bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrapment of porous and stable concanavalin A–peroxidase complex into hybrid calcium alginate–pectin gel
Authors: Matto Mahreen , Husain Qayyum
Published: May 2006

Ammonium sulfate‐fractionated proteins of turnip (Brassica rapa) were used for the simultaneous purification and immobilization of peroxidase by using crude jack bean extract. The concanavalin A–turnip peroxidase complex retained nearly 70% of the original activity. Calcium alginate–pectin‐entrapped soluble turnip peroxidase and the concanavalin A complex of peroxidase retained 63% and 52% of the original activity, respectively. The concanavalin A–peroxidase complex, the alginate–pectin‐entrapped soluble peroxidase and the alginate–pectin‐entrapped concanavalin A–peroxidase complex showed very high stability against denaturation mediated by heat, pH, urea, organic solvents and detergents. The exposure of soluble and immobilized turnip peroxidase to trypsin resulted in an enhancement of the peroxidase activity. The concanavalin A–peroxidase complex entrapped preparation was markedly more stable as compared with the directly entrapped soluble enzyme preparation. The results suggested that such preparations have great potential in the construction of bioreactors to be used for the remediation of aromatic compounds present in polluted wastewater/industrial effluents. Copyright © 2006 Society of Chemical Industry
Ultrafiltration of industrial waste liquors from the manufacture of soy protein concentrates
Authors: Moure Andrés , Domínguez Herminia , Parajó Juan Carlos
Published: May 2006

Protein‐containing waste liquors from the manufacture of soy protein concentrates were processed by ultrafiltration to recover soluble protein using three different membranes (with molecular weight cut‐offs of 10, 30 and 50 kDa). Operating at 20 °C under reversible conditions, the experimental data of the normalized permeate flux (NPF) obtained at various transmembrane pressures were well described by a model reported in the literature. For each membrane and transmembrane pressure, the values of the parameters involved in the model were calculated. Operating at selected transmembrane pressures, protein rejections of 0.705, 0.747 and 0.637 were determined for the 10, 30 and 50 kDa membranes, respectively. Operation with the 10 kDa membrane at temperatures in the range 30–50 °C and operation with the 30 or 50 kDa membranes at 40 or 50 °C resulted in hysteresis. Copyright © 2006 Society of Chemical Industry
Parameters controlling supersaturation by DELOS using carbon dioxide
Authors: Dalvi Sameer V , Mukhopadhyay Mamata
Published: May 2006

The present work pertains to estimation of the maximum degree of supersaturation that can be attained in an organic solution by the DELOS process using carbon dioxide (CO2) as a cosolvent. The paper analyzes the effects of initial mole fraction of carbon dioxide, temperature and pressure on the degree of supersaturation of cholesterol in a CO2—acetone—cholesterol solution. It has been observed that owing to liberation of large amounts of CO2 very large temperature drops may be attained by depressurization, resulting in attainment of very high supersaturation. Within the ranges of the parameters studied in this work, the degree of supersaturation is higher with higher values of initial temperature and initial CO2 mole fraction of the solution due to inverse interdependence of the final temperature and the residual CO2 mole fraction in the depressurized solution. Copyright © 2006 Society of Chemical Industry
Application of magnetic force microscopy in nanomaterials characterization
Authors: de Lozanne Alex
Published: May 2006

This review describes the basic technical aspects of magnetic force microscopy and how this technique has been applied to the study of colossal magnetoresistance materials, superconductors, and patterned magnetic materials. Recently, current distribution in a patterned aluminum strip has been measured by magnetic force microscopy, opening the possibility of measuring currents in buried interconnects in integrated circuits. Microsc. Res. Tech., 2006. © 2006 Wiley‐Liss, Inc.
On the max‐cut problem for a planar, cubic, triangle‐free graph, and the Chinese postman problem for a planar triangulation
Authors: Thomassen Carsten
Published: May 2006

Every 3‐connected planar, cubic, triangle‐free graph with n vertices has a bipartite subgraph with at least 29n/24 − 7/6 edges. The constant 29/24 improves the previously best known constant 6/5 which was considered best possible because of the graph of the dodecahedron. Examples show that the constant 29/24 = 1.2083… cannot be raised to more than 47/38 = 1.2368…. © 2006 Wiley Periodicals, Inc. J Graph Theory 53: 261–269, 2006
Effects of penconazole on two yeast strains: Growth kinetics and molecular studies
Authors: Jawich Dalal , Lteif Roger , Pfohl‐Leszkowicz Annie , Strehaiano Pierre
Published: May 2006

The aim of this study consisted to evaluate the impact of a pesticide (penconazole) on the growth kinetics and genotoxicity on two yeast strains (Saccharomyces cerevisiae and Metschnikowia pulcherrima). When the penconazole was added at different phases of the growth of M. pulcherrima, no effect was noticed on the kinetics of yeast growth but DNA adducts were observed when penconazole was added in the exponential phase. Increasing doses (1–15 maximum residue limit) of the pesticide added at the beginning of the fermentation did not induce DNA adducts while kinetics were affected.
Molecular basis of water proton relaxation in gels and tissue
Authors: Chávez Fabian Vaca , Halle Bertil
Published: May 2006

