bluuebunny/crossref_metadata_2025 huggingface dataset:
Self‐Assembly of Carbon‐Nanotube‐Based Single‐Electron Memories
Authors: Marty Laëtitia , Bonnot Anne‐Marie , Bonhomme Aurore , Iaia Antonio , Naud Cécile , André Emmanuel , Bouchiat Vincent
Published: October 2005

We demonstrate the wafer‐scale integration of single‐electron memories based on carbon nanotube field‐effect transistors (CNFETs) using a process based entirely on self assembly. First, a “dry” self‐assembly step based on chemical vapor deposition (CVD) allows the growth and connection of CNFETs. Next, a “wet” self‐assembly step is used to attach a single 30‐nm‐diameter gold bead in the nanotube vicinity via chemical functionalization. The bead is used as the memory storage node while the CNFET operating in the subthreshold regime acts as an electrometer exhibiting exponential gain. Below 60 K, the transfer characteristics of gold–CNFETs show highly reproducible hysteretic steps. Evaluation of the capacitance confirms that these current steps originate from the controlled storage of single electrons with a retention time that exceeds 550 s at 4 K.
What Is The Role of Mechanical Bowel Preparation in Patients with Pilonidal Sinus Undergoing Surgery? Prospective, Randomized, Surgeon‐blinded Trial
Authors: Terzi Cem , Canda Aras Emre , Unek Tarkan , Dalgic Esra , Fuzun Mehmet
Published: October 2005

The aim of this study was to determine the effect of a mechanical bowel preparation on postoperative surgical wound infections in patients treated with identical antimicrobial prophylaxis undergoing wide excision and primary closure for chronic pilonidal sinus disease. Patients more than 18 years old were included in the study. All patients had intravenous antimicrobial prophylaxis at the time of anesthesia induction. In a prospective, randomized setting, patients were allocated to either the bowel preparation group or the no‐bowel‐preparation group. Mechanical bowel preparation was performed using an oral sodium phosphate solution. On the morning of the procedure a rectal enema was performed with the phosphate solution. The primary outcome measure was the rate of wound infection, but all postoperative complications and recurrences were recorded. All patients were actively observed for 1 year after discharge. The overall infection rate for the entire study population was 12.8% (13/101) including 14.3% (7/49) of those who had had the bowel preparation and 11.5% (6/52) of those with no bowel preparation. There was no statistically significant difference between groups (P = 0.680). The mean rate of recurrence for all 101 patients was 4.9% (5/101) at 19.2 months (range 12–32 months) of follow‐up. The recurrence rate was 6.1% (3/49) in the bowel preparation group and 3.8% (2/52) in the no‐bowel‐preparation group (P = 1.000). Although the number of patients is small in this study, our results showed that the mechanical bowel preparation does not cause a decrease in the rate of surgical wound infections after excision and primary closure in patients with chronic pilonidal sinus disease.
Evaluation of Effect of Hemihepatic Vascular Occlusion and the Pringle Maneuver during Hepatic Resection for Patients with Hepatocellular Carcinoma and Impaired Liver Function
Authors: Chau Gar‐Yang , Lui Wing‐Yiu , King Kuang‐Liang , Wu Chew‐Wun
Published: October 2005

Reducing blood loss during resection of hepatocellular carcinoma (HCC) in patients with impaired liver function is important. This study evaluated the effect and safety of inflow occlusion (hemihepatic vascular occlusion and the Pringle maneuver) in reducing blood loss during hepatectomy. A total of 120 HCC patients with impaired liver function (with a preoperative indocyanine green retention rate at 15 minutes > 10%) who underwent hepatectomy were included in this retrospective study. Patients were divided into three groups, no‐occlusion (n = 30), hemihepatic vascular occlusion (n = 49), and Pringle maneuver (n = 41). There was one hospital death in each group. Of all three groups, 50 patients (41.7%) had blood loss less than 1000 ml. The three groups were similar in terms of clinocopathological features. All patients underwent minor resection. Blood loss was significantly greater in the no‐occlusion group; there was no difference between the hemihepatic group and the Pringle group. Multivariate analysis revealed that risk factors related to blood loss included no inflow occlusion [odds ratios (ORs), 2.93; 95% confidence intervals (CIs) 1.13–7.59], tumor centrally located (ORs, 3.85; 95% CIs, 1.50–9.90), serum albumin level < 3.5 gm/dl (ORs, 5.15; 95% CIs, 1.20–22.07), and serum alanine aminotransferase >120 U/l (ORs, 3.58; 95% CIs, 1.19–10.80). For patients with occlusion time ≥ 45 minutes, postoperative serum total bilirubin and aspartate aminotransferase levels in the Pringle group were significantly higher than those in the hemihepatic and no‐occlusion groups (P < 0.05). In HCC patients with impaired liver function undergoing hepatectomy, both hemihepatic vascular occlusion and the Pringle maneuver are safe and effective in reducing blood loss. Patients subjected to hemihepatic vascular occlusion responded better than those subjected to the Pringle maneuver in terms of earlier recovery of postoperative liver function, especially when occlusion time was ≥ 45 minutes.
The Use of Stereotactic Excisional Biopsy in the Management of Invasive Breast Cancer
Authors: Hanna Waël C. , Demyttenaere Sebastian V. , Ferri Lorenzo E. , Fleiszer David M.
Published: October 2005

