bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between severity of liver dysfunction and the relative ratio of liver to aortic enhancement (RE) on MRI using hepatocyte‐specific contrast
Authors: Kim Young Chul , Kim Myeong‐Jin , Park Young Nyun , Kim Kyung Sik , Ahn Sang Hoon , Jung Seung Eun , Kim Jai Keun
Published: April 2013

Purpose

To evaluate differences in liver enhancement among patients with low and high morbidity risks and to determine the relationship between severity of liver dysfunction and the relative ratio of liver to aortic enhancement (RE) on MRI using hepatocyte‐specific contrast.

Materials and Methods

A total of 126 patients underwent magnetic resonance imaging (MRI) and blood serum testing including serology, bilirubin, international normalized ratio, and creatinine tests. Radiologists analyzed a region of interest in the liver and aorta on precontrast and 10‐ and 20‐minute delayed hepatobiliary phase MR images. Liver enhancement after 10 (LE10min) and 20 minutes (LE20min) were compared between the low‐ and high‐risk groups by independent t‐test. Regression analysis was used to assess the relationship between the Model for Endstage Liver Disease (MELD) score and RE.

Results

All 126 patients were classified into either the low‐risk group (MELD <8; n = 85) or high‐risk group (MELD ≥8; n = 41). The mean LE10min and LE20min were significantly higher in the low‐risk group (471.61; 95% confidence interval [CI]: 449.79–493.43 and 510.69; 95% CI: 486.51–534.87, respectively) than in the high‐risk group (401.6776; 95% CI: 364.75–438.61 and 413.81; 95% CI: 370.91–456.70). There was a moderate inverse correlation between MELD score and the relative ratio of liver enhancement (RLE) (r = −0.5442; 95% CI: −0.6480 to −0.4207; P<0.01), but a high positive correlation between MELD score and RE (r = 0.7470; 95% CI: 0.6665–0.8102; P < 0.01).

Conclusion

Although liver enhancement was significantly greater in low‐risk patients compared to high‐risk patients, RE may be a better predictor of liver function than RLE. J. Magn. Reson. Imaging 2014;39:24–30. © 2013 Wiley Periodicals, Inc.
Respiratory‐induced 3D deformations of the renal arteries quantified with geometric modeling during inspiration and expiration breath‐holds of magnetic resonance angiography
Authors: Suh Ga‐Young , Choi Gilwoo , Draney Mary T. , Herfkens Robert J. , Dalman Ronald L. , Cheng Christopher P.
Published: April 2013

Purpose

To quantify renal artery deformation due to respiration using magnetic resonance (MR) image‐based geometric analysis.

Materials and Methods

Five males were imaged with contrast‐enhanced MR angiography during inspiratory and expiratory breath‐holds. From 3D models of the abdominal aorta, left and right renal arteries (LRA and RRA), we quantified branching angle, curvature, peak curve angle, axial length, and locations of branch points.

Results

With expiration, maximum curvature changes were 0.054 ± 0.025 mm−1 (P < 0.01), and curve angle at the most proximal curvature peak increased by 8.0 ± 4.5° (P < 0.05) in the LRA. Changes in maximum curvature and curve angles were not significant in the RRA. The first renal bifurcation point translated superiorly and posteriorly by 9.7 ± 3.6 mm (P < 0.005) and 3.5 ± 2.1 mm (P < 0.05), respectively, in the LRA, and 10.8 ± 6.1 mm (P < 0.05) and 3.6 ± 2.5 mm (P < 0.05), respectively, in the RRA. Changes in branching angle, axial length, and renal ostia locations were not significant.

Conclusion

The LRA and RRA deformed and translated significantly. Greater deformation of the LRA as compared to the RRA may be due to asymmetric anatomy and mechanical support by the inferior vena cava. The presented methodology can extend to quantification of deformation of diseased and stented arteries to help renal artery implant development. J. Magn. Reson. Imaging 2013;38:1325–1332. © 2013 Wiley Periodicals, Inc.
Quantifying catch‐and‐release: The extensor tendon force needed to overcome the catching flexors in trigger fingers
Authors: Lu Szu‐Ching , Kuo Li‐Chieh , Jou I‐Ming , Wu Chih‐Chung , Tung Wen‐Lin , Sun Yung‐Nien , Su Fong‐Chin
Published: April 2013

The extensor tendon forces required to overcome the catching flexors in trigger fingers are unknown. A biomechanical model with moment equilibrium equations and method of least squares was developed for estimating the tendon force at triggering in trigger fingers. Trigger fingers that exhibited significant catching and sudden release during finger extension were tested. A customized “pulling tester” was used to pull the finger from flexion to extension and provide synchronic measurement of the pulling force. The displacement of the tested finger was measured by a motion capture system. This preliminary study presents kinematic and kinetic data at triggering of 10 trigger fingers. The distal and proximal interphalangeal (PIP) joints presented sudden release while the metacarpophalangeal (MCP) joint started extension in the early phase of finger extension. The tendon tension of flexor digitorum profundus was greater than that of flexor digitorum superficialis (FDS) in six fingers, and less than that of FDS in three fingers. The tension of two flexor tendons was almost equal in one finger. At the PIP and MCP joints, 1.54 times the force of flexors was needed for the extensors to overcome the catching flexors in trigger fingers. This biomechanical model provides clinicians with a clearer idea of the tendon force at triggering. The quantitative results may help in the understanding of movement characteristics of trigger fingers. These findings are useful to better understand the etiology and nature of trigger finger development, and thus aid in further development of better assessments and treatments related to this. © 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:1130–1135, 2013
Polarized micro‐Raman spectroscopy and ab initio phonon modes calculations of LuPO4
Authors: Sanson A. , Giarola M. , Bettinelli M. , Speghini A. , Mariotto G.
Published: April 2013