An extensive set of water‐1H magnetic relaxation dispersion (MRD) data are presented for aqueous agarose and gelatin gels. It is demonstrated that the EMOR model, which was developed in a companion paper to this study (see Halle, this issue), accounts for the dependence of the water‐1H spin‐lattice relaxation rate on resonance frequency over more than four decades and on pH. The parameter values deduced from analysis of the 1H MRD data are consistent with values derived from 2H MRD profiles from the same gels and with small‐molecule reference data. This agreement indicates that the water‐1H relaxation dispersion in aqueous biopolymer gels is produced directly by exchange‐mediated orientational randomization of internal water molecules or labile biopolymer protons, with little or no role played by collective biopolymer vibrations or coherent spin diffusion. This ubiquitous mechanism is proposed to be the principal source of water‐1H spin‐lattice relaxation at low magnetic fields in all aqueous systems with rotationally immobile biopolymers, including biological tissue. The same mechanism also contributes to transverse and rotating‐frame relaxation and magnetization transfer at high fields. Magn Reson Med, 2006. © 2006 Wiley‐Liss, Inc.
Therapy preference and decision‐making among patients with severe sickle cell anemia and their families&
Authors: Hankins Jane , Hinds Pamela , Day Sara , Carroll Yvonne , Li Chin‐Shang , Garvie Patricia , Wang Winfred
Published: May 2006

Background

Patients with severe sickle cell anemia (SCA) may benefit from therapeutic intervention with hydroxyurea (HU), chronic red cell transfusion (CT), or stem cell transplantation (SCT). Determination of best treatment is complicated by the tradeoff between each treatment's risks and benefits and the lack of data comparing them to determine efficacy. We explored factors that influenced making decisions regarding interventions and examined the relations between treatment preference and health‐related quality of life (HRQOL).

Methods

Children with severe SCA and their parents received brochures describing each treatment, discussed risk/benefits with a nurse‐educator, and answered questions regarding HRQOL and the factors influencing treatment preference. Severe SCA was defined as ≥3 pain events requiring ER visits or hospitalizations within 12 months, ≥2 acute chest syndrome (ACS) events within 24 months, or a combination of the two.

Results

Thirty parents and 7 patients participated. HU was preferred by 21 parents and 4 children, CT by 5 parents and 1 child, and SCT by 3 parents and 1 child. One parent was undecided and one child preferred no treatment. Interviewees were most influenced by perceived efficacy and safety, but no factors differed significantly among treatment preference groups. HRQOL median scores (0–100 scale) for parents (56; range, 28–91) and children (61; range, 31–96) did not differ significantly among treatment preference groups.

Conclusions

Patients with severe SCA and their parents can identify their treatment preferences. Improved understanding of their preferences and decision‐making process will aid in the design of future clinical trials and in medical decision‐making. Pediatr Blood Cancer 2007;48:705–710. © 2006 Wiley‐Liss, Inc.
Dose response and local control using radiotherapy in non‐metastatic Ewing sarcoma
Authors: Paulino Arnold C. , Nguyen Thanh X. , Mai Wei Y. , Teh Bin S. , Wen B‐Chen
Published: May 2006

Background

To determine prognostic factors for local control in the radiotherapeutic management of non‐metastatic Ewing sarcoma.

Procedure

Forty patients with localized Ewing sarcoma (ES) were treated with primary site RT at one institution. Median RT dose was 55.8 Gy (range, 25.5–76 Gy). Chemotherapy was given to 34 patients (85%) with the most common regimen being vincristine, dactinomycin, cyclophosphamide, doxorubicin alternating with ifosfamide and etoposide (VACA + IE) in 10. Median follow‐up for surviving patients was 12.3 years (range, 1.7–26.4 years).

Results

The 5‐ and 10‐year local control rate was 78.2%. On multivariate analysis, RT dose was the only prognostic factor to impact on local control. The 5‐ and 10‐year local control rate was 88.7% for RT dose ≥49 Gy and was 37.5% for <49 Gy (P = 0.0002, log‐rank test). For tumors ≤8 cm, the 5‐ and 10‐year local control rate was 94.1% for RT dose ≥49 Gy and 50.0% for RT dose <49 Gy (P = 0.01, log‐rank test). For tumors >8 cm, the 5‐ and 10‐year local control rate was 85.7% for RT dose ≥54 Gy and 26.7% for RT dose <54 Gy (P = 0.006, log‐rank test).

Conclusions

Radiotherapy dose was found to influence local control in ES. In particular, patients who received RT doses ≥49 Gy for tumor size ≤8 cm and ≥54 Gy for tumor size >8 cm had improved local control. Pediatr Blood Cancer 2007;49:145–148. © 2006 Wiley‐Liss, Inc.
Sister Mary Joseph's nodule as presenting sign of a desmoplastic small round cell tumor
Authors: Doros Leslie , Kaste Sue C. , Rodriguez‐Galindo Carlos
Published: May 2006

Umbilical metastases, also named Sister Mary Joseph's nodules, are well documented in the adult population and most often represent an underlying intra‐abdominal malignancy, usually a carcinoma of gastrointestinal or gynecologic origin. They are indicative of widespread abdominal disease and are associated with a poor prognosis. An extensive review of the literature reveals only two such presentations in the pediatric population. A 14‐year‐old male presented with an umbilical mass, which was found to be a metastatic lesion of a desmoplastic small round cell tumor (DSRCT) of the abdomen. The diagnosis of an intra‐abdominal malignancy, most commonly a DSRCT, should be considered in the presence of an umbilical mass in a child. Pediatr Blood Cancer 2008;50:388–390. © 2006 Wiley‐Liss, Inc.
A predictive approach based on the Simha–Somcynsky free‐volume theory for the effect of dissolved gas on viscosity and glass transition temperature of polymeric mixtures
Authors: Di Maio Ernesto , Iannace Salvatore , Mensitieri Giuseppe , Nicolais Luigi
Published: May 2006