Stereotactic breast biopsy techniques minimize the surgical trauma associated with conventional wire‐guided open breast biopsy for non‐palpable breast lesions (NPBLs). Advanced breast biopsy instrumentation (ABBI) allows for a 2‐cm core of breast tissue to be excised under stereotactic guidance in an outpatient setting. We report our initial experience with ABBI. Hospital charts from 89 ABBI procedures between 10/1996 and 07/2002 were retrospectively reviewed for patient characteristics, ABBI parameters, radiographic appearance, pathology, complications, and clinical follow‐up. Data are presented as percentage/median (range). Median age was 59 years (range: 39–80 years), mammographic lesions were classified as calcifications 49% (44/89), soft tissue 39% (35/89), or mixed 11% (10/89). Median radiographic size was 7 mm (1–60 mm). Final pathology revealed ductal carcinoma in situ (DCIS) in 7% (6/89) and invasive cancer in 22% (20/89). Microscopically clear margins were obtained in 55% (11/20) of patients with invasive cancer. Of these, 82% (9/11) chose not to undergo further local surgical therapy. Eight patients remain disease free at 56 months (range: 41–95 months) follow‐up. The ninth patient was deceased at 6 months from an unrelated cause. The overall complication rate was 3% (3/89). A definitive diagnosis was obtained in 100% of malignant and 87% of benign cases. Median waiting time was 19 days (range: 0–90 days). Our experience demonstrates that ABBI is an effective diagnostic tool for NPBLs. It is associated with minimal complications, and provides negative margins in over half of malignant cases. In selected patients with invasive cancer and negative margins, ABBI may obviate the need for further local surgical treatment. ABBI merits additional investigation as a therapeutic modality for early breast cancer.
Access to Care and Satisfaction in Colorectal Cancer Patients
Authors: Porter Geoffrey A. , Inglis Karen M. , Wood Lori A. , Veugelers Paul J.
Published: October 2005

This study described the various components of access to care for resectable colorectal cancer, and correlated the timeliness of these components with patient satisfaction. With a prospective/retrospective cohort design, all patients undergoing surgical resection for primary colorectal cancer from 2/1/01 to 15/12/01, were identified during their admission for surgery. A comprehensive, standardized method of ascertaining specific time intervals, which included a patient interview, was used. A patient satisfaction questionnaire was developed, tested, and used in consenting patients. Over the study period, 118 patients underwent colorectal cancer resection. Of these, 110 (93%) consented to participate and 101 (86%) completed the satisfaction questionnaire, including test–retest. The median time intervals (interquartile range) for the various components of access to care were as follows: symptoms to first physician visit, 32 days (10–75); first physician visit to diagnosis, 88 days (44–218); diagnosis to surgery, 19 days (10–44); surgery to chemotherapy (where applicable), 54 days (47–72). On multivariate analysis, tumor location in the rectum was associated with longer prediagnosis intervals, whereas increasing tumor stage was associated with shorter intervals from diagnosis to surgery. Variation in the time interval from diagnosis to surgery was associated with patient satisfaction (r = 0.49; P < 0.0001). Substantially less correlation was identified between patient satisfaction and the time from first physician visit to diagnosis (r = 0.25, P = 0.04). No significant correlation was identified between patient satisfaction scores and the time interval from symptoms to first physician visit (r = 0.11; P = 0.7). Despite concerns regarding surgical waitlists, the longest time intervals experienced by colorectal cancer patients precede diagnosis. However, variations in the relatively short time period from diagnosis to surgery appeared to have the most impact on patient satisfaction. Interventions which improve the timeliness of specific components of access to care may not necessarily result in improved patient satisfaction.
Reproductive modes of three Ligularia weeds (Asteraceae) in grasslands in Qinghai‐Tibet Plateau and their implications for grassland management
Authors: Ma Rui‐Jun , Du Guo‐Zhen , Lu Bao‐Rong , Chen Jia‐Kuan , Sun Kun , Hara Toshihiko , Li Bo
Published: October 2005

Ligularia virgaurea, L. sagitta and L. przewalskii are noxious weeds that are widely distributed in psychro‐grasslands in the east of Qinghai‐Tibet Plateau of China. However, little is known about reproductive modes and genetic diversity in the populations of L. virgaurea and L. sagitta under different environmental conditions, although such information is available for L. przewalskii. In this study, two experiments were conducted to examine the ex situ clonal growth of these weeds, and to determine the effects of reproductive modes on the diversity of their populations, using random amplified polymorphic DNA (RAPD) analysis. Transplanted seedlings of L.sagitta and L. virgaurea showed considerable clonal growth by forming rhizomes and ramets. The RAPD analysis showed that all individuals collected from natural populations were genetically different, indicating that no individuals originated from clonal growth. It is concluded that L. virgaurea and L. sagitta have the capacity for clonal growth, but the expression of their clonality is constrained by their growing conditions in natural grasslands. Sexual reproduction plays the major role in their population diversity in natural habitats, which requires that the control measures for these weeds should be targeted at the sexually reproducing populations.
Can collaboration between education and health professionals improve the identification and referral of young people with eating disorders in schools? A pilot study
Authors: Rees Liz , Clark‐Stone Sam
Published: October 2005

In this pilot study, a number of different methods of identifying young people with eating disorders in schools were compared. Pupils aged 16–18 years from 3 schools in the South West of the UK participated (389 boys and 374 girls in total). A self‐report questionnaire (EDE‐Q) was found to be the most effective method of case identification. However, very few of these cases accepted the offer of help and it was strongly suspected that other cases went undetected despite teacher, parent and school nurse guidance. Implications for future early intervention studies are discussed.
Assembly of major histocompatibility complex class II subunits with invariant chain
Authors: Neumann Jürgen , Koch Norbert
Published: October 2005