The vibrational dynamics of lutetium orthophosphate (LuPO4) single crystals was carefully investigated by means of polarized micro‐Raman spectroscopy and ab initio calculations. Eleven of the twelve independent components of the polarizability tensor, expected on the basis of the group theory for LuPO4, were selected in turn and assigned in symmetry. The only B1g(2) Raman mode was not observed, likewise due to either its very small intensity or its nearness in energy with forbidden Raman modes, which spill and could hide it. Both Raman and infrared vibrational modes are evaluated by density‐functional theory calculations using effective core pseudo‐potential. The agreement between calculated and experimental frequencies is very good. On the basis of our ab initio results, and of reduced‐mass ratio considerations, the expected wavenumber of the missing B1g (2) mode falls close to that of Eg(3) mode peaked at about 306 cm−1, and therefore we can definitively conclude that the observation of the missing B1g (2) mode is masked by the spill‐over of this Eg mode. Copyright © 2013 John Wiley & Sons, Ltd.
In situ monitoring of styrene polymerization using Raman spectroscopy. Multi‐scale approach of homogeneous and heterogeneous polymerization processes
Authors: Brun Nadège , Youssef Itab , Chevrel Marie‐Claire , Chapron David , Schrauwen Cornélius , Hoppe Sandrine , Bourson Patrice , Durand Alain
Published: April 2013

Free radical polymerization of styrene was monitored in situ by combining Raman spectroscopy to other experimental techniques (gravimetry and rheology). Three different processes were investigated: bulk, emulsion and miniemulsion polymerization. A complete analysis of the evolution of Raman spectrum during the course of reaction showed that a lot of information about molecular dynamics could be extracted and related to chemical phenomena. In addition, we report for the first time the coupling of Raman spectroscopy to a rheometer in order to monitor styrene bulk polymerization both at the scale of chemical bonds and at the scale of macroscopic phenomena (viscosity variation). Copyright © 2013 John Wiley & Sons, Ltd.
Such as pigs eat: the rise and fall of the pannage pig in theUK
Authors: Wealleans Alexandra L
Published: April 2013

Mast‐feeding systems once formed the mainstay of pork production across Europe, but have now largely been forgotten. One of the earliest farming practices, it allowed people to fatten pigs on an otherwise wasted resource. Mast feeding was vital in the ancient world: Rome, Saxon England and the Normans all relied heavily on woodland pigs. As time and technology advanced, mast systems became outmoded and fell into disuse. However, recent public interest in improved animal welfare and sustainable agriculture, combined with anecdotal reports of improved flavour, has once again brought mast feeding into the spotlight. This article chronicles the changes in popularity and perception of mast‐feeding systems throughout history, and uses the historical perspective to outline a possible future for woodland pigs. © 2013 Society of Chemical Industry
A preliminary metagenomic study of puer tea during pile fermentation
Authors: Lyu Changyong , Chen Chaoyin , Ge Feng , Liu Diqiu , Zhao Shenglan , Chen Dan
Published: April 2013

BACKGROUND

Up to now, there has been no report on the taxonomic and functional analysis of the microbial community in fermenting puer tea by pyrosequencing. In this study, metagenomic pyrosequencing was first used in fermenting puer tea to delineate a relatively comprehensive overview of the microbial taxonomy while also preliminarily characterising the functional ontologies of microbial genes present in puer tea pile fermentation.

RESULTS

A total of 251 738 pyrosequencing reads (9197 contigs and 145 402 singletons) were generated by pyrosequencing. Taxonomic analysis revealed three dominant bacterial phyla, Proteobacteria (23.56%), Actinobacteria (23.35%) and Firmicutes (11.37%), and one dominant eukaryotic phylum, Ascomycota (30.47%). A total of 58 664 hits were categorised into 28 functional subsystems based on the SEED database. Moreover, two categories, ‘metabolism of terpenoids and polyketides’ and ‘biosynthesis of other secondary metabolites’, were selectively analysed and 69 enzyme genes were presented in 16 pathways.

CONCLUSION

The dominant microbes of puer tea fermentation were bacteria in the present study, and yeasts rather than moulds accounted for the overwhelming majority of Eukaryota. The analysis of functional genes and metabolic pathways will be helpful for further study of the mechanism of puer tea fermentation at molecular level. © 2013 Society of Chemical Industry
Psychosocial distress is prevalent in head and neck cancer patients
Authors: Buchmann Luke , Conlee John , Hunt Jason , Agarwal Jayant , White Shelley
Published: April 2013

Objectives/Hypothesis

The purpose of this study is to evaluate the levels of psychological distress in head and neck cancer patients using a validated screening tool. We aim to characterize distress in this cancer population and understand the factors driving distress levels.

Study Design

Review of prospectively gathered data.

Methods

A review of prospectively gathered data was undertaken from 89 head and neck cancer patients (HNC) who completed the Distress Thermometer and Problem List (DT) from the National Comprehensive Cancer Network (NCCN).

Results

Distress levels were high in the overall population. The level of distress was significantly greater in patients with a self‐reported history of depression (P <.001), family concerns (P = .030), emotional concerns (P = .001) and physical concerns (P = .014).

Conclusions

Psychosocial distress was found to be high in the HNC population. Factors associated with increased distress level included a self‐reported history of depression, family concerns, emotional concerns, and physical concerns.