The gas concentration and pressure effects on the shear viscosity of molten polymers were modeled by using a unified approach based on a free volume theory. A concentration and pressure dependent “shift factor,” which accounts for free volume changes associated with polymer‐gas mixing and with variation of absolute pressure as well as for dilution effects, has been herein used to scale the pure polymer viscosity, as evaluated at the same temperature and atmospheric pressure. The expression of the free volume of the polymer/gas mixture was obtained by using the Simha and Somcynsky equation of state for multicomponent fluids. Experimental shear viscosity data, obtained for poly(ε‐caprolactone) with nitrogen and carbon dioxide were successfully predicted by using this approach. Good agreement with predictions was also found in the case of viscosity data reported in the literature for polystyrene and poly(dimethylsiloxane) with carbon dioxide. Free volume arguments have also been used to predict the Tg depression for polystyrene/carbon dioxide and for poly(methyl methacrylate)/carbon dioxide mixtures, based on calculations performed, again, with the Simha and Somcynsky theory. © 2006 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 44: 1863–1873, 2006
Effects of filler–polymer interactions on cold‐crystallization kinetics in crosslinked, silica‐filled polydimethylsiloxane/polydiphenylsiloxane copolymer melts
Authors: Chien Allen , Maxwell Robert S. , DeTeresa Steve , Thompson Lisa , Cohenour Rebecca , Balazs Bryan
Published: May 2006

Crystallization in a series of variable crosslink density poly(dimethyl‐diphenyl)siloxanes random block copolymers reinforced through a mixture of precipitated and fumed silica fillers has been studied by differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), nuclear magnetic resonance (NMR), and X‐ray diffraction (XRD). The silicone composite studied was composed of 94.6 mol % dimethoylsiloxane, 5.1 mol % diphenylsiloxane, and 0.3 mol % methyl‐vinyl siloxane (which formed crosslinking after peroxide cure). The polymer was filled with a mixture of 21.6 wt % fumed silica and 4.0 wt % precipitated silica previously treated with 6.8 wt % ethoxy‐end‐blocked siloxane processing aid. Molecular weight between crosslinks and filler–polymer interaction strength were modified by exposure to γ‐irradiation in either air or in vacuo. Isothermal DMA experiments illustrated that crystallization at −85 °C occurred over a 1.8 hour period in silica‐filled systems and 2.2–2.6 hours in unfilled systems. The crystallization kinetics for irradiated samples were found to be dependent on crosslink density. Irradiation in vacuo resulted in faster overall crystallization rates compared to air irradiation for the same crosslink density, likely due to a reduction in the interaction between the polymer chains and the silica filler surface for samples irradiated in air. © 2006 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 44: 1898–1906, 2006
Structure and hydrolysis of the heavy alkaline earth cations: Relativistic studies
Authors: Barysz Maria , Kȩdziera Dariusz , Leszczyński Jerzy , Bilewicz Aleksander
Published: May 2006

The relativistic spin‐averaged Douglas–Kroll theory at the level of the MP2 and CCSD(T) approximations has been applied to explain the hydrolysis trends for the Group 2 dications through the investigation of the structure and energetics of the model complexes with the water molecule. The parallel nonrelativistic calculations have been performed to show the possible role of the relativistic effect on the structure and hydrolysis of the heaviest metal cations. The calculated data are compared with the recent experimental results. © 2006 Wiley Periodicals, Inc. Int J Quantum Chem, 2006
Truncated mutants of human thioredoxin reductase 1 do not exhibit glutathione reductase activity
Authors: Urig Sabine , Lieske Johanna , Fritz-Wolf Karin , Irmler Angelika , Becker Katja
Published: May 2006

The substrate spectrum of human thioredoxin reductase (hTrxR) is attributed to its C‐terminal extension of 16 amino acids carrying a selenocysteine residue. The concept of an evolutionary link between thioredoxin reductase and glutathione reductase (GR) is presently discussed and supported by the fact that almost all residues at catalytic and substrate recognition sites are identical. Here, we addressed the question if a deletion of the C‐terminal part of TrxR leads to recognition of glutathione disulfide (GSSG), the substrate of GR. We introduced mutations at the putative substrate binding site to enhance GSSG binding and turnover. However, none of these enzyme species accepted GSSG as substrate better than the full length cysteine mutant of TrxR, excluding a role of the C‐terminal extension in preventing GSSG binding. Furthermore, we show that GSSG binding at the N‐terminal active site of TrxR is electrostatically disfavoured.
Oxidative damage of periodontal tissue in the rat periodontitis model: Effects of a high‐cholesterol diet
Authors: Tomofuji Takaaki , Azuma Tetsuji , Kusano Hiroki , Sanbe Toshihiro , Ekuni Daisuke , Tamaki Naofumi , Yamamoto Tatsuo , Watanabe Tatsuo
Published: May 2006

Studies suggest an association between consumption of a high‐cholesterol diet and periodontitis. We addressed the mechanism by which high dietary cholesterol could be detrimental to periodontal health in a rat model. Feeding a high‐cholesterol diet augmented the effects of bacterial pathogens and their products (e.g., lipopolysaccharide and proteases) on production of pro‐inflammatory cytokines in fibroblasts. High dietary cholesterol also increased mitochondrial 8‐hydroxydeoxyguanosine in the periodontal tissues. These results suggest that excessive tissue oxidative damage induced by high dietary cholesterol could potentiate pro‐inflammatory cytokine production by fibroblasts stimulated with bacterial pathogens.
Inhibition of Na,K‐ATPase‐suppressive activity of translationally controlled tumor protein by sorting nexin 6
Authors: Yoon Taesook , Kim Moonhee , Lee Kyunglim
Published: May 2006