The highly polymorphic major histocompatibility complex class II (MHCII) polypeptides assemble in the ER with the assistance of invariant chain (Ii) chaperone. Ii binds to the peptide‐binding pocket of MHCII heterodimers. We explored the mechanism how MHCII subunits attach to Ii. Expression with single α or β subunits from three human HLA and two mouse H2 class II isotypes revealed that Ii co‐isolates predominantly with the α polypeptide. Co‐isolation with α chain requires the groove binding Ii‐segment and depends on M91 of Ii. Immunoprecipitation of Ii from pulse chase labeled cells showed sequential assembly of α and β chains.
Transgenic mice expressing bovine PrP with a four extra repeat octapeptide insert mutation show a spontaneous, non‐transmissible, neurodegenerative disease and an expedited course of BSE infection
Authors: Castilla J. , Gutiérrez-Adán A. , Brun A. , Pintado B. , Salguero F.J. , Parra B. , Segundo F. Díaz San , Ramírez M.A. , Rábano A. , Cano M.J. , Torres J.M.
Published: October 2005

Transgenic (Tg) mice carrying four extra octapeptide repeats (OR) in the bovine PrP gene (10OR instead of 6) have been generated. In these mice, neuropathological changes were observed depending upon the level of transgene expression. These changes primarily involved a slowly advancing neurological disorder, characterized clinically by ataxia, and neuropathologically, by vacuolization in different brain areas, gliosis, and loss of cerebellar granule cells. Accumulation of insoluble bovine 10OR‐PrP (bo10OR‐PrP) was observed depending on the level of expression but no infectivity was found associated with this insoluble form. We also compared the behavior of bo6OR‐PrP and bo10OR‐PrP Tg mouse lines in response to BSE infection. BSE‐inoculated bo10ORTg mice showed an altered course of BSE infection, reflected by reduced incubation times when compared to bo6ORTg mice expressing similar levels of the wild type 6OR‐PrP. In BSE‐inoculated mice, it was possible to detect PrPres in 100% of the animals. While insoluble bo10OR‐PrP from non‐inoculated bo10ORTg mice was non‐infectious, brain homogenates from BSE‐inoculated bo10ORTg mice were highly infectious in all the Tg mouse lines tested. This Tg mouse model constitutes a new way of understanding the pathobiology of bovine transmissible spongiform encephalopathy. Its potential applications include the assessment of new therapies against prion diseases.
Eckol isolated from Ecklonia cava attenuates oxidative stress induced cell damage in lung fibroblast cells
Authors: Kang Kyoung Ah , Lee Kyoung Hwa , Chae Sungwook , Zhang Rui , Jung Myung Sun , Lee Youngki , Kim So Young , Kim Hee Sun , Joo Hong Gu , Park Jae Woo , Ham Young Min , Lee Nam Ho , Hyun Jin Won
Published: October 2005

We have investigated the cytoprotective effect of eckol, which was isolated from Ecklonia cava, against oxidative stress induced cell damage in Chinese hamster lung fibroblast (V79‐4) cells. Eckol was found to scavenge 1,1‐diphenyl‐2‐picrylhydrazyl radical, hydrogen peroxide (H2O2), hydroxy radical, intracellular reactive oxygen species (ROS), and thus prevented lipid peroxidation. As a result, eckol reduced H2O2 induced cell death in V79‐4 cells. In addition, eckol inhibited cell damage induced by serum starvation and radiation by scavenging ROS. Eckol was found to increase the activity of catalase and its protein expression. Further, molecular mechanistic study revealed that eckol increased phosphorylation of extracellular signal‐regulated kinase and activity of nuclear factor κ B. Taken together, the results suggest that eckol protects V79‐4 cells against oxidative damage by enhancing the cellular antioxidant activity and modulating cellular signal pathway.
Desumoylation of homeodomain‐interacting protein kinase 2 (HIPK2) through the cytoplasmic‐nuclear shuttling of the SUMO‐specific protease SENP1
Authors: Kim Young Ho , Sung Ki Sa , Lee Sook-Jeong , Kim Yong-Ou , Choi Cheol Yong , Kim Yongsok
Published: October 2005

The modification of homeodomain‐interacting protein kinase 2 (HIPK2) by small ubiquitin‐like modifier 1 (SUMO‐1) plays an important role in its targeting into the promyelocytic leukemia body, as well as in its differential interaction with binding partner, but the desumoylation of HIPK2 by SUMO‐specific proteases is largely unknown. In this study, we show that HIPK2 is a desumoylation target for the SUMO‐specific protease SENP1 that shuttles between the cytoplasm and the nucleus. Mutation analyses reveal that SENP1 contains the nuclear export sequence (NES) within the extreme carboxyl‐terminal region, and SENP1 is exported to the cytoplasm in a NES‐dependent manner. Sumoylated HIPK2 are deconjugated by SENP1 both in vitro and in cultured cells, and the desumoylation is enhanced either by the forced translocation of SENP1 into the nucleus or by the SENP1 NES mutant. Concomitantly, desumoylation induces dissociation of HIPK2 from nuclear bodies. These results demonstrate that HIPK2 is a target for SENP1 desumoylation, and suggest that the desumoylation of HIPK2 may be regulated by the cytoplasmic‐nuclear shuttling of SENP1.
Stg1 is a novel SM22/transgelin‐like actin‐modulating protein in fission yeast
Authors: Nakano Kentaro , Bunai Fumihide , Numata Osamu
Published: October 2005

