bluuebunny/crossref_metadata_2025 huggingface dataset:
Retroauricular Hairline Incision for Removal of Upper Neck Masses
Authors: Roh Jong‐Lyel
Published: December 2005

Background/Objectives: The general population has been increasingly concerned about cosmesis and hopeless about prominent or invisible postoperative scars of the face and neck. The purpose of this study was to evaluate the benefit of a retroauricular hairline incision (RAHI) by comparing it with conventional cervical incision for removal of upper neck masses.

Study Design: Prospective clinical study.

Methods: Thirty‐four patients with upper neck masses were divided into two surgical groups of RAHI (17) and conventional cervical incision (17) matched by age, sex, marital status and size, location, pathology of lesions. The operation time, complications, length of hospital stay, and subjective satisfaction with incision scar checked by visual analogue scale were compared between groups.

Results: The lesions of each group were congenital cysts (6), abscesses (2), inflammatory masses (2), and benign (6) or malignant (1) tumors and located in the upper neck. Mean operation time was 51 ± 17 minute in the RAHI group and 41 ± 13 minutes in the controls (P = .064). Mean hospital stay and complication rates were comparable between groups. Mean score of patient's satisfaction was 8.9 ± 0.7 in the RAHI group and 4.5 ± 2.7 in the controls (P < .001). The degree of incision scarring did not differ between groups, but the scars were less visible in the RAHI group because of hiding by the auricle and hair.

Conclusions: The postauricular approach leading to a potentially invisible area of operation has a clear cosmetic benefit compared with conventional cervical incision. This will be helpful for patients with surgically indicated upper neck masses who hope for invisible incision scars.
The Jaundiced Gunn Rat Model of Auditory Neuropathy/Dyssynchrony
Authors: Shaia Wayne T. , Shapiro Steven M. , Spencer Robert F.
Published: December 2005

Objective: High levels of bilirubin are neurotoxic and may result in deafness or auditory neuropathy/auditory dyssynchrony (AN/AD). The jaundiced (jj) Gunn rat animal model of kernicterus has electrophysiologic and neuroanatomic abnormalities of brainstem auditory nuclei with normal cochlear microphonic recordings. We examined morphologic changes in the cochlea, spiral ganglion, and auditory nerve and relate these findings to current understanding of AN/AD.

Methods: At 15 days of age, jj and nonjaundiced (Nj) littermates were injected with sulfadimethoxine (sulfa) and killed 3 days later by transcardial perfusion. Sections were cut through decalcified temporal bones, cochlear nerves, and auditory brainstem and processed for light and electron microscopy and immunohistochemical localization of calbindin‐D and parvalbumin.

Results: Spiral ganglion neurons were severely degenerated with a paucity of myelinated axons in jj animals. Electron microscopy of the intramodilar auditory nerve revealed a lack of large caliber axons in jj‐sulfa versus Nj‐sulfa controls. Large diameter degenerating axons were characterized by an electron‐dense atrophied axis cylinder resembling an axonopathy.

Conclusions: Our findings of abnormal spiral ganglion cells and selective loss of large, myelinated auditory nerve fibers with no abnormalities in cochlear hair cells, support the sulfa‐treated jj Gunn rat as a model for bilirubin induced AN/AD. The paucity of large caliber neurons undermines temporal coding of auditory information and neural synchrony and demonstrates that in addition to brainstem auditory nuclei, spiral ganglion neurons are selectively vulnerable to bilirubin toxicity.
Confocal microscopy of the Peripheral Gustatory System: Comparison between Healthy Subjects and Patients Suffering from Taste Disorders during Radiochemotherapy
Authors: Just Tino , Pau Hans Wilhelm , Bombor Ingmar , Guthoff Rudolf F. , Fietkau Rainer , Hummel Thomas
Published: December 2005

Objectives: Laser‐scanning microscopy (LSM) was used to compare taste buds and epithelia of fungiform papillae of healthy subjects with those of patients suffering from taste disorders during/after radiochemotherapy (RCT). Aim of the study was to investigate effects responsible for taste loss at a microscopic level.

Study Design: Prospective study.

Methods: Data from 12 healthy subjects (mean age 52.4, SD 9.5 years) were compared with those of 12 patients (mean age 54.7, SD 8.5 years) with head and neck cancer suffering from taste disorders during RCT. Four parameters from LSM were selected for analysis: 1) distance between the pore of the taste buds of fungiform papillae and the crest of the papillary vessels; 2) epithelial cells of each taste bud at 34 μm; 3), cell density, and 4) area of the taste pore at 4 μm. These data were correlated to measures of gustatory sensitivity obtained with both the validated “taste strips” test kit and electrogustometry.

Results: Patients complaining from taste disorders during RCT exhibited a significant decrease of taste function assessed with both natural and electric stimuli. In these patients, we found thicker epithelia and smaller areas of the taste pores compared with healthy subjects. In 30% of those patients, no taste pores were detectable; in deeper sections, however, normal taste buds were present.