Translationally controlled tumor protein (TCTP) has both extra‐ and intracellular functions. Our group recently reported that TCTP interacts with Na,K‐ATPase and suppresses its activity. Our studies led to the identification of sorting nexin 6 (SNX6) which binds with TCTP as a potential negative regulator of TCTP. SNX6 does not interact directly with any cytoplasmic domains of Na,K‐ATPase. However, when overexpressed, it restores the Na,K‐ATPase activity suppressed by TCTP. This was confirmed by measurements of purified plasma membrane Na,K‐ATPase activity after incubation with recombinant TCTP and SNX6. SNX6 alone has no effect on Na,K‐ATPase activity, but activates Na,K‐ATPase via inhibition of TCTP. Inhibition of endogenous TCTP by the overexpression of SNX6 or knockdown of TCTP expression by siTCTP increased Na,K‐ATPase activity above the basal level. The interaction between SNX6 and TCTP thus appears to regulate Na,K‐ATPase activity.
Monocyte chemoattractant protein (MCP‐1) is expressed in human cardiac cells and is differentially regulated by inflammatory mediators and hypoxia
Authors: Hohensinner Philipp J. , Kaun Christoph , Rychli Kathrin , Ben-Tal Cohen Enbal , Kastl Stefan P. , Demyanets Svitlana , Pfaffenberger Stefan , Speidl Walter S. , Rega Gersina , Ullrich Robert , Maurer Gerald , Huber Kurt , Wojta Johann
Published: May 2006

The chemokine MCP‐1 is thought to play a key role – among many other pathophysiological processes – in myocardial infarction. MCP‐1 is not only a key attractant for monocytes and macrophages and as such responsible for inflammation but might also be directly involved in the modulation of repair processes in the heart. We show that cultured human cardiac cells express MCP‐1 and that its expression is upregulated by inflammatory cytokines and downregulated by hypoxia. We hypothesize that inflammation but not hypoxia is the main trigger for monocyte recruitment in the human heart.
Predictors of preterm birth
Authors: Krupa F.G. , Faltin D. , Cecatti J.G. , Surita F.G.C. , Souza J.P.
Published: May 2006

Objective: This is a systematic review to assess published scientific evidence on preterm birth predictors. Methods: An Internet search for predictors of preterm birth was performed and the evidence level of each method was evaluated. Results: There is strong evidence that preterm birth can be predicted using vaginal sonography to evaluate cervical characteristics, fetal fibronectin in cervicovaginal secretions and interleukin‐6 in amniotic fluid. There is consistent evidence that digital cervical examination is a weak predictor, and controversy regarding home uterine activity monitoring. There is scanty evidence about the predictive ability of maternal history and perceptions of symptoms since the study design fails to provide high evidence level. Conclusion: Cervical evaluation by vaginal sonography, fetal fibronectin and interleukin‐6 are the best methods for predicting preterm birth.
Saline irrigation and wound infection in abdominal gynecologic surgery
Authors: Al ‐Ramahi M. , Bata M. , Sumreen I. , Amr M.
Published: May 2006

Objective: To evaluate whether saline wound irrigation decreases the incidence of wound infection following abdominal gynecologic surgery. Method: In this prospective randomized study, 104 patients underwent wound irrigation before wound closure following abdominal gynecologic surgery and 102 patients did not. Results: There were no significant differences between the 2 groups in patient characteristics or in factors influencing the incidence of wound infection after abdominal gynecologic surgery. The incidence of wound infection was 10.6% among women who underwent wound irrigation and 9.8% among those who did not, and the difference was not statistically significant. Conclusion: Saline wound irrigation before abdominal wall closure is not helpful in decreasing the incidence of wound infection after abdominal gynecologic surgery.
The Implications of “Pay‐for‐Performance” Reimbursement for Otolaryngology—Head and Neck Surgery
Authors: Cognetti David M. , Reiter David
Published: May 2006

OBJECTIVE

To introduce otolaryngologists to outcomes‐linked reimbursement (“pay‐for‐performance”), identify clinical practice implications, and recommend changes for successful transition from the traditional “pay‐for‐effort” reimbursement model.

STUDY DESIGN

Policy review.

RESULTS

Payers are actively linking reimbursement to quality. Since the Institute of Medicine issued its report on medical errors in 1999, there has been much public and private concern over patient safety. In an effort to base health care payment on quality, “pay‐for‐performance” programs reward or penalize hospitals and physicians for their ability to maintain standards of care established by payers and regulatory groups. More than 100 such programs are operational in the United States today. This reimbursement model relies on detailed documentation in specific patient care areas to facilitate evaluation of outcomes for purposes of determining reimbursement. Because performance criteria for reimbursement have not yet been proposed within otolaryngology—head and neck surgery, otolaryngologists must be involved to ensure the adoption of reasonable goals and development of reasonable systems for documentation.

CONCLUSION

“Pay‐for‐performance” reimbursement is increasingly common in the current era of outcomes‐based medicine. It will assume an even greater role over the next 3 years and will directly affect most otolaryngologists.
Combined Transtemporal Access for Large (>3 cm) Meningiomas of the Cerebellopontine Angle
Authors: Leonetti John P. , Anderson Douglas E. , Marzo Sam J. , Origitano Thomas C. , Schuman Rita
Published: May 2006

OBJECTIVES

Large meningiomas of the cerebellopontine angle present a formidable surgical challenge due to tumor vascularity, neural attachment, and brain stem compression. The purpose of this paper is to present our use of the combined transtemporal approach in the surgical treatment of 29 large meningiomas.