We identified a novel actin‐modulating protein Stg1 in the fission yeast Schizosaccharomyces pombe. Stg1 is similar to mammalian SM22/transgelin, and biochemical experiments showed that Stg1 crosslinked F‐actin. Microscopic observation suggested that Stg1 was a component of actin patch. Overexpression of Stg1 caused a defect in cytokinesis by suppressing the formation of a contractile ring and formation of abnormal aggregates of F‐actin in the ends and mid‐region of cells. Although distribution of the actin cytoskeleton was not affected by disrupting stg1
+, genetic interaction suggested that Stg1 was likely involved in controlling the organization of the actin cytoskeleton in cell morphogenesis and cytokinesis in fission yeast.
The N‐terminal cleavage of cellular prion protein in the human brain
Authors: Laffont-Proust Isabelle , Faucheux Baptiste A. , Hässig Raymonde , Sazdovitch Véronique , Simon Stéphanie , Grassi Jacques , Hauw Jean-Jacques , Moya Kenneth L. , Haïk Stéphane
Published: October 2005

Human brain cellular prion protein (PrPc) is cleaved within its highly conserved domain at amino acid 110/111 ↓ 112. This cleavage generates a highly stable C‐terminal fragment (C1). We examined the relative abundance of holo‐ and truncated PrPc in human cerebral cortex and we found important inter‐individual variations in the proportion of C1. Neither age nor postmortem interval explain the large variability observed in C1 amount. Interestingly, our results show that high levels of C1 are associated with the presence of the active ADAM10 suggesting this zinc metalloprotease as a candidate for the cleavage of PrPc in the human brain.
The haloperoxidase of the agaric fungus Agrocybe aegerita hydroxylates toluene and naphthalene
Authors: Ullrich René , Hofrichter Martin
Published: October 2005

The mushroom Agrocybe aegerita secretes a peroxidase (AaP) that catalyzes halogenations and hydroxylations. Phenol was brominated to 2‐ and 4‐bromophenol (ratio 1:4) and chlorinated to a lesser extent to 2‐chlorophenol. The purified enzyme was found to oxidize toluene via benzyl alcohol and benzaldehyde into benzoic acid. A second fraction of toluene was hydroxylated to give p‐cresol as well as o‐cresol and methyl‐p‐benzoquinone. The UV–Vis absorption spectrum of purified AaP showed high similarity to a resting state cytochrome P450 with the Soret band at 420 nm and additional maxima at 278, 358, 541 and 571 nm; the AaP CO‐complex had a distinct absorption maximum at 445 nm that is characteristic for heme‐thiolate proteins. AaP regioselectively hydroxylated naphthalene to 1‐naphthol and traces of 2‐naphthol (ratio 36:1). H2O2 was necessarily required for AaP function and hence the hydroxylations catalyzed by AaP can be designated as peroxygenation and the enzyme as an extracellular peroxygenase.
Refinement in the Rehabilitation of the Paralyzed Face using Botulinum Toxin
Authors: Bikhazi Nadim B. , Maas Corey S.
Published: October 2005

A number of surgical procedures exist to improve facial symmetry for patients with facial paralysis. Whereas static symmetry is often improved, dynamic asymmetry frequently persists because of the imbalance of complex coordinated movements of facial expression. The paralyzed face is often distorted by the excessive pull of the normal contralateral face during emotional expression. This study reports an expanded clinical indication for botulinum toxin in patients with unilateral facial paralysis. Ten patients with facial paralysis and markedly asymmetric smiles were treated with botulinum toxin A injections into the contralateral zygomaticus major, levators labii superioris and angulii oris, or risorius muscles. Eight of the 10 patients noted improvement in the symmetry of their smiles and underwent repeat injections. The onset and duration of effect averaged 5.9 days and 3 months, respectively. Botulinum toxin therapy provides a safe and efficacious modality for refining the appearance of the paralyzed face during mimetic activity.
Impairment and Disability in Patients with Facial Neuromuscular Dysfunction
Authors: Brach Jennifer S. , Van Swearingen Jessie , Delitto Anthony , Johnson Peter C.
Published: October 2005

Integration of impairment measures and disability measures may provide clinicians with an accurate and comprehensive picture of the patient's dysfunction. The purpose of this study was to indicate the usefulness of two new scales of measuring facial impairment and disability in describing characteristics of individuals with facial neuromuscular dysfunction. Fifty‐one individuals with unilateral facial neuromuscular dysfunction and a House‐Brackmann grade of III or higher were included in the study. The subjects' movement impairments were assessed using the Facial Grading System (FGS). The subjects reported their physical and social function on the Facial Disability Index (FDI). Nine variables were subjected to a confirmatory principal‐components factor analysis to indicate important factors in describing patients with facial nerve disorders. The confirmatory principal‐components factor analysis identified three factors, impairment, disability, and temporal characteristics of disease, accounting for 72% of the variance in describing individuals with facial neuromuscular dysfunction. Integration of these measures may provide clinicians with an accurate and comprehensive picture of the patient's dysfunction, thus aiding in the determination of intervention and the measurement of clinical outcomes.
Gender and Racial Variations in Cephalometric Analysis
Authors: Lee James J. , Ramirez Sylvester G. , Will Michael J.
Published: October 2005