Conclusions: In conclusion, in RCT patients with taste disorders, LSM indicates changes of epithelia of fungiform papilla but no changes of the taste bud structure. Damage of the chorda tympani nerve by scattered rays, direct or indirect mucotoxic effects of chemotherapeutic agents, and covering of taste pores by epithelial cells are likely reasons for taste loss during RCT.
Does Severity of Obstructive Sleep Apnea/Hypopnea Syndrome Predict Uvulopalatopharyngoplasty Outcome?
Authors: Friedman Michael , Vidyasagar Ramakrishnan , Bliznikas Darius , Joseph Ninos
Published: December 2005

Objectives:Uvulopalatopharyngoplasty (UP3) is the single most commonly performed surgical procedure for the treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS), but its success is limited. Our objective was to determine whether severity of disease of OSAHS based on polysomnography (PSG) data (apnea/hypopnea index [AHI]) is a significant factor in predicting successful treatment by UP3. In addition, we compared anatomic staging with severity of disease to determine which is the better predictor of success.

Study Design:A retrospective chart review of 134 patients who underwent UP3 as an isolated procedure for the treatment of OSAHS in a tertiary university‐affiliated medical center.

Results:Forty‐five patients had mild disease with an AHI less than 20. The surgical success rate (defined as a 50% reduction in AHI and a postoperative AHI of < 20) was 26.7%. There were 40 patients with moderate disease (AHI 20–40) who had a surgical success rate of 42.5%. There were 49 patients with severe disease (AHI < 40) with a surgical success rate of 26.5%. The same patients were analyzed by the Friedman Staging System using anatomic findings without incorporating the severity of disease. Results indicated the following. Stage I had a success rate of 80.6%, stage II patients had a success rate of 37.9%, and stage III had a success rate of 8.1%. Assessment of severity within each stage did not affect outcome.

Conclusions:Patients with mild disease based on PSG data do not have a better chance of successful treatment than patients with severe disease. Severity of disease should not be incorporated in the staging system. The Friedman Staging System based on anatomic factors is superior to severity of disease as a predictor of successful UP3.
Quality of Life and Head and Neck Cancer: A 5 Year Prospective Study
Authors: Abendstein Helmut , Nordgren Mats , Boysen Morten , Jannert Magnus , Silander Ewa , Ahlner‐Elmqvist Marianne , Hammerlid Eva , Bjordal Kristin
Published: December 2005

Objectives: Assessment of health‐related quality of life (HRQL) in head and neck cancer patients from diagnosis to 5 years after start of treatment.

Study Design: A prospective, descriptive study

Methods: three hundred fifty‐seven patients from Norway and Sweden filled in HRQL questionnaires, the European Organisation for Research and Treatment of Cancer (EORTC) QLQ–C30 and the EORTC QLQ‐H&N35, six times during the first year and then after 5 years. At 5 years, 167 (87%) of the 192 living patients filled in questionnaires.

Results: Group data: clinical significant improvements in HRQL were not found between 1 and 5 years. Problems with teeth, opening of the mouth, dryness in the mouth, and sticky saliva were persistent or worsening. Similar findings were found regardless of sex, age, stage, or site when clinical significant changes are considered. Patients who died between 1 and 5 years reported reduced HRQL on 15 of 28 scales at 1 year compared with the survivors. Individual data: 40% of patients reported improved global HRQL from diagnosis to 5 years after start of treatment. In addition, 11% had “top scores” at both assessment points. The pattern in global HRQL scores also applies for most of the other function and symptom scales.

Conclusion: After the first year after treatment, recovery of the persisting side effects of treatment cannot be expected for the group as a whole. Patients must be prepared for this. Some individual patients experience improvement in global HRQL. HRQL assessments in daily clinical practice can identify patients who are in need of additional support and symptom relief.
Spontaneous Temporomandibular Joint Herniation into the External Auditory Canal: A Case Report and Review of the Literature
Authors: Moriyama Masaomi , Kodama Satoru , Suzuki Masashi
Published: December 2005

Objectives: Case report of a man presenting with spontaneous temporomandibular joint (TMJ) herniation into the external auditory canal (EAC).

Study Design: Case report and literature review.

Methods: A case report of a patient with spontaneous TMJ herniation into the EAC is presented.

Results: The patient was a 41‐year‐old man complaining of tinnitus in his right ear. Examination revealed that the anterior wall of the bony EAC moved backward when the patient's mouth was closed and forward when opened, causing the resultant discomfort. In this case, surgery was performed, resulting in a good outcome with no complications. Thirteen other cases of spontaneous TMJ herniation into the EAC were found in the literature.

Conclusion: Few cases of spontaneous TMJ herniation into the EAC have been reported; however, if surgical treatment is desired, we should comply with the patient's request.
Comparison of Open Dilatational Tracheostomy with Conventional Pediatric Tracheostomy in a Growing Animal Model
Authors: Baek Chung‐Hwan , Chung Young‐Jun , Jeong Han‐Sin , Kim Sang‐Woo
Published: December 2005

Objectives: To compare the tracheal changes after applying a new open dilatational tracheostomy (ODT) technique with those from a conventional open tracheostomy (COT) with vertical cartilage incision in a growing animal model.

Study Design: Prospective, experimental investigation in a rabbit model.

Materials and Methods: Thirteen New Zealand white rabbits as a pediatric model were divided into three groups: six rabbits had COT (n = 6), another six underwent an ODT (n = 6), and one rabbit acted as a control. Each rabbit underwent tracheostomy by assigned procedures on the first day. On day 8, they were decannulated. On day 15, their tracheas were harvested. We examined the gross findings and histologic changes of each tracheal segment at the stomal level. In addition, we analyzed three parameters: the quotient of the stomal and nonstomal segment in sagittal diameter, coronal diameter, and cross‐sectional area.