STUDY DESIGN AND SETTING

Twenty‐nine patients with large meningiomas of the CPA were surgically treated through a combined retrosigmoid‐transpetrosal‐transcochlear approach at our tertiary care academic medical center from July 1995 through July 2004. Data was collected from a retrospective medical records review.

RESULTS

Total tumor removal was achieved in 19 of 29 (67%) of the patients and the facial nerve was anatomically preserved in 26 of 29 (89%) of the cases. Cerebrospinal fluid leakage was seen in 3.5% of the patients and additional transient cranial nerve deficits were noted in 14% of the cases, but no significant neurologic sequelae occurred. Of the 10 patients with residual tumor, 6 have been stable without growth, 2 were treated with reoperation for regrowth of disease, and 2 were controlled with localized radiotherapy.

CONCLUSIONS

This combined lateral transtemporal approach provided wide exposure to the cerebellopontine angle and optimized the surgical extirpation of 29 large meningiomas presented in this series.
The Utility of Bipolar Electrocautery in Hereditary Hemorrhagic Telangiectasia
Authors: Ghaheri Bobak A. , Fong Karen J. , Hwang Peter H.
Published: May 2006

OBJECTIVE

The surgical treatment of epistaxis associated with hereditary hemorrhagic telangiectasia (HHT) is varied. Laser therapy is often inadequate for larger complex lesions. This study sought to determine if bipolar cautery can be effectively and safely used in treating HHT‐associated epistaxis.

STUDY DESIGN AND SETTING

Records from all patients with HHT treated surgically over 8 years were reviewed retrospectively. Outcomes or complications were noted in the clinic on follow‐up evaluation.

RESULTS

Twenty‐seven patients with HHT who underwent surgical treatment of epistaxis were evaluated; 18 were treated with bipolar cautery. Forty‐two separate bipolar treatments were performed. No new septal perforations or synechiae were noted. Twenty‐two of 42 treatments were coupled with ancillary laser treatments. The bipolar was also used as the sole technique in 20 procedures.

CONCLUSION

Bipolar electrocautery is a safe and effective tool for the intraoperative control of HHT‐related epistaxis.

SIGNIFICANCE

Bipolar electrocautery may be used as an adjunct to laser techniques or as a stand‐alone technique.
Conductive Hearing Loss and Otopathology in Cleft Palate Patients
Authors: Goudy Steven , Lott David , Canady John , Smith Richard J.H.
Published: May 2006

OBJECTIVES

Assess incidence of conductive hearing loss, ear pathology, and associated communicative disorders in cleft palate patients.

STUDY DESIGN

Retrospective chart review of 101 patients all treated at a tertiary facility since birth.

RESULTS

The median patient age was 19 years old (range 8–25) at last follow‐up, 35% female. Median age of cleft palate repair was 16 months (range 12–60). Median number of myringotomy tubes was 3 (range 1–7). Conductive hearing loss (CHL) greater than 20 db PTA was found in 25% of patients at last follow‐up. Severity of CHL was mild in 75%, moderate in 21%, and severe in 4%. Cholesteatoma was identified in 5.9%. The mean age at resolution of CHL was 5 years (range 3–19). Risk factors associated with CHL at last follow‐up included middle ear surgery (P = 0.016), cholesteatoma (P = 0.003), and 4 or more myringotomy tube insertions (P = 0.030). Associations between CHL and age at cleft repair, speech impairment, or learning disabilities were not found.

CONCLUSIONS

Children requiring increased number of myringotomy tubes and middle ear surgery and found to have cholesteatoma are at increased risk for long‐standing CHL.

EBM rating: C‐4

SIGNIFICANCE

Cleft palate children requiring multiple tube insertions should be monitored closely for CHL.
Gerbilline Cholesteatoma Development. Part II: Temporal Histopathologic Changes in the Tympanic Membrane and Middle Ear
Authors: Tinling Steven P. , Chole Richard A.
Published: May 2006

OBJECTIVE

Determine the sequence of gross and histopathologic change to the normal middle ear (ME), tympanic membrane (TM), and external auditory canal (EAC) during spontaneous gerbilline cholesteatoma development.

STUDY DESIGN AND SETTING

Sixty‐six gerbils were examined weekly and periodically sacrificed for analysis.

RESULTS

Cholesteatoma development followed this sequence: 1) slightly thickened pars flaccida (PF) without ME effusion, 2) thickened PF with ME effusion, 3) continuous buildup of EAC debris, and 4) complete occlusion of the lateral EAC. In the cholesteatoma group, keratinizing epithelium (KE) thickness was increased in all regions over normal controls and regional gradations in the TM remained the same.

CONCLUSION

Spontaneous cholesteatoma formation was significantly associated with middle ear effusion, a failure to clear canal debris with resultant retrograde thickening of the EAC, PF, and then pars tensa.

SIGNIFICANCE

Inflammatory insult and alteration of the epithelial clearance mechanism appears to result in spontaneous cholesteatoma formation in gerbils as hypothesized for humans.
Contemporary Surgical Management of HIV‐Associated Facial Lipoatrophy
Authors: Funk E. , Bressler F.J. , Brissett A.E.
Published: May 2006

OBJECTIVES

The purpose of this study is to describe our experience with facial volume restoration in 39 HIV‐associated facial lipoatrophy patients, and formulate a treatment algorithm that can be utilized for these patients based on their disease severity.

METHODS

Preoperative and postoperative photographs were evaluated by 2 experienced facial plastic surgeons using grading scales. The reviewers' scores were then compared and the distribution of scores was analyzed.