Level of Evidence

4.
Low body mass index and jaw movement are protective of hearing in users of personal listening devices
Authors: Li Lieber Po‐Hung , Chuang Ann Yi Chiun , McMahon Catherine , Tung Tao‐Hsin , Chen Joshua Kuang‐Chao
Published: April 2013

Objectives/Hypothesis

Sound pressure level delivered through personal listening devices (PLDs) and reaching the ear drum might be affected by body size and jaw movements. This study aimed to investigate whether jaw movement and/or smaller body mass index (BMI) resulted in decrease of sound pressure level within the ear canals of PLD users via an earbud earphone.

Study Design

Case series.

Methods

Forty‐five normal‐hearing subjects (16 males; mean age, 23.3 years) participated in this study. A probe‐microphone system was used to measure sound pressure level in the external ear canal with music delivered from a media player via an earbud earphone. Test materials consisted of two 20‐second excerpts from a heavy metal music piece. Subjects were instructed to adjust the volume of the media player to conform to three conditions for sound pressure measurement: comfortable, loud, and maximum. Measurements were then repeated while subjects mimicked chewing action under the same listening conditions.

Results

Sound pressure levels were significantly lower when measured with jaw movement than without jaw movement (P < .05). Sound pressure levels monitored with/without jaw movement were generally lower in subjects with a BMI<23 than those with a BMI ≥23 (P < .05).

Conclusions

Jaw movement and low BMI (<23) reduced the overall sound level of PLDs at the ear canal. Sound pressure levels detected in the external ear canal of our subjects using earbud earphones were significantly lower under conditions of jaw movement/BMI <23. Our research invites further studies on a larger group of PLD users to correlate these variables with hearing threshold shifts over time.

Level of Evidence

4. Laryngoscope, 123:1983–1987, 2013
Epidemiology of unilateral sensorineural hearing loss with universal newborn hearing screening
Authors: Ghogomu Nsangou , Umansky Amy , Lieu Judith E. C.
Published: April 2013

Objectives/Hypothesis

Compare the epidemiology of pediatric unilateral sensorineural hearing loss before and after implementation of universal newborn hearing screening in Missouri.

Study Design

Inception cohort.

Methods

Charts of 134 children born between January 1, 1990 and December 31, 2007, diagnosed with unilateral sensorineural hearing loss at a single institution in Missouri were reviewed to determine the effects of universal newborn hearing screening on age of detection and etiology of hearing loss.

Results

Mean age of detection declined from 4.4 (standard deviation [SD] 1.8) to 2.6 (SD 2.6) years of age, whereas the rate of detection by 6 months of age increased from 3% to 42%. The majority (58%) of cases had normal hearing at birth. The most common etiological category was unknown (41%) before screening and congenital (45%) after screening. The use of magnetic resonance imaging has increased by 21% (2‐fold), whereas use of computed tomography has declined by 8% since 2002. Yields of connexin, Pendred, electrocardiogram, and syphilis testing were 0/48 and 2/31 before and after screening, respectively.

Conclusions

Implementation of universal newborn hearing screening in Missouri is associated with a decrease in age of detection of unilateral sensorineural hearing loss. The majority of cases are either not present or not detectable at birth. The combination of hearing status at birth and imaging findings suggests that the majority of cases are congenital rather than of unknown etiology.

Level of Evidence

2b. Laryngoscope, 124:295–300, 2014
Evaluation of a teaching tool to increase the accuracy of pilot balloon palpation for measuring tracheostomy tube cuff pressure
Authors: Jiang Nancy , Del Signore Anthony G. , Iloreta Alfred M. , Malkin Benjamin D.
Published: April 2013

Objectives/Hypothesis

The purpose of this study was to evaluate the efficacy of a novel teaching tool to improve health care providers' ability to inflate tracheostomy tube cuffs to the appropriate pressure.

Study Design

Single‐blinded, randomized, controlled trial.

Methods

Subjects were randomized to a control and study group. The control group viewed a video about inflating tracheostomy tube cuffs to safe pressure levels. The study group viewed the same video and also got to palpate the pilot balloons of tracheostomy tube cuffs inflated to three different pressures. All subjects inflated tracheostomy tube cuffs to pressures they believed to be appropriate based on palpation of the pilot balloon preintervention, and immediately, 2 weeks, and 3 months postintervention.

Results

Forty‐nine health care providers participated in the study. There was no significant difference in the mean preintervention cuff inflation pressures between the two groups (36 cm H2O vs. 38 cm H2O, P = 0.4888), with both initially overinflating. Postintervention, the study group inflated the cuffs to significantly lower pressures than the control group, closer to the ideal of 25 cm H2O (26 cm H2O vs. 35 cm H2O, P = 0.0001). This difference was also observed 2 weeks (28 cm H2O vs. 37 cm H2O P <0.0001) and 3 months (28 cm H2O vs. 36 cm H2O, P = 0.0002) postintervention.

Conclusions

The novel teaching tool evaluated in this study is simple, easily reproducible, and low‐cost. Its use leads to long‐lasting improvement in health care providers' ability to more accurately inflate tracheostomy tube cuffs to safe pressures.

Level of Evidence

1b. Laryngoscope, 123:1884–1888, 2013
Squamous cell carcinoma of the temporal bone: Outcomes of radical surgery and postoperative radiotherapy
Authors: Leong Samuel C. , Youssef Ahmed , Lesser Tristram H.
Published: April 2013

Objectives/Hypothesis

To analyze the treatment outcomes for squamous cell carcinoma (SCC) of the temporal bone and to identify factors that may influence prognosis.