Results: The framework of cartilages at the stomal level were more distorted in the COT group. Histologic examination also showed buckling of the anterior tracheal wall, loss of cartilage, infiltration by many polymorphonuclear neutrophils, and the marked ingrowth of fibrous tissue in the COT group. Sagittal and coronal diameters and cross‐sectional areas were significantly affected more severely after a COT than after an ODT.

Conclusion: Our new modification of percutaneous dilatational tracheostomy, named “open dilatational tracheostomy,” was successfully applied to a small, growing animal model and showed more favorable and consistent healing of trachea compared with COT. Therefore, the authors' new tracheostomy procedure could be applied to children who require short‐term tracheostomy at any age in clinical settings.
Predictive Factors for Posterior Triangle Metastasis in HNSCC
Authors: McDuffie Chad M. , Amirghahari Nazanin , Caldito Gloria , Lian Timothy S. , Thompson Luke , Nathan Cherie‐Ann O.
Published: December 2005

Objective: Surgical modifications sparing uninvolved structures such as the spinal accessory nerve have been implemented since the advent of the radical neck dissection in 1906. The increased morbidity to the spinal accessory nerve involved with the dissection of level V lymph nodes has led to much controversy. In this study, we examine the incidence of nodal metastasis to all nodal levels involved with upper aerodigestive squamous cell carcinoma and attempt to determine when level V dissection is indicated.

Study Design: Retrospective chart review.

Methods: A study of all radical and modified radical neck dissections was performed at Louisiana State University ‐ Shreveport Health Sciences Center and Overton Brooks Veterans Administration Hospital between 1996 and 2003 for upper aerodigestive squamous cell carcinoma. Univariate and multivariate analyses were performed to determine which neck and patient factors were significantly associated with level V metastasis.

Results: Seventy–nine patients with a total of 94 neck dissections were analyzed. The prevalence of level V metastasis was 7.4% of the total neck dissections. Multivariate analysis found that positive lymph nodes involving levels II, III, and IV was the only independent significant factor for level V metastasis (P = .0003).

Conclusion: Our study is in concordance with other studies in the literature, revealing a low prevalence of level V metastasis in upper aerodigestive squamous cell carcinoma. Unlike other studies, we have found if levels II, III, and IV lymph nodes are found to be positive, dissection of level V is warranted.
Objective Computerized versus Subjective Analysis of Facial Synkinesis
Authors: Wu Zhenqing B. , Silverman Carol A. , Linstrom Christopher J. , Tessema Belachew , Cosetti Maura K.
Published: December 2005

Objectives/Hypothesis: To compare the sensitivity of an objective, computerized approach to measurement of facial synkinesis with that for a subjective approach and to examine the test‐retest reliability of these approaches.

Study Design: Prospective, nonrandomized, and blinded.

Methods: Remote facial motion at the upper eyelids and oral commissures during a closed‐lip smile and eyelid closure were measured using a commercially available computerized motion analysis system. Thirty healthy adults with normal facial nerve function were enrolled to establish normative data and a threshold value for synkinesis. Thirty consecutive patients were analyzed based on the synkinesis threshold value. Blinded subjective evaluations by two observers were also performed independently on the same patients.

Results: Facial synkinesis was detected significantly more frequently with objective than subjective analysis for eyelid closure; no significant differences between approaches were shown for the closed‐lip smile. Interestingly, five (17%) patients developed early synkinesis within 3 months from the onset of the facial nerve injury. The test‐retest reliability of all objective measures was excellent for both expressions. Close agreement in percent of patients with synkinesis between test and retest subjective evaluations was obtained for both observers for both expressions.

Conclusions: The objective, computerized approach to detection of facial synkinesis has excellent reliability and is more sensitive than the subjective approach to assessment to the presence of facial synkinesis associated with eyelid closure. The finding of early synkinesis suggests that central nervous reorganization plays a role in regeneration of the facial nerve.
Predictive Factors and Outcomes in Endoscopic Sinus Surgery for Chronic Rhinosinusitis
Authors: Smith Timothy L. , Mendolia‐Loffredo Sabrina , Loehrl Todd A. , Sparapani Rodney , Laud Purushottam W. , Nattinger Ann B.
Published: December 2005

Purpose:To assess objective and quality of life (QOL) outcomes before and after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS) and to determine preoperative factors that predict surgical outcome in these patients.

Methods:One hundred nineteen adult patients with CRS and a mean follow‐up of 1.4 ± 0.35 years were evaluated prospectively including the following patient factors: prior sinus surgery, polyps, asthma, acetylsalicylic acid intolerance (ASA), smoking, allergy, depression, and sex. Computed tomography (CT), endoscopy, and QOL assessment was performed. Predictive value of patient factors was determined based on change in endoscopy and QOL scores after ESS.

Results:Objective outcomes: preoperative CT scores were significantly worse in patients with polyps, asthma, and ASA, whereas CT score was unaffected by prior sinus surgery, smoking, allergy, depression, and sex. Patients with CRS demonstrated significant improvement on nasal endoscopy after ESS, but preoperative, postoperative, and change in scores were affected by certain patient factors. Endoscopy scores were significantly worse in patients with prior sinus surgery, polyps, asthma, and ASA, but these patients also experienced the greatest improvement in endoscopy scores. Smokers and patients with depression had the least change in endoscopy scores. QOL outcomes: patients with CRS experienced improvement in QOL after ESS. Pre‐ and postoperative QOL was positively affected by polyps and adversely affected by ASA, depression, and female sex, but these groups still experienced significant improvement in QOL scores. Pre‐ and postoperative QOL was unaffected by prior sinus surgery, asthma, smoking, and allergies, and all of these groups experienced significant improvement in QOL scores. Factors predictive of outcome: ASA and depression were predictive of worse outcome. Preoperative CT scores approached significance as being predictive of outcome.