Cephalometric analysis has earned a vital role in the evaluation of obstructive sleep apnea. However, the normal measurements cited in the literature are not sex or race specific. Skeletal differences in sexes and races have been established. This study was initiated to examine whether race and sex variations in soft tissue and skeletal measurements exist in cephalometric analysis. A total of 89 volunteers of different race and sex participated in this study. The data support the hypothesis that there are statistically significant differences in (1) sella‐nasion‐subspinale angle (SNA) between black men, and both Caucasian and Hispanic men, (2) sella‐nasion‐supramentale angle (SNB) between black men and Caucasian men, (3) posterior airway space between Caucasian men and women, and (4) mandibular plane to hyoid distance between Caucasian men and women. These data suggest that only SNA and SNB need racial specificity. Furthermore, Caucasian women need a separate set of normal values from men, specifically posterior airway space and mandibular plane to hyoid bone.
Preoperative and Postoperative Nasal Septal Surgery Assessment with Acoustic Rhinometry
Authors: Shemen Larry , Hamburg Richard
Published: October 2005

INTRODUCTION

Acoustic rhinometry is a relatively new tool used for the measurement of the geometry of the nasal fossa. We hypothesized that acoustic rhinometry would be useful for preoperative and postoperative assessment of patients undergoing septal surgery.

METHODS AND MATERIAL

Twenty‐four patients undergoing septal surgery performed by two surgeons underwent preoperative and postoperative rhinometry. The indications for surgery were nasal obstruction caused by a deviated nasal septum. Rhinometry was conducted with the Eccovision Acoustic Rhinometry System (Hood Laboratories). Analysis of the data was performed with the Kwikstat program (Texasoft) and Excel (Microsoft).

RESULTS

Subjective improvement in nasal patency was significantly correlated with improvement in acoustic rhinometry.

CONCLUSIONS

Acoustic rhinometry is valuable in objectively confirming nasal patency after nasal septal and turbinate surgery.
The Assessment of Nasality with a Nasometer and Sound Spectrography in Patients with Nasal Polyposis
Authors: Hong Ki Hwan , Kwon Sam Hyun , Jung Sang Sool
Published: October 2005

With the development of computerized acoustic analysis systems, an objective measure of nasal speech has become readily available by means of a simple, noninvasive technique. In this study, we assessed the nasality in patients with multiple nasal polyposis before and after endoscopic sinus surgery. With the nasometer, we measured nasalance, which reflects the ratio of acoustic energy output of nasal sounds from the nasal and oral cavities, and the slope score of the nasogram curve. The nasalance scores of nasal sentences and the slope scores of the nasogram curves for all nasal consonants were significantly lower in patients with nasal polyposis than in healthy subjects. After surgery, however, the nasalance and slope scores increased significantly to the normal range. On the sound spectrographic analysis, the frequencies of the first nasal formant decreased slightly and the sound intensity increased slightly for all nasal consonants after surgery. However, no significant change was noticed in the frequencies of the second nasal formant. In conclusion, nasometric and sound spectrographic analyses are considered to be useful tools for objectively assessing the extent of nasality in patients with nasal airway obstruction.
Diffuse Nasal Polyposis: Postoperative Long‐Term Results after Endoscopic Sinus Surgery and Frontal Irrigation
Authors: Klossek Jean‐Michel , Peloquin Louis , Friedman William H. , Ferrier Jean‐Claude , Fontanel Jean‐Pierre
Published: October 2005

Diffuse nasal polyposis remains a challenge despite recent improvements in endonasal surgery. The purpose of this study is to evaluate the results after a radical complete sphe‐noethmoidectomy with peroperative and postoperative frontal irrigation in cases of diffuse nasal polyposis. In this prospective study, we include 50 consecutive patients with diffuse nasal polyposis suffering from nasal obstruction, anosmia, and other symptoms of chronic sinusitis. All patients were refractory to medical therapy. In each patient an endoscopic complete sphenoethmoidectomy including total excision of all diseased ethmoid mucosa was performed. Preoperative and postoperative frontal irrigation was performed systematically. The patients were followed closely with serial endoscopic examination, and CT scanning was performed between 2 and 3 years after surgery. There were no complications. Thirty‐nine of the 50 patients regained satisfactory olfaction. Partial nasal obstruction persisted in four of the 50 patients. Endoscopically, polyp recurrence was noted in 3% of posterior ethmoids, 23% of anterior ethmoids, and 50% of frontal recesses. We conclude that in cases of refractory and extensive nasal polyposis, a total sphenoethmoidectomy with perioperative frontal irrigation followed by long‐term postoperative topical steroid therapy provides excellent improvement or cure with safety and reliability.
Sinusitis in the Intensive Care Unit Patient
Authors: Kountakis Stilianos E. , Burke Luke , Rafie Jean‐Jacques , Bassichis Benjamin , Maillard Alberto A. J. , Stiernberg Charles M.
Published: October 2005

A retrospective study was undertaken to determine the incidence of sinusitis as a source of fever in the intensive care unit (ICU) patient, evaluate the effectiveness of radiologic studies in diagnosing sinusitis, and develop guidelines that may help predict the result of antral levage. Sixteen of 52 (30.7%) lavages in patients studied with plain films and 27 of 67 (40.3%) lavages in patients studied with computed tomography of the sinuses revealed purulence in the maxillary sinuses. Conversely, 23 of 30 (76.7%) of the cases with purulence in the middle meatus had purulence in the maxillary sinus (chi‐squared = 27.1). If no purulence was seen, the results of the antral lavage were negative in 68 of 89 cases (76.4%). When physical examination was used in conjunction with computed tomography, 92.3% of lavages confirmed purulence in the maxillary sinus (chi‐squared = 16.6). In conclusion, the most important factor in predicting a positive result with antral lavage is the presence of purulence in the middle meatus on physical examination in conjunction with the presence of sinus disease on computed tomography of the sinuses.
Comparison of Sinus Computed Tomography Staging Systems
Authors: Metson Ralph , Gliklich Richard E. , Stankiewicz James A. , Kennedy David W. , Duncavage James A. , Hoffman Sanford R. , Ohnishi Toshio , Terrell Jeffrey E. , White Paul S.
Published: October 2005

