bluuebunny/crossref_metadata_2025 huggingface dataset:
Towardsin vivointradermal surface enhanced Raman scattering (SERS) measurements: silver coated microneedle based SERS probe
Authors: Yuen Clement , Liu Quan
Published: May 2013

We propose a microneedle coated with silver (Ag) to detect analytes at low concentrations positioned at a depth of more than 700 μm below the surface of a skin phantom with absorbers and scatterers for mimicking the intradermal surface‐enhanced Raman scattering (SERS) measurements. The Ag layer in the Ag‐coated microneedle‐based probe is found to be the key to the effective detection of analytes buried inside the aforesaid phantom. Glucose concentrations ranging from 5 to 150 mM inside phantoms can be estimated with a root mean square error (RMSE) of 3.3 mM. This work shows the potential of using microneedles for simplein vivointradermal SERS measurements of analytes with clinical relevance. (© 2014 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Tuning scaffold mechanics by laminating native extracellular matrix membranes and effects on early cellular remodeling
Authors: Amensag Salma , McFetridge Peter S.
Published: May 2013

At approximately 50 µm thin, the human amniotic membrane (hAM) has been shown to be a versatile biomaterial with applications ranging from ocular transplants to skin and nerve regeneration. These investigations describe laminating layers of the hAM into a multilayered, conformation creating a thicker, more robust biomaterial for applications requiring more supportive structures. Amniotic membranes were decellularized using 4 M NaCl and prepared as either flat single‐layered sheets or rolled into concentric five‐layered configurations. Constructs were seeded with human vascular smooth muscle cells and cultured over 40 days to quantify biological and mechanical changes that occurred during early remodeling events. By day 40 single‐layered constructs displayed a decreasing trend in cellular densities and glycosaminoglycan (GAG) concentration, comparative to multilayered constructs with increasing cell densities (from 9.1 to 32 × 106 cells/g) and GAG concentrations (from 6.07 to 17.4 mg/g). Oxygen diffusion was calculated and found to be sufficient to maintain cell populations through the constructs full thickness. Although an overall decrease in the modulus of elasticity was noted, the modulus in the failure range of rolled constructs stabilized at values 25 times higher than single‐layered constructs. Rolled constructs typically displayed an upregulation of contractile and matrix remodeling markers (α‐actin, SM22 and type 1 collagen, MMP‐2 respectively) indicating biological adaptation. Considerable design flexibility can be achieved by varying the number of scaffold layers, allowing the possibility of tuning the constructs physical dimensions, shape and tensile properties to suit specific targeted vascular locations. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 1325–1333, 2014.
Preparation and properties of cellulose nanocrystals reinforced collagen composite films
Authors: Li Weichang , Guo Rui , Lan Yong , Zhang Yi , Xue Wei , Zhang Yuanming
Published: May 2013

Collagen films have been widely used in the field of biomedical engineering. However, the poor mechanical properties of collagen have limited its application. Here, rod‐like cellulose nanocrystals (CNCs) were fabricated and used to reinforce collagen films. A series of collagen/CNCs films were prepared by collagen solution with CNCs suspensions homogeneously dispersed at CNCs: collagen weight ratios of 1, 3, 5, 7, and 10. The morphology of the resulting films was analyzed by scanning electron microscopy (SEM), the enhancement of the thermomechanical properties of the collagen/CNCs composites were demonstrated by thermal gravimetric analysis (TGA) and mechanical testing. Among the CNCs contents used, a loading of 7 wt % led to the maximum mechanical properties for the collagen/CNCs composite films. In addition, in vitro cell culture studies revealed that the CNCs have no negative effect on the cell morphology, viability, and proliferation and possess good biocompatibility. We conclude that the incorporation of CNCs is a simple and promising way to reinforce collagen films without impairing biocompatibility. This study demonstrates that the composite films show good potential for use in the field of skin tissue engineering. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 1131–1139, 2014.
In vivobiocompatibility and biodegradation of a novel thin and mechanically stable collagen scaffold
Authors: Rahmanian‐Schwarz Afshin , Held Manuel , Knoeller Tabea , Stachon Susanne , Schmidt Timo , Schaller Hans‐Eberhard , Just Lothar
Published: May 2013