Conclusion:Surgical management of CRS was associated with significant improvement on objective and QOL measures; however, specific patient factors, in particular ASA and depression, predict poorer outcome. Preoperative CT may be a predictor of endoscopic and QOL outcome and deserves further study.
Utility of a Three‐Item Smell Identification Test in Detecting Olfactory Dysfunction
Authors: Jackman Alexis H. , Doty Richard L.
Published: December 2005

Objective: Physicians rarely assess smell function, largely because of time considerations. Therefore, there is clinical need for very brief cranial nerve I screening tests. Although a few such tests exist, none have been adequately validated. The goal of this study was to empirically assess the utility of a three‐item microencapsulated odor identification test in detecting olfactory dysfunction.

Setting: Smell and taste center at a university medical center.

Methods: The test was administered to 224 consecutive patients (98 men and 126 women ranging in age from 15–88 years). As part of their overall assessment, the well‐validated 40‐item University of Pennsylvania Smell Identification Test (UPSIT) was also administered. Sensitivity, specificity, and both negative and positive predictive values of the three‐item test were established relative to UPSIT dysfunction categories. Test‐retest reliability was determined in a subset of 39 patients.

Results: The three‐item test was abnormal in 99% (67/68) of patients with anosmia, 85% (35/41) of those with severe microsmia, 76% (31/41) of those with moderate microsmia, and 50% (17/34) of those with mild microsmia. Of the 40 normosmic patients, 62.5% (25/40) correctly identified all odors, 25% (10/40) two odors, and 12.5% (5/40) one odor. None of the normosmic patients missed all three items. Using a cut‐off score of 2, the test's sensitivity and specificity were 99% and 40%, respectively, for detecting total anosmia. The corresponding negative and positive predictive values were 98% and 43%. For detecting anosmia and severe microsmia, these values were 93%, 45%, 88%, and 63%. For detecting any olfactory pathology, they were 82%, 63%, 42%, and 91%. The test‐retest reliability was 0.87.

Conclusion: The brief three‐item test used in this study was found to be highly sensitive in identifying olfactory loss in patients with chemosensory complaints, particularly those with severe dysfunction. Although only moderately specific, its high reliability and negative predictive value suggests it may be an appropriate screening test for olfactory loss.
Linking of Bone Morphogenetic Protein‐2 To Resorbable Fracture Plates for Enhancing Bone Healing
Authors: Shibuya Terry Y. , Wadhwa Ashish , Nguyen Kevin H. , Panossian Abraham M. , Kim Sanghun , Wong Hausin , Feinberg Steven , Damisah Eyiyemisi C. , Camilon P Ryan , Bang Hoang
Published: December 2005

Objective: To test whether bone morphogenetic protein (BMP)‐2 may be covalently linked to resorbable fracture repair plates using an ester‐hydrolysis reaction and determining whether the linked compound can facilitate bone growth.

Study Design: Laboratory in vitro experiments.

Method: Resorbable fracture repair plates were partially hydrolyzed using varying concentrations of acid or base. This intermediate was then reacted with EDAC (1‐ethyl‐3[‐3‐dimethylamino propyl carbodiimide) to form an EDAC intermediate, which was then reacted with either horseradish peroxidase (HRP), interleukin (IL)‐2, or BMP‐2. Compound binding to the plate was confirmed by immunofluorescent staining. Confirmation of protein function was determined by the following assays: HRP's ability to cleave peroxide, IL‐2's ability to stimulate lymphocytes, and BMP‐2's ability to stimulate C3H10T1/2 cells to generate alkaline phosphatase.

Results: Three compounds (HRP, IL‐2, and BMP‐2) were successfully linked to plates as confirmed by immunofluorescence staining or functional testing. Compounds demonstrated better covalent linking to plates under basic conditions. HRP, IL‐2, and BMP‐2 retained function after binding as measured by cleaved peroxide levels, lymphocytes proliferation, and alkaline phosphatase production.

Conclusions: Covalent linking of compounds such as HRP, IL‐2, and BMP‐2 to resorbable plates is possible and represents a novel protein delivery technique. BMP‐2 covalently linked to resorbable plates may be used to facilitate bone healing. Covalent linking of compounds to plates represents a novel method for delivering concentrated levels of growth factors to a specific site and potentially extending their half‐life. Further investigation into this application for bone healing may lead to quicker healing.
N‐Acetyltransferase 2 Gene Polymorphism and Presbycusis
Authors: Ünal Murat , Tamer Lülüfer , Doğruer Zeynep Nil , Yildirim Hatice , Vayisoğlu Yusuf , Çamdeviren Handan
Published: December 2005

Objectives/Hypothesis: The enzyme of N‐acetyltransferase (NAT) is involved in the metabolism and detoxification of cytotoxic and carcinogenic compounds as well as reactive oxygen species (ROS). The excessive amount of ROS generation occurs in the ageing inner ear. The exact etiopathogenesis of presbycusis is not known, but it is generally accepted that it is the result of series of insults, such as physiologic age‐related degeneration, noise exposure, medical disorders and their treatment, as well as hereditary susceptibility. The effect of aging shows a wide interindividual range; we aimed to investigate whether profiles of NAT2 genotypes may be associated with the risk of presbycusis.