Study Design

Retrospective case series.

Methods

Case notes review of patients with histologically proven SCC of the temporal bone who had treatment with a curative intent at a tertiary referral center in the Northwest of England, United Kingdom.

Results

A total of 35 patients were treated in this unit over a 12‐year period. The most common presentation was otorrhoea, which was present in all patients, followed by otalgia (66%), bleeding (54%), and facial palsy (46%). The overall survival for this series was 48.6%. There were four patients with stage I tumor, and one case each of stage II and stage III disease. The disease‐free survival for patients with stage I to stage III disease in this series was 100%. The remaining 29 patients (84%) had stage IV disease, with an overall survival in this group of 41.4%. The average survival period of the 18 patients who succumbed to local disease was 9.2 months (range 3–22). Poorly differentiated SCC was associated with significantly poorer survival (P < 0.05) when compared to well and moderately differentiated SCC. Parotid involvement of SCC, node‐positive neck, and the presence of preoperative facial palsy was not associated with poorer survival outcomes.

Conclusions

SCC of the temporal bone is a highly malignant disease that is associated with high morbidity and mortality despite aggressive multimodal treatment.

Level of Evidence

4. Laryngoscope, 123:2442–2448, 2013
Treatment of bleeding upper aerodigestive tract tumor—A novel approach with antifibrinolytic agent
Authors: Low Tsu‐Hui (Hubert) , Huang Johnson , Reid Colin , Elliott Michael , Clark Jonathan R.
Published: April 2013

Objectives/Hypothesis

Symptomatic bleeding among patients with advanced upper aerodigestive tract tumor is a challenging problem. Given the limited options for topical treatment, embolization is often required to control the hemorrhage. There are recent reported cases of novel and successful treatment of patients with recalcitrant tracheo‐bronchial bleed with tranexamic acid. We therefore described our initial experience of four consecutive cases of patients with bleeding from advanced aerodigestive tract tumor, successfully treated with oral tranexamic acid.

Study Design

Case series.

Methods

Case series of four consecutive patients with acute bleed from upper aerodigestive tract tumors, treated with oral tranexamic acid. Tranexamic acid was administered topically and systemically (1gm PO QID) for the orophayngeal and supraglottic tumor cases, where as systemic‐only therapy were administered to the patients with nasal and nasopharyngeal tumors.

Results

None of the patients experienced further bleeding following the commencement of tranexamic acid treatment, and no adverse effect was noted. These are the first reported cases of symptomatic upper aerodigestive hemorrhage being controlled with tranexamic acid. It is increasingly being used in patients with life‐threatening bleeding following trauma and major surgery. The optimum dose of tranexamic acid is undetermined. In vivo studies suggested concentrations of 10 μg/mL to 16 μg/mL for optimal anti‐fibrinolytic effect, which is achievable with 1gm QID of oral administration. Large randomized controlled trials assessing the utility of tranexamic acid in various orthopedic surgeries did not show increased thromboembolic events.

Conclusions

Tranexamic acid should be considered for patients with symptomatic nonarterial bleeding of the upper aerodigestive tract tumors.

Level of Evidence

4. Laryngoscope, 123:2449–2452, 2013
Use of topical nasal therapies in the management of Chronic rhinosinusitis
Authors: Wei Calvin C. , Adappa Nithin D. , Cohen Noam A.
Published: April 2013

Objectives/Hypothesis

To determine whether the use of topical nasal therapies with saline alone and in combination with antibiotics, antifungals, or corticosteroids is effective in the treatment of patients with chronic rhinosinusitis (CRS).

Data Sources

A systematic literature search was performed utilizing the MEDLINE database (1966 to May 2012), EMBASE database (1980 to May 2012), and the Cochrane Central Register of Controlled Trials.

Review Methods

Electronic databases were searched by three otolaryngologists. Studies on five major categories of topical nasal therapies searched included saline (hypotonic, isotonic and hypertonic); topical antibiotics, topical steroids, and topical antifungals were obtained. Randomized controlled trials and meta‐analyses of randomized controlled trials were included.

Results

Sixteen randomized controlled trials were identified examining topical saline (hypertonic or isotonic) in CRS patients. Two randomized controlled trials were found studying the effect of topical antibiotics in patients with CRS. Four randomized controlled trials were identified studying topical antifungal treatment for CRS. Twenty‐five randomized controlled trials were found studying topical steroids in CRS patients.

Conclusion

A high aggregate quality of evidence supports the effectiveness of saline irrigations in treating CRS. There is insufficient evidence to support a clear benefit of topical antibiotics in patients with chronic rhinosinusitis. Topical antifungal therapies have not been shown to be significantly different in efficacy than saline controls on CRS outcomes. Topical steroids are beneficial in the treatment of CRS with nasal polyps, but have not been shown to be effective in CRS without nasal polyps. Laryngoscope, 123:2347–2359, 2013
A simple mechanical device reduces subglottic injury in ventilated animals
Authors: Osborn Alexander J. , Chami Rose , Propst Evan J. , Luginbuehl Igor , Taylor Glenn , Fisher Joseph A. , Forte Vito
Published: April 2013

Objectives/Hypothesis

To test whether a simple inexpensive device that dynamically minimizes endotracheal cuff pressure throughout the respiratory cycle reduces endotracheal cuff pressure‐related subglottic injury.

Study Design

Hypoxic animal model with one control and one experimental group.