The demand for scaffolds comprised of natural materials such as collagen has increased in recent years. However, many scaffolds rely on chemical or physical modifications in order to comply with the necessary requirements for biomedical engineering. We evaluated thein vivobiocompatibility and biodegradation of a novel, thin, mechanically stable, and chemically non‐crosslinked collagen cell carrier (CCC). CCC was implanted subcutaneously into 25 adult Lewis rats and biopsies were taken on days 7, 14, 21, 42, and 84 after surgery. For histological analysis, paraffin sections of implanted skin were immunolabeled for CD68 and stained by hematoxylin–eosin and Masson–Goldner's trichrome method. Macroscopic analysis of skin surface during wound healing process showed a normal physiological reaction. Biodegradation of CCC was completed 42 days after subcutaneous implantation. Histological evaluation revealed no evidence of encapsulation, scar formation, or long‐term vascularization and inflammation. The collagen type I based biomaterial demonstrated a highin vivobiocompatibility, low irritability, complete resorption, and replacement by autologous tissue. Thein vivobiocompatibility and degradation behavior encourage for further evaluation of CCC in surgical applications and regenerative medicine. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 1173–1179, 2014.
Comparison of degradation behavior and the associated bone response of ZK60 and PLLA in vivo
Authors: Qi Zheng‐Rong , Zhang Qiang , Tan Li‐Li , Lin Xiao , Yin Yi , Wang Xiu‐Li , Yang Ke , Wang Yan
Published: May 2013

The aim of this study was to investigate whether ZK60, an extruded magnesium alloy, reacts in vivo with an appropriate host response, and to investigate how microarc oxidation treatment influences this in vivo corrosion behavior. Twelve cylinders were machined from as‐extruded ZK60, with six cylinders treated with MAO and six left untreated; poly‐l‐lactic acid pins were used as a control to compare biocompatibility. These cylinders were implanted into the right distal femur of mice along the transepicondylar axis from the medial condyle. Microcomputerized tomography was used to quantitatively analyze corrosion in a nondestructive manner in vivo and the corrosion rate was calculated based on the volume measurements of the residual implants. The physiological response of the rats postimplantation was obtained by clinical observation and blood biochemical analysis. Histological analyses of the soft tissue around the implants were used to assess bone response in relation to the implants. The results obtained clearly indicate that the untreated ZK60 alloy showed high degradation rates in vivo, and that MAO treatment had a significant but unsatisfying effect on protecting the implant from further corrosion. Compared with PLLA, the ZK60 alloy showed good osteoconductivity and osteoinductivity, and, according to biochemical indicators, had good biocompatibility in vivo. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 1255–1263, 2014.
Magnetic‐directed patterning of cell spheroids
Authors: Whatley Benjamin R. , Li Xiaowei , Zhang Ning , Wen Xuejun
Published: May 2013

We have described an approach to fabricate three‐dimensional (3D) cell‐based structures using functionalized super paramagnetic iron oxide nanoparticles (SPIONs) as patterning agents to guide the assembly of endothelial cell spheroids into 3D patterns using the magnetic forces generated by a prefabricated magnetic template. SPIONs were first uptaken by endothelial cells before they were assembled into uniform‐sized spheroids through a home‐made robotic spheroid maker. To guide the magnetic spheroids, a unique magnetic template was fabricated using computer‐aided design and cut from a magnetic sheet. The spheroids were then guided to the prefabricated magnetic template through the attractive magnetic forces between the SPIONs inside the endothelial cells and the magnetic template. Fusion of endothelial cell spheroids over time while adhered to the magnetic template allowed for the formation of 3D cell‐based structures. Subsequent removal of the prefabricated magnetic template left 3‐D endothelial cell sheets, which may be stacked to fabricate complicated 3D multicellular tissue structures. To enhance the cytocompatibility, SPIONs were silica‐coated before use. At low concentrations, the SPIONs did not adversely affect cell viability, proliferation, and phenotype stability. Light and confocal microscopy showed that endothelial cell spheroids could be reproducibly created with high uniformity. The endothelial cells were able to remain viable and maintain the 3D structure in vitro. We have proved the concept to use SPIONs as a patterning agent to direct the attachment and self assembly of SPION‐loaded endothelial cell spheroids on a prefabricated magnetic template for the formation of 3D cell based structures. A magnetic‐directed technique allows quick patterning of cell spheroids in accordance with desirable magnetic patterns, therefore, holding promise for scalable fabrication of complicated 3D multicellular tissue structures. By varying the cell types and the prefabricated magnetic patterns, this magnetic‐directed patterning strategy may find use in bioprinting and multicellular tissue graft fabrication. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 1537–1547, 2014.
First observational evidence of the modulation of the threshold height h'Fc for the occurrence of equatorial spread F by neutral composition changes
Authors: Madhav Haridas M. K. , Manju G. , Pant Tarun Kumar
Published: May 2013