Study Design: Hospital‐based, case‐control study.

Methods: We examined 68 adults with presbycusis and 98 healthy controls. DNA was extracted from whole blood, and the polymorphisms of NAT2*5A, NAT2*6A, NAT2*7A/B, and NAT2*14A were determined using a real‐time polymerase chain reaction and fluorescence resonance energy transfer with a Light‐Cycler Instrument. Associations between specific genotypes and the development of presbycusis were examined by use of logistic regression analyses to calculate odds ratios and 95% confidence intervals.

Results: Gene polymorphisms at NAT2*5A, NAT2*7A/B, and NAT2*14A in subjects with presbycusis were not significantly different from in the controls (P > .05). However, in NAT2*6A, the risk of presbycusis was 15.2‐fold more in individuals with mutant allele than subjects with wild genotype (P = .013). Individuals with NAT2*6A heterozygote allele had a 0.34‐fold less risk in the development of presbycusis than subjects with mutant allele (P = .032)

Conclusion: We demonstrated a significant association between the NAT2*6A polymorphism and age‐related hearing loss in this population. However, the sample size was relatively small, and further studies need to investigate the exact role of NAT2 gene polymorphism in the etiopathogenesis of the presbycusis.
Sinonasal Leiomyosarcoma: Review of Literature and Case Report
Authors: Ulrich Christian T. , Feiz‐Erfan Iman , Spetzler Robert F. , Isaacs Jeffrey D. , Hott Jonathan S. , Nakaji Peter , Coons Stephen W. , Joganic Edward J. , Kresl John J. , Milligan John M. , Lettieri Salvatore C.
Published: December 2005

Objectives/Hypothesis: To determine prognosis of primary sinonasal leiomyosarcomas after treatment.

Study Design: Literature review and case report.

Methods: Review of English literature from MEDLINE and independent sources with the addition of our case.

Results: Including our case, 63 cases have been reported. Primary treatment includes resection with or without radiation. Chemotherapy has not been reported to be effective. In our case, however, chemotherapy, consisting of etoposide and high‐dose ifosfamide, caused the tumor to shrink significantly. On the basis of a review of all reported cases, the overall survival rate at a mean follow‐up of 38.24 month is 66%. The minimal overall survival rates at 5 and 10 years are 20% and 6%, respectively.

Conclusion: The prognosis for primary sinonasal leiomyosarcomas is poor. However, a 10–year survival has been reported in a few patients. Chemotherapy may be a useful adjunct when managing extensive lesions unamenable to curative resection.
Antivascular Therapy of Oral Tongue Squamous Cell Carcinoma with PTK787
Authors: Yazici Yasemin D. , Kim Seungwon , Jasser Samar A. , Wang Zhuoying , Carter Kenny B. , Bucana Corazan D. , Myers Jeffrey N.
Published: December 2005

Objectives/Hypothesis: Vascular endothelial growth factor (VEGF) is an important mediator in tumor vascularization, growth, and metastasis. We investigated whether blockade of the VEGF receptor (VEGF‐R) signaling pathway by the tyrosine kinase inhibitor PTK787 combined with CPT‐11, a semisynthetic camptothecin analogue, can inhibit the tumor growth and angiogenesis of squamous cell carcinoma of the oral tongue in an orthotopic nude mouse model.

Methods: JMAR human oral squamous cell carcinoma cells were injected into the tongues of nude mice. Seven days later, the mice were randomized to receive a placebo, daily oral PTK787, weekly CPT‐11 injection, or PTK787 plus CPT‐11. After 4 weeks of treatment, the mice underwent necropsy, and the tongue tumors, cervical lymph nodes, and lungs were removed for immunohistochemical analyses.

Results: CPT‐11, PTK787, and PTK787 plus CPT‐11 significantly decreased tumor volumes and prolonged survival. The combination treatment group had the most significant decrease in volume and increase in survival. PTK787 alone or in combination with CPT‐11 reduced the phosphorylation of VEGF‐R in tumor cells and tumor‐associated endothelial cells, was associated with decreased microvessel density, a decreased proliferative index, and an increased apoptotic index. PTK787 alone or the combination therapy resulted in apoptosis of both tumor cells and tumor‐associated endothelial cells.