Methods

Twelve S. scrofa domesticus piglets (14–16kg) were intubated with standard endotracheal tubes and maintained in a hypoxic state to accelerate airway injury. Animals in the control group (n = 6) were ventilated with a constant pressure of 20 cm H2O in the endotracheal tube cuff. Animals in the experimental group (n = 6) were ventilated using a custom‐designed circuit that altered the pressure in the endotracheal tube cuff in synchrony with the ventilatory cycle. Larynges were harvested at the end of the experiment and examined histologically to determine the degree of airway injury induced by the endotracheal cuff.

Results

Animals in the experimental group suffered significantly less airway damage than those in the control group. The differences were seen primarily in the subglottis (aggregate damage score 6.5 vs. 12, P <0.05), where the experimental endotracheal tube cuff exerted the least pressure. There was no difference in damage to the glottic or supraglottic structures.

Conclusions

A simple, reliable, and inexpensive means of modulating endotracheal tube cuff pressure with the ventilatory cycle led to a substantial decrease in airway injury in our animal model. Such reduction in cuff pressure may prove important for humans, particularly those in intensive care units who tend to have underlying conditions predisposing them to tracheal damage from the endotracheal tube cuff.

Level of Evidence

N/A. Laryngoscope, 123:2742–2748, 2013
Cochlear schwannoma removed through the external auditory canal by a transcanal exclusive endoscopic technique
Authors: Presutti Livio , Alicandri‐Ciufelli Matteo , Cigarini Elisa , Marchioni Daniele
Published: April 2013

Surgical approaches to the inner ear and internal auditory canal (IAC) are widely known and extensively recorded. The most popular can be classified as retrosigmoid, transmastoid‐translabyrinthine, and middle cranial fossa approaches. For the first time, an exclusive endoscopic approach to the IAC is described here, used to remove a cochlear schwannoma involving both the IAC and labyrinth. The operation provided a direct transcochlear intradural approach from lateral to medial and from external to internal auditory canal, without any external incision. The pathology was totally removed, and the postoperative outcome of the facial nerve was grade II (House‐Brackmann grading system) at 3‐month follow‐up. Laryngoscope, 123:2862–2867, 2013
A new paradigm for the management of essential vocal tremor with botulinum toxin
Authors: Gurey Lowell E. , Sinclair Catherine F. , Blitzer Andrew
Published: April 2013

Objectives/Hypothesis

1) To clarify essential voice tremor (EVT) phenomenology; 2) To report a management paradigm for essential voice tremor using botulinum toxin.

Study Design

Retrospective analysis of prospectively collected data.

Methods

Phenomenology from patients diagnosed with EVT between April 1996 and March 2012 was recorded, charted, and analyzed. A paradigm for treatment of EVT using botulinum toxin based on individualized clinical findings is discussed.

Results

Sixteen patients were included. Fewer than 50% patients were responsive to centrally acting oral medications. Fifteen patients analyzed had horizontal laryngeal tremor and received botulinum toxin injections to bilateral thyroarytenoid muscles. Thirteen patients had a vertical laryngeal tremor, and these patients underwent additional strap muscle injections. All patients had symptomatic improvement with reduced tremor amplitude. Dose adjustments over time depended on degree of symptomatic improvement.

Conclusions

Management of essential voice tremor with botulinum toxin is optimized by individualizing treatment based on the tremor phenomenology observed during clinical examination.

Level of Evidence

4. Laryngoscope, 123:2497–2501, 2013
New analyses of the sensory organization test compared to the clinical test of sensory integration and balance in patients with benign paroxysmal positional vertigo
Authors: Mulavara Ajitkumar P. , Cohen Helen S. , Peters Brian T. , Sangi‐Haghpeykar Haleh , Bloomberg Jacob J.
Published: April 2013

Objectives/Hypothesis

To determine whether the Sensory Organization Test (SOT) of the computerized dynamic posturography battery or the Clinical Test of Sensory Integration and Balance (CTSIB) is more likely to indicate balance disorders in people with benign paroxysmal positional vertigo (BPPV).

Study Design

Normal controls were compared to patients with unilateral BPPV of the posterior semicircular canal.

Methods

Subjects performed tests with eyes open or closed on stable and unstable surfaces, with head still or with head moving at 0.33 Hz in pitch or yaw. Dependent variables were the percent time of the standard duration each subject could perform the task, the number of head motions made, and kinematic variables measured with head‐ and torso‐mounted inertial motion units.

Results

Because equilibrium scores of control subjects improved significantly over repeated trials on SOT, patients were given only one trial per condition. For percent time between‐group differences were found on CTSIB with eyes closed, on foam, head moving in yaw showing significantly reduced performance by BPPV subjects compared to controls. Compared to controls, patients made significantly fewer head movements on CTSIB, eyes closed, on foam, head still, in pitch and yaw. Kinematic data also differed between the groups on tests with eyes closed and unstable surfaces with different head movement combinations, indicating increased instability in BPPV patients.

Conclusions

For screening, CTSIB with head movements is more likely than SOT to indicate balance deficits, especially when dependent measures include percent time as well as head movement counts and kinematic measures.

Level of Evidence

3b. Laryngoscope, 123:2276–2280, 2013
Outcome predictors in squamous cell carcinoma of the maxillary alveolus and hard palate
Authors: Eskander Antoine , Givi Babak , Gullane Patrick J. , Irish Jonathan , Brown Dale , Gilbert Ralph W. , Hope Andrew , Weinreb Ilan , Xu Wei , Goldstein David P.
Published: April 2013

Objectives/Hypothesis

Hard palate and maxillary alveolus are two commonly grouped oral cavity subsites due to their anatomic contiguity and oncologic disease behavior. Few studies have been conducted investigating clinical presentation, staging, prevalence of cervical metastases, and outcomes in this population. The primary objective of this study was to analyze predictors of disease‐free survival (DFS) in surgically treated patients, particularly as it relates to the role of neck dissection.