In the present study, the seasonal and solar activity variations of the threshold height for equatorial spread F occurrence irrespective of the polarity of the meridional winds during magnetically disturbed period are presented for the first time. The modulation of the seasonal pattern of the threshold height by the seasonal mean O/N2 values is also examined. The Ionosonde data of magnetic equatorial location Trivandrum (8.5°N, 76.5°E) and low latitude station SHAR (13.7°N, 80.2°E) in the Indian longitude sector during equinoxes, winter, and summer seasons of 2002 to 2006 and the corresponding Thermosphere Ionosphere Mesosphere Energetics and Dynamics/GUVI (Global Ultra Violet Imager) O/N2 data are used for the study. The important findings that have emerged from this study are (i) the substantial increase of threshold height with magnetic activity for all the seasons and (ii) the modulation of h'Fc by neutral density changes, irrespective of season, solar, or magnetic activity.
Laboratory characterization of PM emissions from combustion of wildland biomass fuels
Authors: Hosseini S. , Urbanski S. P. , Dixit P. , Qi L. , Burling I. R. , Yokelson R. J. , Johnson T. J. , Shrivastava M. , Jung H. S. , Weise D. R. , Miller J. W. , Cocker D. R.
Published: May 2013

Particle emissions from open burning of southwestern (SW) and southeastern (SE) U.S. fuel types during 77 controlled laboratory burns are presented. The fuels include SW vegetation types: ceanothus, chamise/scrub oak, coastal sage scrub, California sagebrush, manzanita, maritime chaparral, masticated mesquite, oak savanna, and oak woodland, as well as SE vegetation types: 1 year, 2 year rough, pocosin, chipped understory, understory hardwood, and pine litter. The SW fuels burned at higher modified combustion efficiency (MCE) than the SE fuels resulting in lower particulate matter mass emission factor. Particle mass distributions for six fuels and particle number emission for all fuels are reported. Excellent mass closure (slope = 1.00,r2 = 0.94) between ions, metals, and carbon with total weight was obtained. Organic carbon emission factors inversely correlated (R2 = 0.72) with average MCE, while elemental carbon (EC) had little correlation with average MCE (R2 = 0.10). The EC/total carbon ratio sharply increased with MCE for MCEs exceeding 0.94. The average levoglucosan and total polycyclic aromatic hydrocarbon (PAH) emissions factors ranged from 25 to 1272 mg/kg fuel and 1.8 to 11.3 mg/kg fuel, respectively. No correlation between average MCE and emissions of PAHs/levoglucosan was found. Additionally, PAH diagnostic ratios were observed to be poor indicators of biomass burning. Large fuel type and regional dependency were observed in the emission rates of ammonium, nitrate, chloride, sodium, and potassium.
Using lytic bacteriophages to eliminate or significantly reduce contamination of food by foodborne bacterial pathogens
Authors: Sulakvelidze Alexander
Published: May 2013

Bacteriophages (also called ‘phages’) are viruses that kill bacteria. They are arguably the oldest (3 billion years old, by some estimates) and most ubiquitous (total number estimated to be 1030–1032) known organisms on Earth. Phages play a key role in maintaining microbial balance in every ecosystem where bacteria exist, and they are part of the normal microflora of all fresh, unprocessed foods. Interest in various practical applications of bacteriophages has been gaining momentum recently, with perhaps the most attention focused on using them to improve food safety. That approach, called ‘phage biocontrol’, typically includes three main types of applications: (i) using phages to treat domesticated livestock in order to reduce their intestinal colonization with, and shedding of, specific bacterial pathogens; (ii) treatments for decontaminating inanimate surfaces in food‐processing facilities and other food establishments, so that foods processed on those surfaces are not cross‐contaminated with the targeted pathogens; and (iii) post‐harvest treatments involving direct applications of phages onto the harvested foods. This mini‐review primarily focuses on the last type of intervention, which has been gaining the most momentum recently. Indeed, the results of recent studies dealing with improving food safety, and several recent regulatory approvals of various commercial phage preparations developed for post‐harvest food safety applications, strongly support the idea that lytic phages may provide a safe, environmentally‐friendly, and effective approach for significantly reducing contamination of various foods with foodborne bacterial pathogens. However, some important technical and nontechnical problems may need to be addressed before phage biocontrol protocols can become an integral part of routine food safety intervention strategies implemented by food industries in the USA. © 2013 Society of Chemical Industry
Optimization of subcritical fluid extraction of carotenoids and chlorophyll a from Laminaria japonica Aresch by response surface methodology
Authors: Lu Jie , Feng Xiaomei , Han Yuqian , Xue Changhu
Published: May 2013