RESULTS

Thirty‐nine patients underwent malar silastic implantation. Seven patients required postoperative adjuvant filler injection. Most patients' results were rated good to excellent. There were 4 late complications.

CONCLUSION

HIV‐associated facial lipoatrophy is a socially disabling condition that causes noticeable disfigurement and stigmatizes the patient. We demonstrate the importance of combining a reliable grading scale with a strategic treatment algorithm that utilizes multiple modalities for volume restoration.
Patient Tolerance of In‐Office Pulsed Dye Laser Treatments to the Upper Aerodigestive Tract
Authors: Rees Catherine J. , Halum Stacey L. , Wijewickrama Rohan C. , Koufman Jamie A. , Postma Gregory N.
Published: May 2006

INTRODUCTION

Recent advances in technology have facilitated a movement toward unsedated in‐office treatment of laryngeal, tracheal, and esophageal lesions. The objective of this study was to determine patient tolerance of inoffice pulsed‐dye laser (PDL) treatment of upper aerodigestive tract pathoses via the transnasal esophagoscope.

METHODS

Three hundred twenty‐eight unsedated in‐office PDL cases were performed at a university‐based tertiary referral center in 131 patients. These procedures were performed for various upper aerodigestive pathoses, including recurrent respiratory papillomatosis, chronic granulomas, and recurrent leukoplakia. Eighty‐nine subjects completed a phone survey concerning their discomfort level after the PDL procedure. They were also asked specific questions about recovery time, pain medication, and preference of operating room versus inoffice procedures.

RESULTS

The average comfort score was 7.4 (10 being minimal discomfort). Eighty‐four percent did not use any pain medication; 87% stated that, if possible, they would prefer to undergo unsedated inoffice procedures rather than surgeries under general anesthesia for further treatment of their upper aerodigestive tract pathosis.

CONCLUSIONS

Unsedated transnasal treatment of upper aerodigestive tract pathoses is readily accepted and well‐tolerated by otolaryngology patients. Patients overwhelmingly prefer the inoffice PDL over surgeries under general anesthesia.
A Hormonal Association between Estrogen Metabolism and Proliferative Thyroid Disease
Authors: Chan Edwin K. , Sepkovic Daniel W. , Yoo Bowne Helen J. , Yu Guo Pei , Schantz Stimson P.
Published: May 2006

OBJECTIVE

To illustrate a relationship between proliferative thyroid disease and estrogen metabolism through the analysis of urinary estrogen metabolites.

STUDY DESIGN AND SETTING

Case‐control study of 49 subjects with proliferative thyroid disorders and matching them to 49 controls. Urinary estrogen metabolite ratios were obtained, measuring 2‐hydroxyestrone, an anti‐proliferative metabolite, to 16α‐hydroxyestrone, a proliferative metabolite. The patients were stratified into low (0 to 1.00), medium (1.01 to 2.00), or high (>2.00) groups according to their estrogen metabolite ratio.

RESULTS

Fifty‐one percent (25 of 49) of the cases had a low 2/16 ratio compared to 31% (15 of 49) in the control group while 20% (10 of 49) of the control group had a high 2/16 ratio as compared to 8% (4 of 49) in the case group (P value < 0.05).

CONCLUSIONS

Increased 16α‐hydroxyestrone activity compared to 2‐hydroxyestrone activity appears to be associated with proliferative thyroid disease.

SIGNIFICANCE

Further study of estrogen metabolites in relation to proliferative thyroid disease is warranted and may lead to implications for new treatment modalities for proliferative thyroid disease.
Prototype of a Silicon Nitride Ceramic‐Based Miniplate Osteofixation System for the Midface
Authors: Neumann Andreas , Unkel Claus , Werry Christoph , Herborn Christoh U. , Maier Horst R. , Ragoß Christian , Jahnke Klaus
Published: May 2006

OBJECTIVE

The favorable properties of silicon nitride (Si3N4) ceramics, such as high mean strength level and fracture toughness, suggest biomedical use as an implant material. Minor reservations about the biocompatibility of Si3N4 ceramics were cleared up by previous in vitro and in vivo investigations.

STUDY DESIGN AND SETTING

A Si3N4 prototype mini‐fixation system was manufactured and implanted for osteosynthesis of artificial frontal bone defects in 3 minipigs. After 3 months, histological sections, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans were obtained. Finite element modeling (FEM) was used to simulate stresses and strains on Si3N4 miniplates and screws to calculate survival probabilities.

RESULTS

Si3N4 miniplates and screws showed satisfying intraoperative workability. There was no implant loss, displacement, or fracture. Bone healing was complete in all animals. The formation of new bone was observed in direct contact to the implants. The implants showed no artifacts on CT and MRI scanning. FEM simulation confirmed the mechanical reliability of the screws, whereas simulated plate geometries regarding pullout forces at maximum load showed limited safety in a bending situation.

CONCLUSIONS

Si3N4 ceramics show a good biocompatibility outcome both in vitro and in vivo. In ENT surgery, this ceramic may serve as a biomaterial for osteosynthesis (eg, of the midface including reconstruction the floor of the orbit and the skull base). To our knowledge, this is the first introduction of a ceramic‐based miniplate‐osteofixation system. Advantages compared with titanium are no risk of implantation to bone with mucosal attachment, no need for explantation, and no interference with radiologic imaging. Disadvantages include the impossibility of individual bending of the miniplates.
Dysphagia after Sequential Chemoradiation Therapy for Advanced Head and Neck Cancer
Authors: Goguen Laura A. , Posner Marshall R. , Norris Charles M. , Tishler Roy B. , Wirth Lori J. , Annino Donald J. , Gagne Adele , Sullivan Christopher A. , Sammartino Daniel E. , Haddad Robert I.
Published: May 2006

OBJECTIVES

Assess impact of sequential chemoradiation therapy (SCRT) for advanced head and neck cancer (HNCA) on swallowing, nutrition, and quality of life.