Study Design

Cohort study with planned data collection.

Methods

This cohort study used planned data collection over 15 years (1994–2008) at a large tertiary care cancer center to study all patients presenting with squamous cell carcinoma of the maxillary alveolus and hard palate treated surgically. Univariate and multivariate Cox regression analyses were used to identify predictors of DFS.

Results

Ninety‐seven patients met the inclusion criteria (54 male, 56%). The majority of patients (54, 56%) presented with locally advanced disease (cT3, cT4). Occult nodal metastases were noted in 26% (17 of 65) of patients clinically staged as N0. The 3‐year DFS was 70% (95% confidence interval = 59%–78%) with a median time to failure of 1.1 years (range = 0.3–9.7 years). Cox regression multivariate model demonstrated that advanced pathologic T stage, hard palate tumor site, and poorly differentiated tumor grade were each independent predictors of DFS.

Conclusions

A significant portion of the patients with hard palate and maxillary alveolus tumors harbor occult cervical metastases. Elective neck dissection in the high‐risk patients may potentially be beneficial in providing more accurate staging and improving DFS.

Level of Evidence

2b. Laryngoscope, 123:2453–2458, 2013
Transoral laser microsurgery for early glottic cancer as one‐stage single‐modality therapy
Authors: Lee Hyoung Shin , Chun Bong‐Gwon , Kim Sung Won , Kim Seung Tae , Oh Jung Ho , Hong Jong Chul , Lee Kang Dae
Published: April 2013

Objectives/Hypothesis

A study was undertaken to determine the oncologic outcomes in a consecutive series of early glottic carcinomas treated with transoral CO2 laser microsurgery (TLM) as a one‐stage single‐modality therapy, without any postoperative radiation therapy or retreatment with laser. We further evaluated correlations between the oncologic outcomes and clinicopathologic factors including tumor location and surgical margin.

Study Design

Retrospective analysis of medical records.

Methods

The medical records of 118 consecutive patients with early stage (T1, T2) glottic carcinoma who underwent TLM by a single surgeon as an initial treatment from 1997 to 2011 were retrospectively reviewed. The oncologic outcomes were evaluated, and correlations to clinicopathologic factors were analyzed.

Results

The 5‐year disease‐free survival, ultimate local control with laser alone, disease‐specific survival, overall survival, and organ preservation rates were 87.9%, 94.2%, 99.0%, 92.2%, and 96.2%, respectively. Neither the reported surgical margin nor the extension of tumor to the anterior commissure, arytenoid, subglottis, and ventricle showed any significant impact on local control or survival.

Conclusions

Transoral CO2 laser microsurgery as one‐stage single‐modality therapy resulted in a high rate of local control and a high survival rate in selected cases of early glottic carcinoma, regardless of the location of tumor and histopathology report on the surgical margin.

Level of Evidence

4 Laryngoscope, 123:2670–2674, 2013
Sinonasal adenoid cystic carcinoma
Authors: Sanghvi Saurin , Patel Neal R. , Patel Chirag R. , Kalyoussef Evelyne , Baredes Soly , Eloy Jean Anderson
Published: April 2013

Objectives/Hypothesis

Sinonasal adenoid cystic carcinoma (SNACC) is a rare malignancy that most commonly arises in the maxillary sinus. Characteristics of SNACC are slow growth, perineural invasion, and long clinical course. Because it is a rare tumor, population‐based studies are limited. We analyzed the incidence and survival for SNACC using a national population‐based database.

Study Design

Retrospective cohort study using national cancer database.

Methods

The United States National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry was utilized to calculate incidence and survival trends for SNACC between 1973 and 2009. Patient data were then analyzed according to age, sex, and race. Incidence trends were studied for the last 30 years, and survival outcomes were compared across the different demographic parameters.

Results

A total of 412 cases of SNACC were identified (57.52% female). Incidence trend analysis revealed a significant decrease in yearly rates from 1973 to 2009 for the overall population, females, whites, blacks, and “others.” Overall 5‐year survival for SNACC was 68.80%, 10‐year survival was 48.03%, and 20‐year survival was 22.39%. Significant differences in survival outcomes were noted between whites, blacks, and “others.” “Others” had the best 20‐year survival outcomes.

Conclusions

The overall incidence of SNACC is declining. Sex and race seem to influence the overall survival for this rare tumor. Future studies need to be conducted to investigate these dynamic trends related to SNACC.

Level of Evidence

2b Laryngoscope, 2013
Chiari type I malformation
Authors: Chambers Kyle J. , Setlur Jennifer , Hartnick Christopher J.
Published: April 2013

To highlight an unusual cause of chronic cough, we present two cases of chronic cough in older children referred to a pediatric otolaryngology outpatient clinic with persistent symptoms despite extensive previous workup and treatment. Cranial neuropathy was identified in each case. As a result, magnetic resonance imaging was performed revealing Chiari type I malformation. In each case, surgical decompression provided symptom improvement. Chronic cough is a rare presenting symptom in children with Chiari type I malformation. We emphasize the significance of awareness for unusual cases of cough to aid in the correct identification and treatment in children. Laryngoscope, 123:2888–2891, 2013
Head and neck trauma in Iraq and Afghanistan: Different war, different surgery, lessons learned
Authors: Brennan Joseph
Published: April 2013

Objectives/Hypothesis

The objectives are to compare and contrast the head and neck trauma experience in Iraq and Afghanistan and to identify trauma lessons learned that are applicable to civilian practice.