In an attempt to establish a standardized rating system for CT of the paranasal sinuses, the Committee on Rhinology and Paranasal Sinus Disease of the American Academy of Otolaryngology‐Head and Neck Surgery instituted a protocol for the review of sinus CT scans at six international sites. Fifty identical scans were rated by four otolaryngologists at each site according to five established sinus CT staging systems. Twenty of 24 reviewers repeated the rating session at least 1 week later to determine intrarater variability. The number of CT scans that could not be classified by a particular rating system ranged from 1.3% to 5.5%. The range of intrarater agreement (κ = 0.39 to 0.74) exceeded that of inter‐rater agreement (κ = 0.18 to 0.49). A skewed distribution of CT scans resulted in a system with high rater agreement but poor ability to differentiate among disease states. The use of a numeric rating system to assign a score to each scan produced a comprehensive and disease‐sensitive system, but one with low rater agreement. A precise definition of mucosal thickening in terms of millimeters appeared to enhance the raters' ability to assign stage and improve a system's comprehensiveness and reproducibility. On the basis of these findings, recommendations are made for the use of CT rating systems to study clinical outcomes in patients with chronic sinusitis.
Computerized Dynamic Platform Posturography
Authors: Monsell Edwin M. , Furman Joseph M. , Herdman Susan J. , Konrad Horst R. , Shepard Neil T.
Published: October 2005

Computerized dynamic platform posturography is defined in this technology assessment. The review discusses what computerized dynamic platform posturography measures, what the reliability and validity of the information are, and the uniqueness of the information provided. The clinical contribution and indications for testing are discussed. There are comments on future directions for research on computerized dynamic platform posturography and a summary and conclusion.
Phonatory Characteristics of Patients Undergoing Thyroidectomy without Laryngeal Nerve Injury
Authors: Hong Ki Hwan , Kim Young Ki
Published: October 2005

Complications that arise after thyroid surgery may be associated with infection, hemorrhage, hormonal problems, and laryngeal nerve injury. Voice alteration after thyroidectomy is usually caused by recurrent or superior laryngeal nerve injury. This voice dysfunction may also be associated with laryngotracheal fixation with impairment of vertical movement or by temporary malfunction of the strap muscles after surgery. In this study, we evaluated the voice function phonetically before and after thyroidectomy in 54 patients, although function of the recurrent and superior laryngeal nerves was normal. During surgery, the superior and recurrent laryngeal nerves were identified and protected, and after surgery electromyographic testing of the cricothyroid muscle was performed. Typical voice symptoms after surgery were easy fatigue during phonation and difficulty with high pitch and singing voice. Acoustic analysis revealed that the phonation time and fundamental frequency were not changed after surgery, but the speaking fundamental frequency, range of speaking fundamental frequency, and vocal range were significantly diminished after surgery. These data allowed us to suggest that the cause of voice dysfunction is not seen in neural lesions, but in a disturbance of the extralaryngeal skeleton. These voice changes emphasize the importance of the extralaryngeal mechanism for pitch control.
Prosthesis Size in Stapedectomy
Authors: Fucci Michael J. , Lippy William H. , Schuring Arnold G. , Rizer Franklin M.
Published: October 2005

Primary stapedectomies were performed on 60 patients with bilateral otosclerosis. Every patient had a 4 mm long Robinson prosthesis with a 0.4 mm wide shaft placed in one ear and a 4 mm long Robinson prosthesis with 0.6 mm wide shaft placed in the opposite ear. With the 0.4 mm wide prosthesis, 54 patients overclosed the air bone gap and 6 were within 10 dB of closing. With the 0.6 mm wide prosthesis, which was placed in the opposite ear, 51 patients overclosed their air‐bone gap and 8 were within 10 dB of closing. We conclude that there is no statistical difference in hearing results between the 0.4 mm and the 0.6 mm wide Robinson prosthesis when they are used in a partial stapedectomy with a vein graft covering the oval window.
Induction of Labyrinthitis Ossificans after Pneumococcal Meningitis: An Animal Model
Authors: Brodie Hilary A. , Thompson Teresa C. , Vassilian Lara , Lee Becky N.
Published: October 2005

Newly formed disorganized bone fills the open spaces within the otic capsule in various pathologic conditions, resulting in labyrinthitis ossificans. The pathologic mechanisms of this disease remain poorly understood. To better study the sequence of events and contributing mechanisms involved in labyrinthitis ossificans, an animal model was developed. Three groups of Mongolian gerbils received either an intralabyrinthine injection of normal saline solution (group 1) or Streptococcus pneumoniae polysaccharide capsule antigens (groups 2 and 3). The temporal bones were harvested after 3 months and serially sectioned. None of the eight control animals (group 1), which received intralabyrinthine injections of normal saline solution had any histologic changes in their temporal bones. Nine of the surviving 19 animals in groups 2 and 3 had fibrosis or evidence of early ossification. A fourth group of Mongolian gerbils received two intrathecal injections of live S. pneumoniae organisms. The temporal bones were harvested after 3 months and serially sectioned. Fourteen of the surviving 15 animals had fibrosis or ossification or both. This animal model will provide a method for study of the mechanisms of labyrinthitis ossificans.
Sac‐Vein Decompression for Intractable Meniere's Disease: Two‐Year Treatment Results
Authors: Gianoli Gerard J. , Larouere Michael J. , Kartush Jack M. , Wayman John
Published: October 2005