STUDY DESIGN

Prospective cohort study of 59 patients undergoing SCRT for advanced head and neck cancer. Follow‐up median was 47.5 months.

SETTING

Regional Cancer Center.

RESULTS

Median time to gastrostomy tube removal was 21 weeks. Eighteen of 23 patients who underwent modified barium swallow demonstrated aspiration; none developed pneumonia. Six of 7 with pharyngoesophageal stricture underwent successful dilatation. Functional Assessment of Cancer Therapy—Head and Neck Scale questionnaires at median 6 months after treatment revealed “somewhat” satisfaction with swallowing. At the time of analysis, 97% have the gastronomy tube removed and take soft/regular diet.

CONCLUSION

Early after treatment dysphagia adversely affected weight, modified barium swallow results, and quality of life. Diligent swallow therapy, and dilation as needed, allowed nearly all patients to have their gastronomy tubes removed and return to a soft/regular diet.

SIGNIFICANCE

Dysphagia is significant after SCRT but generally slowly recovers 6 to 12 months after SCRT.
Does Otitis Media in Early Childhood Affect Reading Performance in Later School Years?
Authors: Golz Avishay , Thomas Westerman S. , Westerman Liane M. , Gilbert David A. , Netzer Aviram
Published: May 2006

OBJECTIVE

To evaluate reading performance in children with recurrent otitis media during childhood once middle‐ear diseases have resolved and the children grew older.

STUDY DESIGN AND SETTING

Seventy‐five children with middle‐ear problems during childhood and poor reading performance in first grades and 60 healthy controls free of middle ear diseases were enrolled in the study. All children underwent an otologic and audiologic evaluation followed by reading tests.

RESULTS

Reading performance was not affected once otitis media had been cured and hearing restored; reading scores of the healed children were almost the same as those of the otitis‐free children (3.39% and 3.1%, respectively). Children who still suffer from middle‐ear problems and hearing loss had an average percentage of reading mistakes of 7.3%.

CONCLUSIONS AND SIGNIFICANCE

Once children are cured from their middle‐ear diseases and hearing is restored, previously noted reading impairments are no longer evident. Reading is still impaired among children who continue to suffer from middle‐ear problems and hearing loss even when they grow older.
Giant Myxomas of the Maxillofacial Skeleton and Skull Base
Authors: DeFatta Robert J. , Verret Daniel J. , Ducic Yadranko , Carrick Kelley
Published: May 2006

OBJECTIVES

To review our experience with patients diagnosed with giant myxomas of the maxillofacial skeleton.

STUDY DESIGN

All patients undergoing excision of myxomas of the head and neck from September 1998 through September 2003 with a minimum follow‐up of 1 year by the senior author (YD) were included in the study.

METHODS

A retrospective chart review was conducted to select all patients who met the inclusion criteria. Clinical presentation, preoperative radiology findings, excisions performed, reconstruction, and follow‐up were recorded and reported.

RESULTS

Four patients were identified who met the inclusion criteria. All underwent wide en bloc excision of the tumor with various reconstructions. Complete resection was achieved in each case, and no patients have had evidence of recurrence.

CONCLUSIONS

Giant myxomas of the maxillofacial skeleton have been reported to have significant rates of recurrence. Wide en bloc resection with appropriate reconstruction can result in excellent quality of life postoperatively and minimize the risk of recurrence. Lesser resections may not be appropriate especially in giant myxomas because of the potential morbidity that would be associated with a multifocal recurrence.
Comparison of Serum Calcium Change Following Thyroid and Nonthyroid Neck Surgery
Authors: Mehta Nicholas , Watts Nelson B. , Welge Jeffrey A. , Steward David
Published: May 2006

OBJECTIVE

Compare serum calcium changes following thyroid and nonthyroid/parathyroid neck surgery.

STUDY DESIGN

Controlled historic cohort study of 190 patients undergoing total thyroidectomy (TT, n = 97), completion thyroidectomy (CT, n = 27), and lateral neck dissection (ND, n = 66).

RESULTS

Each group experienced significant corrected serum calcium drop pre‐op to POD #1 (mean change (mg/dL) TT = 0.97, CT = 0.79, ND = 0.46; all P < 0.001) with significantly greater drop in TT and CT (P < 0.0001). TT and ND had significantly greater calcium drop from pre‐op to PACU than CT (0.54, 0.43, 0.15; P = 0.04). TT and CT experienced significantly greater calcium drop from PACU to POD #1 than ND (0.45, 0.53, 0.05; P < 0.0001). No significant difference in hypocalcemia rate between TT and CT.

CONCLUSIONS

Perioperative calcium drop in nonthyroid neck surgery is likely hemodilutional, occurring intraoperatively, whereas in thyroid surgery it likely results from both hemodilution and parathyroid dysfunction with the latter manifesting after PACU. Postoperative calcium monitoring should be similar following total and completion thyroidectomy due to similar rates of hypocalcemia and mean calcium drops.
The Effectiveness of Tonsillectomy and Adenoidectomy in the Treatment of Pediatric Obstructive Sleep Apnea/Hypopnea Syndrome: A Meta‐Analysis
Authors: Brietzke Scott E. , Gallagher Daniel
Published: May 2006

OBJECTIVE

Present and evaluate the currently available literature reporting on the effectiveness of adenotonsillectomy (T/A) in treating obstructive sleep apnea/hypopnea syndrome (OSAHS) in uncomplicated pediatric patients.