Study Design

A retrospective review of one head and neck surgeon's operative experience in Iraq and Afghanistan was performed using operative logs and medical records.

Methods

The surgeon's daily operative log book with patient demographic data and operative reports was reviewed. Also, patient medical records were examined to identify the preoperative and postoperative course of care.

Results

The head and neck trauma experiences in Iraq and Afghanistan were very different, with a higher percentage of emergent cases performed in Iraq. In Iraq, only 10% of patients were pretreated at a facility with surgical capabilities. In Afghanistan, 93% of patients were pretreated at such facilities. Emergent neck exploration for penetrating neck trauma and emergent airway surgery were more common in Iraq, which most likely accounted for the increased perioperative mortality also seen in Iraq (5.3% in Iraq vs. 1.3% in Afghanistan). Valuable lessons regarding soft tissue trauma repair, midface fracture repair, and mandible fracture repair were learned.

Conclusion

The head and neck trauma experiences in Iraq and Afghanistan were very different, and the future training for mass casualty trauma events should reflect these differences. Furthermore, valuable head and neck trauma lessons learned in both war zones are applicable to the civilian practice of trauma.

Level of Evidence

Level 4. Laryngoscope, 123:2411–2417, 2013
NTHi induction of Cxcl2 and middle ear mucosal metaplasia in mice
Authors: Preciado Diego , Burgett Katelyn , Ghimbovschi Svetlana , Rose Mary
Published: April 2013

Objectives/Hypothesis

Chronic otitis media (COM) develops after sustained inflammation and is characterized by secretory middle ear epithelial metaplasia and effusion, most frequently mucoid. Nontypeable Haemophilus influenzae (NTHi), the most common acute otitis media (OM) pathogen, is known to activate inflammation and mucin expression in vitro and in animal models of OM. The goals of this study were to examine histopathological and expression profiling epithelial effects of NTHi challenge in murine middle ears.

Study Design

In vitro and in vivo murine model of OM.

Methods

Weekly transtympanic inoculation of Balb/c mice with 300 μg/ml of NTHi lysates versus saline was performed. Histopathologic analysis was carried out at 4 weeks. Expression microarray analysis was performed at 1 and 7 days. Microarray findings were validated in independent animal samples and in a cultured murine middle ear epithelial cell (mMEEC) line.

Results

Histopathologic analyses revealed middle ear mucosal thickening after NTHi exposure. Microarray analyses of inflammatory response genes which changed significantly demonstrated that the chemokine Cxcl2 had the largest fold‐change, with significantly increased expression at 1 and 7 days after NTHi injection compared to either saline or no‐injection (P <0.01). Validation by real‐time qPCR revealed similar significantly increased relative mRNA levels for Cxcl2. NTHi lysates were also found to significantly upregulate the transcription of Cxcl2 in mMEEC in a time‐ and dose‐dependent manner (P <0.05).

Conclusions

Middle ear NTHi challenge in mice leads to chronic epithelial mucosal metaplasia and overexpression of inflammatory mediators, most notably Cxcl2. This finding is parallel to NTHi‐mediated pulmonary mucosal metaplasia where Cxcl2 has been identified as an important inflammatory mediator.

Level of Evidence

N/A. Laryngoscope, 123:E66–E71, 2013
Pre‐operative urodynamics in women with stress urinary incontinence increases physician confidence, but does not improve outcomes
Authors: Zimmern Philippe , Litman Heather , Nager Charles , Sirls Larry , Kraus Stephen R. , Kenton Kimberly , Wilson Tracey , Sutkin Gary , Siddiqui Nazema , Vasavada Sandip , Norton Peggy ,   For the Urinary Incontinence Treatment Network
Published: April 2013

Aims

To determine if pre‐operative urodynamic testing (UDS) affects physicians' diagnostic confidence and if physician confidence affects treatment outcomes at 1 year.

Methods

The Value of Urodynamic Evaluation (ValUE) trial randomized 630 women with predominant stress urinary incontinence (SUI) to office evaluation (OE) or OE plus UDS prior to surgery. After OE, physicians completed a checklist of five clinical diagnoses: SUI, overactive bladder (OAB) wet and dry, voiding dysfunction (VD), and intrinsic sphincter deficiency (ISD), and reported their confidence in each. Responses ranged from 1 to 5 with; 1 = “not very confident (<50%)” to 5 = “extremely confident (95 + %).” After UDS, investigators again rated their confidence in these five clinical diagnoses. Logistic regression analysis correlated physician confidence in diagnosis with treatment success.

Results

Of 315 women who received OE plus UDS, 294 had complete data. Confidence improved after UDS in patients with baseline SUI (4.52–4.63, P < 0.005), OAB‐wet (3.55–3.75, P < 0.001), OAB‐dry (3.55–3.68 P < 0.005), VD (3.81–3.95, P < 0.005), and suspected ISD (3.63–3.92, P < 0.001). Increased confidence after UDS was not associated with higher odds of treatment success although mean changes in confidence were slightly higher for those who achieved treatment success. Physician diagnoses shifted more from not confident to confident for ISD and OAB‐wet after UDS (McNemar's P‐value <0.001 for both).