Conclusions: These results suggest that targeting VEGF‐R tyrosine kinase activity can be an effective therapeutic approach in squamous cell carcinoma of the oral tongue.
Transnasal, Endoscopic Vocal Fold Augmentation
Authors: Trask Douglas K. , Shellenberger D Luke , Hoffman Henry T.
Published: December 2005

The practice of injection laryngoplasty under local anesthesia has become more common as both the indications for the procedure and the number of injectable substances increased. Modifications to the injection techniques used for vocal fold augmentation have been described over the last decade that reflect changes in the established percutaneous and transoral approaches. These percutaneous and transoral injection techniques for the treatment of dysphonia secondary to glottic incompetence are well described and provide an adequate approach for most cases. However, these traditional methods may be difficult to master, require great patient tolerance, and may be impossible to perform when anatomic or physiologic barriers exist. We describe a new application of the fiberoptic transnasal endoscope to perform laryngeal injection using a flexible needle through a port in the endoscope. This technique is easily mastered and readily tolerated by patients who would not be candidates for the other injection techniques under local anesthesia. We present our favorable experience with this technique and identify its shortcomings coupled with recommendations to address future technical modifications.
Prevalence of Laryngeal Irritation Signs Associated with Reflux in Asymptomatic Volunteers: Impact of Endoscopic Technique (Rigid vs. Flexible Laryngoscope)
Authors: Milstein Claudio F. , Charbel Samer , Hicks Douglas M. , Abelson Tom I. , Richter Joel E. , Vaezi Michael F.
Published: December 2005

Objectives: The objectives of this study were to 1) determine the prevalence of ENT findings in the normal asymptomatic population and 2) to compare findings between flexible and rigid laryngoscopes in an attempt to increase specificity of diagnosis of reflux in endoscopic laryngeal examinations.

Study Design: Prospective study.

Methods: Fifty‐two nonsmoker volunteers (24 male, 28 female), mean age of 42.7 years, with no history of ENT abnormalities or gastroesophageal reflux disease, underwent both rigid and flexible videolaryngologic examinations with a digital endoscopic unit. A group of three expert judges reviewed the oral and transnasal examinations blindly and independently for physical signs of irritation/inflammation commonly associated with reflux.

Results: Atleast one sign of tissue irritation was detected in 93% and 83% of the population when using a flexible and a rigid laryngoscope, respectively. Results showed a high incidence of posterior commissure bar (53.2% and 51.9%), arytenoid complex edema/erythema (76.3% and 53.2%), and pseudosulcus (37.2% and 7.7%). Most signs were more frequently detected on flexible transasal examinations than with rigid transoral examinations: posterior pharyngeal wall (<0.01), interarytenoid irritation (<0.01), arytenoids complex irritation (<0.01), ventricular obliteration (<0.01), and pseudosulcus (<0.01).

Conclusions: Several signs of posterior laryngeal irritation (e.g., interarytenoid bar, erythema of the medial wall of the arytenoids), which are generally considered to be signs of laryngopharyngeal reflux, are present in a high percentage of nonsymptomatic individuals, raising question about their diagnostic specificity. In addition, these signs were more often detected with flexible than with rigid laryngoscopes, suggesting that flexible laryngoscopy is more sensitive but less specific in identifying laryngeal tissue irritation.
A ChemoSensory Questionnaire for Patients Treated for Cancer of the Head and Neck
Authors: Goldberg Andrew N. , Shea Judy A. , Deems Daniel A. , Doty Richard L.
Published: December 2005

Objectives: To investigate primary chemosensory issues experienced by patients who undergo treatment for cancer of the head and neck and to develop and assess a ChemoSensory Questionnaire (CSQ).

Design: Cross sectional survey for questionnaire development and testing.

Methods: Literature, expert opinion, and focus group methodology were used to identify aspects of smell and taste affecting patients before, during, and after therapy for cancer of the head and neck. A draft instrument was compiled, reviewed, and revised. The revised instrument was administered along with a demographic and clinical form, the SF‐12, the Performance Status Survey, and the University of Michigan Head and Neck Quality of Life Questionnaire (HRQOL) to a sample of patients. After item and scale analyses and reductions, a final instrument was assembled. Construct validity and test‐retest reliability were assessed.

Results: Two hundred six patients were included in the study. The final survey instrument consisted of eight items, four on smell and four on taste. Cronbach's alpha was 0.89 for the smell scale and 0.78 for the taste scale. Correlations with other HRQOL scales ranged from 0.20 to 0.64 for the taste scale and from 0.10 to 0.33 for the smell scale. Good construct validity of the CSQ scores was demonstrated.

Conclusions: Treatment for head and neck cancer negatively impacts smell and taste. A survey instrument was developed to evaluate chemosensory function that is simple to administer and is brief. This instrument will be of value in identifying factors that contribute to chemosensory disturbance and may serve as a guide for planning treatment regimens that minimize such disturbance.
Space and contact networks: capturing the locality of disease transmission
Authors: Parham Paul E , Ferguson Neil M
Published: December 2005

While an arbitrary level of complexity may be included in simulations of spatial epidemics, computational intensity and analytical intractability mean that such models often lack transparency into the determinants of epidemiological dynamics. Although numerous approaches attempt to resolve this complexity–tractability trade-off, moment closure methods arguably offer the most promising and robust frameworks for capturing the role of the locality of contact processes on global disease dynamics. While a close analogy may be made between full stochastic spatial transmission models and dynamic network models, we consider here the special case where the dynamics of the network topology change on time-scales much longer than the epidemiological processes imposed on them; in such cases, the use of static network models are justified. We show that in such cases, static network models may provide excellent approximations to the underlying spatial contact process through an appropriate choice of the effective neighbourhood size. We also demonstrate the robustness of this mapping by examining the equivalence of deterministic approximations to the full spatial and network models derived under third-order moment closure assumptions. For systems where deviation from homogeneous mixing is limited, we show that pair equations developed for network models are at least as good an approximation to the underlying stochastic spatial model as more complex spatial moment equations, with both classes of approximation becoming less accurate only for highly localized kernels.
Acoustic and vibrational damping in porous solids
Authors: Göransson Peter
Published: December 2005

A porous solid may be characterized as an elastic–viscoelastic and acoustic–viscoacoustic medium. For a flexible, open cell porous foam, the transport of energy is carried both through the sound pressure waves propagating through the fluid in the pores, and through the elastic stress waves carried through the solid frame of the material. For a given situation, the balance between energy dissipated through vibration of the solid frame, changes in the acoustic pressure and the coupling between the waves varies with the topological arrangement, choice of material properties, interfacial conditions, etc.