Surgical intervention has been offered to patients with Meniere's disease who have failed medical treatment and have disabling symptoms. Surgical options have included labyrinthectomy (mechanical and chemical), vestibular neurectomy, and endolymphatic sac surgery with or without shunting. We present a modification of endolymphatic sac decompression surgery that includes wide decompression of the sigmoid sinus, posterior cranial fossa dura, and endolymphatic sac (sac‐vein decompression). Thirty‐five patients underwent 37 primary procedures with 2 years of follow‐up. Patients were evaluated according to the 1985 American Academy of Otolaryngology‐Head and Neck Surgery criteria for assessing Meniere's disease. Vestibular symptom severity was resolved or mild in 92% and disability severity was none or mild in 95% of patients at 2 years after surgery. Vertigo control was complete or substantial in 85% and 100% of patients at 1 and 2 years after surgery. Audiologic data showed stable or improved hearing in 86% and 85% of patients at 1 and 2 years after surgery. In summary, wide decompression of the sigmoid sinus, posterior cranial fossa dura, and endolymphatic sac offers improved control of vertigo and hearing stabilization for intractable Meniere's disease compared with simple endolymphatic sac decompression or shunt surgery.
Otologic and Laryngologic Manifestations of Mucopolysaccharidoses after Bone Marrow Transplantation
Authors: Papsin B. C. , Vellodi A. , Bailey C.M. , Ratcliffe P. C. , Leighton S. E. J.
Published: October 2005

INTRODUCTION

Children with mucopolysaccharidosis have significant functional impairment of a number of systems because of deposition of glycosaminoglycans. The otolaryngologic system is affected, resulting in conductive and sensorineural hearing loss and voice abnormality.

METHOD

Eleven children who had undergone bone marrow transplantation had their hearing and voices assessed. Unmatched data from patients who had not undergone transplantation were collected for nonstatistical comparison.

RESULTS

The hearing loss in children who had undergone bone marrow transplantation was variable but on average was less severe than in the younger children who had not undergone transplantation. The incidence of otitis media with effusion was diminished in the transplanted group. Approximately half had normal voices.

DISCUSSION

Diminution of the progression of hearing loss and voice abnormality probably occurs in patients after treatment by bone marrow transplantation.
Distortion‐Product Otoacoustic Emissions Hearing Screening in High‐Risk Newborns
Authors: Salata James A. , Jacobson John T. , Strasnick Barry
Published: October 2005

Universal infant hearing screening has recently been recommended by the National Institutes of Health. Otoacoustic emissions have been proposed as the first‐level screening technique. Although transient evoked otoacoustic emissions have shown limited applications, distortion‐product otoacoustic emissions hold promise as a screening technique but have not been fully investigated. The purpose of this study was to determine the validity of distortion‐product otoacoustic emissions as a hearing screening technique. A total of 208 ears of 104 infants at risk for hearing loss were tested with both automated auditory brain stem response and distortion‐product otoacoustic emission screening protocols. Acoustic brain stem response results were used as the standard for normal hearing. Distortion‐product otoacoustic emission results were analyzed by means of calculation of the difference between the mean of the response levels and the mean of the noise floor levels from five frequency pairs between 2000 and 4000 Hz. Pass‐fail rates for response above noise floor criteria of 5, 10, and 15 dB were examined. The sensitivity of distortion‐product otoacoustic emissions was 50%, 67%, and 87%, and the specificity was 94%, 68%, and 38% at the 5,10, and 15 dB levels, respectively. The pass‐fail criterion of distortion‐product otoacoustic emissions should be based on instrumentation calibration, infant status, and an acceptable false‐positive, false‐negative yield. The ability to test rapidly the hearing of all infants with distortion‐product otoacoustic emissions points to the feasibility of using this test as a first‐stage screen.
Effects of 21‐Aminosteroid U‐74389G on Acute Otitis Media in a Guinea Pig Model
Authors: Haddad Joseph , Egusa Kentaro , Takoudes Thomas G.
Published: October 2005

Free radicals participate in the development of disease under inflammatory conditions. Lipid peroxides such as malondialdehyde are regarded as markers of cell membrane damage by oxidative stresses. Previous work from our laboratory has demonstrated that Iipidperoxidation is increased in acute otitis media in guinea pigs, implicating a role for free radicals as contributors to inflammation. In this study we examined the effect of Iazaroid U‐74389G, a 21‐aminosteroid, on acute otitis media in guinea pigs. Streptococcus pneumoniae organisms were inoculated into the right tympanic cavity; sterilized phosphate‐buffered saline solution was injected into the left ear to serve as a control. The guinea pigs were given intraperitoneal injections of 40 mg/kg of a Iazaroid compound or its vehicle every 12 hours. Middle ear mucosa was collected and used for assay. We quantified lipid peroxide by means of the methylene blue‐hemoglobin method and by means of measurement of thiobarbituric acid reactive substance. Lazaroid significantly (p<0.05) suppressed production of lipid hyproperoxide of the middle ear mucosa of the guinea pigs with acute otitis media for up to 24 hours. These results suggest that Iazaroid may reduce Iipoperoxidation in the middle ear at an early stage of acute otitis media.
Complications of Tonsillectomy and Adenoidectomy
Authors: Randall David A. , Hoffer Michael E.
Published: October 2005