STUDY DESIGN AND SETTING

Systematic review of the literature and meta‐analysis of the reduction of the polysomnogram (PSG)‐measured Apnea Hypopnea Index (AHI events/hour) resulting from T/A and the overall success rate of T/A in normalizing PSG measurements (%).

RESULTS

Fourteen studies met the inclusion criteria. Mean sample size was 28. All were case series (level 4 evidence). The summary change in AHI was a reduction of 13.92 events per hour (random effects model 95% CI 10.05–17.79, P < 0.001) from T/A. The summary success rate of T/A in normalizing PSG was 82.9% (random effects model 95% CI 76.2%–89.5%, P < 0.001).

CONCLUSION/SIGNIFICANCE

T/A is effective in the treatment of OSAHS. However, success rates are far below 100%, which could have far‐reaching pediatric public health consequences.
Taste Disturbance after Uvulopalatopharyngoplasty for Obstructive Sleep Apnea
Authors: Li Hsueh‐Yu , Lee Li‐Ang , Wang Pa‐Chun , Hsiao Han‐Ren , Hsu Chung‐Yao , Chen Ning‐Hung , Fang Tuan‐Jen
Published: May 2006

OBJECTIVES

This study investigated factors that may attribute to taste disturbance (TD) following uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA).

STUDY DESIGN

This longitudinal intervention study enrolled 108 patients who received UPPP for OSA. Patients who reported TD in the postoperative questionnaire were examined using the three‐drop‐method gustatory function test (GFT).

RESULTS

The GFT revealed that 5 patients (4.6%) reporting TD lost at least one of the four basic tastes 3 months after surgery. Deficiency of sweet sense was the most common type of TD (80%). The use of electrocautery for developing the uvulopalatal flap was the only significant predictor that may attribute to TD (odds ratio: 14.1). Repeating the GFT 9 months after operation showed a restoration of tastes in 4 patients.

CONCLUSIONS

Development of the uvulopalatal flap using electrocautery may increase the likelihood of postoperative TD. Patients with taste disturbance after UPPP may eventually recover their taste function over time.
Thermal Welding versus Bipolar Tonsillectomy: A Comparative Study
Authors: Karatzias George T. , Lachanas Vassilios A. , Sandris Vassilios G.
Published: May 2006

OBJECTIVE

To compare thermal welding tonsillectomy (TWT) with bipolar electrocautery tonsillectomy (BET) procedure.

STUDY DESIGN AND SETTING

A prospective randomized study was conducted on 150 consecutive adult patients undergoing tonsillectomy. Indications included chronic tonsillitis and obstructive sleep apnea syndrome. Exclusion criteria included peritonsillar abscess history, bleeding disorders, and any other procedure together with tonsillectomy. Patients were randomly assigned to TWT or BET groups. Intraoperative bleeding, operative time, postoperative pain, complication rates, and return to normal diet were evaluated.

RESULTS

In the TWT group there was no measurable intraoperative bleeding, while mean bleeding for BET group was 16 mL. No significant difference regarding mean operative time was noticed. Mean postoperative pain score and mean time for return to normal diet were significantly lower in the TWT group. Primary hemorrhage occurred in 1 subject of the BET group. Secondary postoperative hemorrhage was noticed in 1 subject of the TWT group and 3 subjects of the BET group.

CONCLUSION

Thermal welding tonsillectomy procedure provides sufficient hemostasis, lower postoperative pain, and quick return to normal diet.
Hearing Aids: A Review of What's New
Authors: Kim Harold H. , Barrs David M.
Published: May 2006

OBJECTIVE

To review the recent innovations in hearing aid technology.

STUDY DESIGN

Review of the literature.

SETTING

Private tertiary referral otology/neurotology practice.

RESULTS

Recent innovations including digital signal processing (DSP), directional microphone technology, and open mold hearing aid fitting have resulted in improved satisfaction with current hearing aids.

CONCLUSION

Current hearing aid technology with its innovations better meet needs of individuals who are hard of hearing.

SIGNIFICANCE

The image commonly held of hearing aids by the general public is a negative one that can be improved with greater education.
A fast workspace-density-driven inverse kinematics method for hyper-redundant manipulators
Authors: Wang Yunfeng
Published: May 2006

Hyper-redundant manipulators have a very large number of redundant degrees of freedom. They have been recognized as a means to improve manipulator performance in complex and unstructured environments. However, the high degree of redundancy also poses new challenges when performing inverse kinematics calculations. Prior works have shown that the workspace density (generated by sampling the joint space and evaluating the frequency of occurrence of the resulting end-effector reference frames) is a valuable quantity for use in ${\cal O}(P)$ inverse kinematics algorithms. Here $P$ is the number of modules in a manipulator constructed of a serial cascade of modules. This paper develops a new “divide-and-conquer” method for inverse kinematics using the workspace density. This method does not involve a high-dimensional Jacobian matrix and offers high accuracy. And its computational complexity is only ${\cal O}({\rm log}_2\,P)$, which makes it ideal for very high degree-of-freedom systems. Numerical simulations are performed to demonstrate this new method on a planar example, and a detailed comparison with a breadth-first search method is conducted.
Handling uncertainty due to the delay between complex sensing and manipulation in an industrial workcell
Authors: Liu Yanfei , Hoover Adam W. , Walker Ian D.
Published: May 2006

In this paper, we propose a generic method to model the dynamic intercept and manipulation capability of vision-based industrial robot systems. In order to verify the method, we present experiments using our industrial workcell prototype to dynamically intercept and manipulate semi-randomly moving objects.