Engineering of foams, i.e. designs built on systematic and continuous relationships between polymer chemistry, processing, micro-structure, is still a vision for the future. However, using state-of-the-art simulation techniques, multiple layer arrangements of foams may be tuned to provide acoustic and vibrational damping at a low-weight penalty.

In this paper, Biot's modelling of porous foams is briefly reviewed from an acoustics and vibrations perspective with a focus on the energy dissipation mechanisms. Engineered foams will be discussed in terms of results from simulations performed using finite element solutions. A layered vehicle-type structure is used as an example.
X-ray tomography and three-dimensional image analysis of epoxy-glass syntactic foams
Authors: Maire Eric , Gimenez Nelly , Sauvant-Moynot Valérie , Sautereau Henry
Published: December 2005

Syntactic foams (glass hollow spheres embedded in an epoxy matrix) were produced on purpose to be used as test materials for the present study. Two kinds of spheres (MS1 and MS2) were adjoined to a same polymer matrix, MS1 with a volume fraction of 55 and MS2 with 30 and 55%. The samples were analysed by X-ray tomography using synchrotron radiation. The three-dimensional images were used to observe the qualitative differences between the three samples. Three-dimensional image processing was then carried out to quantify the differences. The images were used to retrieve the fraction of the different phases which was in fairly good agreement with the expected values. The external and internal diameter of the spheres and their thickness were also measured. The MS1 spheres are smaller, thicker and their size distribution is less homogeneous compared to the MS2. The size distribution of the spheres before blowing was retrieved and evidenced to be similar for the two kinds of spheres. The thickness depends only weakly on the diameter of the spheres.
Multifunctional periodic cellular metals
Authors: Wadley Haydn N.G
Published: December 2005

Periodic cellular metals with honeycomb and corrugated topologies are widely used for the cores of light weight sandwich panel structures. Honeycombs have closed cell pores and are well suited for thermal protection while also providing efficient load support. Corrugated core structures provide less efficient and highly anisotropic load support, but enable cross flow heat exchange opportunities because their pores are continuous in one direction. Recent advances in topology design and fabrication have led to the emergence of lattice truss structures with open cell structures. These three classes of periodic cellular metals can now be fabricated from a wide variety of structural alloys. Many topologies are found to provide adequate stiffness and strength for structural load support when configured as the cores of sandwich panels. Sandwich panels with core relative densities of 2–10% and cell sizes in the millimetre range are being assessed for use as multifunctional structures. The open, three-dimensional interconnected pore networks of lattice truss topologies provide opportunities for simultaneously supporting high stresses while also enabling cross flow heat exchange. These highly compressible structures also provide opportunities for the mitigation of high intensity dynamic loads created by impacts and shock waves in air or water. By filling the voids with polymers and hard ceramics, these structures have also been found to offer significant resistance to penetration by projectiles.
Coronal magnetohydrodynamic waves and oscillations: observations and quests
Authors: Aschwanden Markus J
Published: December 2005

Coronal seismology, a new field of solar physics that emerged over the last 5 years, provides unique information on basic physical properties of the solar corona. The inhomogeneous coronal plasma supports a variety of magnetohydrodynamics (MHD) wave modes, which manifest themselves as standing waves (MHD oscillations) and propagating waves. Here, we briefly review the physical properties of observed MHD oscillations and waves, including fast kink modes, fast sausage modes, slow (acoustic) modes, torsional modes, their diagnostics of the coronal magnetic field, and their physical damping mechanisms. We discuss the excitation mechanisms of coronal MHD oscillations and waves: the origin of the exciter, exciter propagation, and excitation in magnetic reconnection outflow regions. Finally, we consider the role of coronal MHD oscillations and waves for coronal heating, the detectability of various MHD wave types, and we estimate the energies carried in the observed MHD waves and oscillations: Alfvénic MHD waves could potentially provide sufficient energy to sustain coronal heating, while acoustic MHD waves fall far short of the required coronal heating rates.
Alfvénic-turbulence-heated magnetic loops: effects of lateral expansion and magnetic twist
Authors: Li Bo , Li Xing
Published: December 2005

Using a 1.5-dimensional two-fluid magnetic loop model in which loops are heated by Alfvénic turbulence, we explore the effects on the loop parameters of the varying cross-section and the magnetic twist. The introduced magnetic twist is set to be around the kink instability threshold for a curved loop. It is found that: (i) The lateral expansion, which takes place close to footpoints, can significantly influence the heating profile, leading to a significant footpoint plasma flow. When observed on disc, the corresponding footpoint blue/red shift may be found for upper transition region lines. (ii) The effects introduced by magnetic twist are twofold. Firstly, the twist-related force may contribute to the axial force balance. Secondly, the projection effect reduces the electron and proton thermal conductivities. The former is found to be of little significance; however, the latter gives rise to considerable changes compared to the untwisted case.
Coronal waves: propagation in the multi-fluid description
Authors: Mecheri Redouane , Marsch Eckart
Published: December 2005