Adenotonsillectomy is generally safe surgery, but surgeons should be cognizant of potential complications and be prepared to manage them. Postoperative hemorrhage usually responds to local measures or cautery but can be life‐threatening. Preoperative screening of coagulation profiles appears unnecessary. Anesthetic risks have declined with modern techniques, but airway risks, aspiration, and pulmonary edema are possible. Nasopharyngeal valving may be altered by velopharyngeal incompetence or nasopharyngeal stenosis. Sore throat, otalgia, fever, dehydration, and uvular edema are more common postoperative complaints. Less common complications include atlantoaxial subluxation, mandible condyle fracture, infection, eustachian tube injury, and psychological trauma. The prevalence, management, and strategies for avoidance of these are discussed.
An Anatomic Study of the Rat Larynx: Establishing the Rat Model for Neuromuscular Function
Authors: Inagi Katsuhide , Schultz Edward , Ford Charles N.
Published: October 2005

The gross and microscopic anatomy of the rat larynx was studied with particular attention to myology and neuromuscular structures to further validate it as a model to evaluate morphologic and functional changes induced by botulinum injection. A laryngeal alar cartilage (LAlC), alar cricoarytenoid (ACA) muscle, and a superior cricoarytenoid muscle (SCA) were identified as anatomic structures not previously described. Two portions (medial and lateral) of the thyroarytenoid muscle (TA) were distinguished. The function of the ACA was suggested to be similar to the aryepiglottis muscle in humans and the function of the SCA was suggested to be similar to the human interarytenoid muscle. The predominant pattern of motor endplate (MEP) distribution in rat laryngeal muscles (posterior cricoarytenoid, lateral cricoarytenoid, cricothyroid, and SCA) was to have MEPs concentrated mostly at the midbelly of muscle where they were distributed throughout the cross‐sectional area of the midbelly. The TA and ACA differed from this pattern. The lateral TA had MEPs concentrated at the anterior third of its belly and those of the medial TA were located at the midbelly. Motor endplates in the ACA were located mostly at the posterior portion of muscle. Muscle fiber‐typing showed subtle differences between the intrinsic laryngeal muscles. Fast fibers were predominant in the rat laryngeal muscles. This study supports the expanded use of rats in studies of laryngeal neuromuscular function and disease in humans.
A New Concept in Laryngeal Muscle: Multiple Myosin Isoform Types in Single Muscle Fibers of the Lateral Cricoarytenoid
Authors: Wu Ya Zhen , Baker Michael J. , Crumley Roger L. , Blanks Robert H. I. , Caiozzo Vincent J.
Published: October 2005

This report describes the first known investigation of canine laryngeal muscle in which single fibers were dissected and their myosin heavy chain (MHC) isoform content was analyzed. Both SDS‐polyacrylamide gel electrophoresis (SDS‐PAGE) and western blot techniques were used. The data from single fiber SDS‐PAGE indicate that the lateral cricoarytenoid (LCA) is predominantly a fast muscle composed of the following MHC isoforms: Type I, 16.3%; Type IIA, 71.3%; Type IIX, 10.4%; and Type IIB, 2.0%. The results reveal a phenomenon that, to our knowledge, has not been previously described for laryngeal muscle: the presence of two or more MHC isoforms in a single canine LCA muscle fiber. A large number (41%) of muscle fibers coexpressed two or more MHC isoforms. The three most common patterns of coexpression were Type IIA/IIX (72%), Type IIA/I (16%), and Type IIA/IIX/I (8%). Interestingly, the fast Type IIX MHC isoform was typically present with other isoforms and rarely found by itself in individual fibers. Additional experiments are underway to determine whether other laryngeal muscles exhibit such an unusually high ratio of MHC isoform polymorphism.
Superior Orbital Fissure Syndrome Caused by Indolent Aspergillus Sphenoid Sinusitis
Authors: Bikhazi Nadim B. , Sloan Steven H.
Published: October 2005

Aspergillus fumigatus is the most common fungal pathogen of the paranasal sinuses. Its clinical significance ranges from noninvasive colonization to fulminant invasion of the sinuses and surrounding structures. Immunocompromised individuals are at highest risk for invasive infection. While the maxillary sinus is most commonly affected, isolated sphenoid sinusitis is infrequent.1 Complications of sphenoid involvement result from extension into contiguous structures such as the orbit, cavernous sinus, or brain. Prompt diagnosis and treatment are paramount to reducing morbidity and mortality.

Superior orbital fissure syndrome includes ophthalmoplegia, ptosis, forehead hypesthesia, and retro‐orbital pain. Any process that invades the superior orbital fissure may lead to this constellation of findings. We report a case of indolent Aspergillus sphenoid sinusitis presenting as a superior orbital fissure syndrome over a 6‐week period. The unusual clinical and radiologic features of this report that led to a delay in diagnosis and treatment are detailed.
Management of Cancer in the Elderly: Therapeutic Dilemmas
Authors: Hirano Minoru , Mori Kazunori
Published: October 2005

As the average life span has increased, the number of elderly patients with cancer has increased. One of the greatest dilemmas in the management of cancer in the elderly is the fact that often regular curative treatment cannot be executed. From this viewpoint, 679 patients with head and neck cancer treated during a recent 5‐year period were reviewed. They were classified into two age groups: those younger than 75 years (n = 560) and those 75 years and older (n = 119). The frequency with which curative treatment could not be executed was 8.8% in the younger group and 26.1% in the older group. The major reasons were concomitant health problems and failure to obtain the patient's consent, and these problems were significantly more common in the older group. The incidence of asthma, pulmonary emphysema, cardiac failure, hypertension, arrhythmia, cerebrovascular disease, and kidney failure was greater in the older group. The overall 3‐year survival rate was 18% in the cases with no curative treatment and 77% in those curatively treated.