exactly as for the bow shock on a body of revolution; the equivalent body of revolution for any direction is determined in terms of the thickness distribution of the wing and varies with the direction chosen. Finally in §8, the wave drag on the wing is calculated from the rate of dissipation of energy by the shocks. The drag is found to be the mean of the drags on the equivalent bodies of revolution for the different directions.
Supersonic flow past a bluff body with a detached shock Part I Two-dimensional body
Authors: Chester W.
Published: March 2006

The flow at high Mach number past a body with a rounded nose is considered. Viscosity and heat conduction are neglected, and the body is assumed to be two-dimensional and symmetrical about an axis parallel to the incident stream.

An exact solution is first obtained in the case λ → 1, M → ∞, where λ is the adiabatic index and M is the Mach number. This solution is then used as the basis of a double expansion in δ = (λ - 1)/(λ + 1) and M−2, after the exact solution has been modified to make the series expansion converge near the body. The expansion is carried out as far as the terms of order (δ + M−2)2.

The results are displayed for various values of δ and M−2; typical results are as follows. With M−2 = 0, δ = 1/6 (λ = 1.4), and for a parabolic body having unit radius of curvature at the nose, the shock is approximately a parabola with radius of curvature 1.822 at the nose. The distance between the body and the shock along the axis of symmetry is 0.323, and the height of the sonic point from this axis is 0.744 both on the shock and on the body. The actual pressure distribution on the body is shown in figure 4, and agrees well with experiment. The pressure falls to zero at a distance 0.86 downstream from the nose of the body, measured along the axis of symmetry. On the assumption that the pressure remains negligible beyond this point, the total drag is 1.39 ρV2, where ρ0 is the density andV is the velocity of the incident stream.
On the theory of hypersonic flow past plane and axially symmetric bluff bodies
Authors: Freeman N. C.
Published: March 2006

The ‘Newtonian-plus-centrifugal’ approximate solution (Busemann (1933) and Ivey (1948)) for hypersonic flow past plane and axially symmetric bluff bodies in gases with the ratio of the specific heats λ constant and equal to unity is rederived using ‘boundary layer’ techniques together with the von Mises variables x and ψ. A method of successive approximations then gives a closer approximation to this solution for ε (λ − 1)/(λ + 1) small and the free-strea Mach number infinite. Formulae for the streamlines, shock shape and pressure distribution are determined to this approximation. These formulae are valid for any plane or axially symmetric shape, giving the ‘stand-off’ distance of the shock wave from the body as ½εlog(4|3ε) and ε times the nose radius of curvature for plane and axially-symmetric flows respectively. Particular results are computed for a number of special shapes. For certain shapes, the theory has a singular point where the first approximation to the pressure vanishes (θ = 60° for a sphere). Actually, the theory is not applicable where the pressure becomes too small. The corresponding theory for gases of general thermodynamic properties is deduced, the approximation being valid provided the total energy of the gas is large compared with the energy contained in the translational modes of the gas molecules.
Shock compression of a perfect gas
Authors: Evans Cerda , Evans Foster
Published: March 2006

The compression of a perfect gas between a uniformaly moving piston and a rigid wall is discussed in the one-dimensional case. If the piston moves with a finite speed, it will initiate a shock in the gas which will reflect successively from rigid wall and piston and cause the compression process to deviate from a reversible adiabatic process. Expressions are derived for the relative changes in pressure and density at each shock reflection. Then values of density and pressure after any number of shock reflections are computed relative to their initial values, and, in terms of these, the corresponding values of temperature and entropy, as well as shock speeds, are determined. The limiting value of the entropy change, as the number of reflections goes to infinity, is obtained as a function of the ratio of specific heats of the gas and the strength of the initial shock. Hence it is possible to estimate an upper limit to the deviation of the shock compression process from a reversible adiabatic process. Some illustrative numerical examples are given.
Propagation of spherical shock waves in stars
Authors: Sakurai Akira
Published: March 2006

Propagation of spherical shock waves through self-gravitating polytropic gas spheres such as stars, caused by an instantaneous central explosion of finite energy E, is discussed theoretically. The problem is characterized by two lengths R0, L, where
$R_0 = \left(\frac {E}{4\pi p_0}\right)^{1|3},\;\;\;\;\; L = \left(\frac {3C^2_0}{2\pi \rho_0G} \right)^{1|2}$p0 and C0 are the values of pressure, density and velocity of sound at the centre of the equilibrium pre-explosion state, and G is the constant of gravitation. R0 and L are scales connected with the power of the explosion and the dimensions of the star respectively, and their ratio A = R0/L has a fundamental significance. A solution especially suitable in the case of A = O(1) is developed in the form of power series in R/R0 (R is the distance between the shock front and the centre) by a method similar to that used in previous papers by the present author (1953, 1954). An approximation to this solution is carried out up to the term in R3. In particular, the velocity of the shock wave U is found to be
$\frac {U}{C_0} = 1\cdot30 \left(\frac{R}{R_0}\right)^{-3|2} \{1 +0\cdot41A^2\left(\frac{R}{R_0}\right)^2 + 0\cdot 57\left(\frac{R}{R_0}\right)^3 +\ldot\}$
for the case of λ = 1.4, where λ is the ratio of specific heats.