We study wave propagation in the low-β coronal plasma using a collisionless multi-fluid model. Neglecting the electron inertia, this model allows us to take into account ion-cyclotron wave effects that are absent in the magnetohydrodynamics model. To accomplish this, we perform a Fourier plane-wave perturbation analysis. Solving numerically the dispersion relations obtained from a two- and three-fluid model, dispersion curves for representative parameters of the solar corona are presented. The results reveal the presence of resonance frequencies that might play a role in coronal heating.
Massive genome erosion and functional adaptations provide insights into the symbiotic lifestyle of Sodalis glossinidius in the tsetse host
Authors: Toh Hidehiro , Weiss Brian L. , Perkin Sarah A.H. , Yamashita Atsushi , Oshima Kenshiro , Hattori Masahira , Aksoy Serap
Published: December 2005

Sodalis glossinidius is a maternally transmitted endosymbiont of tsetse flies (Glossina spp.), an insect of medical and veterinary significance. Analysis of the complete sequence of Sodalis' chromosome (4,171,146 bp, encoding 2,432 protein coding sequences) indicates a reduced coding capacity of 51%. Furthermore, the chromosome contains 972 pseudogenes, an inordinately high number compared with that of other bacterial species. A high proportion of these pseudogenes are homologs of known proteins that function either in defense or in the transport and metabolism of carbohydrates and inorganic ions, suggesting Sodalis' degenerative adaptations to the immunity and restricted nutritional status of the host. Sodalis possesses three chromosomal symbiosis regions (SSR): SSR-1, SSR-2, and SSR-3, with gene inventories similar to the Type-III secretion system (TTSS) ysa from Yersinia enterolitica and SPI-1 and SPI-2 from Salmonella, respectively. While core components of the needle structure have been conserved, some of the effectors and regulators typically associated with these systems in pathogenic microbes are modified or eliminated in Sodalis. Analysis of SSR-specific invA transcript abundance in Sodalis during host development indicates that the individual symbiosis regions may exhibit different temporal expression profiles. In addition, the Sodalis chromosome encodes a complete flagella structure, key components of which are expressed in immature host developmental stages. These features may be important for the transmission and establishment of symbiont infections in the intra-uterine progeny. The data suggest that Sodalis represents an evolutionary intermediate transitioning from a free-living to a mutualistic lifestyle.
Defining the mammalian CArGome
Authors: Sun Qiang , Chen Guang , Streb Jeffrey W. , Long Xiaochun , Yang Yumei , Stoeckert Christian J. , Miano Joseph M.
Published: December 2005

Serum response factor (SRF) binds a 1216-fold degenerateciselement known as the CArG box. CArG boxes are found primarily in muscle- and growth-factor-associated genes although the full spectrum of functional CArG elements in the genome (the CArGome) has yet to be defined. Here we describe a genome-wide screen to further define the functional mammalian CArGome. A computational approach involving comparative genomic analyses of human and mouse orthologous genes uncovered >100 hypothetical SRF-dependent genes, including 10 previously identified SRF targets, harboring a conserved CArG element within 4000 bp of the annotated transcription start site (TSS). We PCR-cloned 89 hypothetical SRF targets and subjected each of them to at least two of several validations including luciferase reporter, gel shift, chromatin immunoprecipitation, and mRNA expression following RNAi knockdown of SRF; 60/89 (67%) of the targets were validated. Interestingly, 26 of the validated SRF target genes encode for cytoskeletal/contractile or adhesion proteins. RNAi knockdown of SRF diminishes expression of several SRF-dependent cytoskeletal genes and elicits an attending perturbation in the cytoarchitecture of both human and rodent cells. These data illustrate the power of integrating existing algorithms to interrogate the genome in a relatively unbiased fashion forcis-regulatory element discovery. In this manner, we have further expanded the mammalian CArGome with the discovery of an array of cyto-contractile genes that coordinate normal cytoskeletal homeostasis. We suggest one function of SRF is that of an ancient master regulator of the actin cytoskeleton.
A genome-wide study of dual coding regions in human alternatively spliced genes
Authors: Liang Han , Landweber Laura F.
Published: December 2005

Alternative splicing is a major mechanism for gene product regulation in many multicellular organisms. By using different exon combinations, some coding regions can encode amino acids in multiple reading frames in different transcripts. Here we performed a systematic search through a set of high-quality human transcripts and show that ∼7% of alternatively spliced genes contain dual (multiple) coding regions. By using a conservative criterion, we found that in these regions most secondary reading frames evolved recently in mammals, and a significant proportion of them may be specific to primates. Based on the presence of in-frame stop codons in orthologous sequences in other animals, we further classified ancestral and derived reading frames in these regions. Our results indicated that ancestral reading frames are usually under stronger selection than are derived reading frames. Ancestral reading frames mainly influence the coding properties of these dual coding regions. Compared with coding regions of the whole genome, ancestral reading frames largely maintain similar nucleotide composition at each codon position and amino acid usage, while derived reading frames are significantly different. Our results also indicated that prior to acquisition of a new reading frame, the suppression of in-frame stop codons in the ancestral state is mainly achieved by one-step transition substitutions at the first or second codon position. Finally, the selective forces imposed on these dual coding regions will also be discussed.