Conclusions

In women undergoing UDS for predominant SUI, UDS increased physicians' confidence in their clinical diagnoses; however, this did not correlate with treatment success. Neurourol. Urodynam. 33:302–306, 2014. © 2013 Wiley Periodicals, Inc.
Impact of transfer pricing methods for tax purposes on supply chain performance under demand uncertainty
Authors: Huh Woonghee Tim , Park Kun Soo
Published: April 2013

Transfer pricing refers to the pricing of an intermediate product or service within a firm. This product or service is transferred between two divisions of the firm. Thus, transfer pricing is closely related to the allocation of profits in a supply chain. Motivated by the significant impact of transfer pricing methods for tax purposes on operational decisions and the corresponding profits of a supply chain, in this article, we study a decentralized supply chain of a multinational firm consisting of two divisions: a manufacturing division and a retail division. These two divisions are located in different countries under demand uncertainty. The retail division orders an intermediate product from the upstream manufacturing division and sets the retail price under random customer demand. The manufacturing division accepts or rejects the retail division's order. We specifically consider two commonly used transfer pricing methods for tax purposes: the cost‐plus method and the resale‐price method. We compare the supply chain profits under these two methods. Based on the newsvendor framework, our analysis shows that the cost‐plus method tends to allocate a higher percentage of profit to the retail division, whereas the resale‐price method tends to achieve a higher firm‐wide profit. However, as the variability of demand increases, our numerical study suggests that the firm‐wide and divisional profits tend to be higher under the cost‐plus method than they are under the resale‐price method. © 2013 Wiley Periodicals, Inc. Naval Research Logistics, 2013
Ellagic Acid and Derivatives from Cochlospermum angolensis Welw. Extracts: HPLC–DAD–ESI/MSn Profiling, Quantification and In Vitro Anti‐depressant, Anti‐cholinesterase and Anti‐oxidant Activities
Authors: Ferreres Federico , Grosso Clara , Gil‐Izquierdo Angel , Valentão Patrícia , Andrade Paula B.
Published: April 2013

Introduction

Cochlospermum angolensis Welw. bark is a medicinal plant consumed for the treatment of hepatic diseases and for the prophylaxis of malaria. Nevertheless, there are few studies concerning its chemical composition and biological potential.

Objective

Since phenolic compounds are described as powerful anti‐oxidants and neuroprotective agents, the purpose of this study was to characterise the phenolic profile of this species and to extend the knowledge on its medicinal properties, namely its potential against oxidative stress, Alzheimer's disease and depression.

Methods

The phenolic composition of aqueous and hydromethanolic extracts was characterised by HPLC–DAD–ESI/MSn. Anti‐radical potential was tested against 2,2‐diphenyl‐1‐picrylhdrazyl, superoxide anion and nitric oxide radicals, and neuroprotective effect was assessed against acetylcholinesterase, butyrylcholinesterase and monoamine oxidase A.

Results

Eight compounds were characterised for the first time. Hydromethanolic extract was richer in methyl ellagic acid and its derivatives, while aqueous extract had higher amounts of ellagic acid and its derivatives. Methyl ellagic acid pentoside isomer and ellagic acid were the major compounds in the two extracts, respectively. Both extracts and ellagic acid revealed radical scavenging capacity stronger than that of ascorbic acid, but a weak effect on cholinesterases was observed. Their anti‐depressant activity was also very strong.

Conclusion

The results provided evidence of the value of C. angolensis as a source of health‐promoting anti‐oxidants and anti‐depressant compounds, with potential to be used as a raw product for food and pharmaceutical industries. Copyright © 2013 John Wiley & Sons, Ltd.
A Simple and Rapid Single Kernel Screening Method to Estimate Amylose Content in Rice Grains
Authors: Agasimani Somanath , Selvakumar G. , Joel A. John , Ganesh Ram Sundaram
Published: April 2013

Introduction

In rice breeding programmes large number of grain samples are routinely analysed for amylose content (AC) through a tedious spectrophotometric method that also involves high reagent costs.

Objective

Here, we propose a rapid and economic screening technique for assessment of AC based on the amylose–iodine complex formation in the cut grains of rice, which we refer to as the cut grain dip (CGD) method.

Methods

The CGD method involves cutting the rice kernels in the middle with a pair of scissors and dipping the cut end in an optimised iodide:iodine (KI‐I) solution termed the rapid amylose detection solution (RADS).

Results

It was found that the time taken for deep blue colouration by the cut end of the grains after dipping in RADS was proportional to the AC. The CGD method was further validated in a large set of rice mutants with varied AC.

Conclusion

The proposed method can be used to screen samples for AC rapidly, with a single rice caryopsis, without any costly equipment and can be especially suitable for screening of mutants and segregants with altered AC in large breeding populations. Copyright © 2013 John Wiley & Sons, Ltd.
Cell‐free fetal DNA sex determination identified a maternal SRY gene with a known X chromosome deletion
Authors: Searle C. J. , Smith K. , Daniels G. , Maher E. J. , Quarrell O.
Published: April 2013

What's already known about this topic?

Cell‐free fetal DNA testing is commonly used as a noninvasive method of determing fetal sex.

Presence of sex‐determining region Y (SRY) on the X chromosome is associated with a variable sexual phenotype.

What does this study add?

Details an unexpected cell‐free fetal DNA sexing result.

Highlights the importance of using the technique of quantitative polymerase chain reaction in free fetal DNA testing.

If a similar result is found again, we would recommend further testing of the maternal chromosomes to look for a translocation encompassing the sex‐determining region Y (SYR) gene.