BACKGROUND

The carotenoids and chlorophyll a of Laminaria japonica Aresch were extracted using ethanol‐modified subcritical 1,1,1,2‐tetrafluoroethane (R134a). In the present study, the effects of pressure (5–17 MPa), temperature (303–333 K) and the amount of cosolvent(2–6% R134a, w/w)were investigated. Response surface methodology (RSM) combined with a Box–Behnken design was applied to evaluate the significance of the three independent variables on each response. A desirability function was conducted to simultaneously optimize the multiple responses.

RESULTS

The optimum extraction conditions were as follows: extraction temperature 324.13 K, extraction pressure 17 MPa and a cosolvent amount of 4.73%. Under these conditions, the yields of carotenoids and chlorophyll a were predicted to be 0.239 and 2.326 g kg−1, respectively.

CONCLUSION

It has been proved that subcritical R134a is a potential solvent, which can be an alternative to supercritical CO2 for extraction of natural ingredients under mild conditions. © 2013 Society of Chemical Industry
Support Mechanisms and Vulnerabilities in Relation to PTSD in Veterans of the Gulf War, Iraq War, and Afghanistan Deployments: A Systematic Review
Authors: Wright Breanna K. , Kelsall Helen L. , Sim Malcolm R. , Clarke David M. , Creamer Mark C.
Published: May 2013

Pretrauma factors of psychiatric history and neuroticism have been important in highlighting vulnerability to posttraumatic stress disorder (PTSD), whereas posttrauma support mechanisms have been associated with positive health and well‐being outcomes, particularly in veterans. The relationship between these factors and PTSD has not been the subject of a systematic review in veterans. An online search was conducted, supplemented by reference list and author searches. Two investigators systematically and independently examined eligible studies. From an initial search result of 2,864, 17 met inclusion criteria. A meta‐analysis of unit cohesion involving 6 studies found that low unit cohesion was associated with PTSD, standardised mean difference of −1.62, 95% confidence interval (CI) [−2.80, −0.45]. A meta‐analysis of social support involving 7 studies found that low social support was associated with PTSD, standardised mean difference of − 12.40, 95% CI [−3.42, −1.38]. Three of 5 studies found a significant relationship between low‐family support and PTSD; insufficient data precluded a meta‐analysis. Regarding pretrauma vulnerability, 2 studies on psychiatric history and 1 on neuroticism found positive relationships with PTSD. Posttrauma factors of low support were associated with higher reporting of PTSD. Cross‐sectional methodology may be inadequate to capture complex relationships between support and PTSD; more longitudinal research is required.
Immunohistochemical detection of SATB1 is independent of thyroid cancer differentiation
Authors: Murono Shigeyuki , Tsuji Akira , Endo Kazuhira , Kondo Satoru , Wakisaka Naohiro , Yoshizaki Tomokazu
Published: May 2013

Objectives/Hypothesis

The association of special AT‐rich binding protein 1 (SATB1) with a poor prognosis in various cancers has been reported. However, this association is controversial. SATB1 expression in aggressive types of thyroid cancer has not been reported to date.

Study Design

Retrospective.

Methods

SATB1 expression was immunohistochemically investigated in 35 papillary thyroid cancers, one follicular thyroid cancer, six poorly differentiated thyroid cancers, and two anaplastic thyroid cancers.

Results

SATB1 expression was observed in none of two anaplastic thyroid cancers, one of six poorly differentiated thyroid cancers, and nine of 36 well‐differentiated thyroid cancers. SATB1 expression was not significantly associated with any high‐risk group‐related clinicopathologic factors in well‐differentiated thyroid cancer. Survival was not associated with SATB1 expression.

Conclusions

SATB1 expression is independent of thyroid cancer differentiation, as well as high‐risk‐related factors. SATB1 may not play a role in the aggressiveness of thyroid cancer.

Level of Evidence

N/A Laryngoscope, 123:2909–2912, 2013
The effect of unilateral superior laryngeal nerve lesion on swallowing threshold volume
Authors: Ding Peng , Campbell‐Malone Regina , Holman Shaina D. , Lukasik Stacey L. , Thexton Allan J. , German Rebecca Z.
Published: May 2013

Objectives/Hypothesis

The superior laryngeal nerve (SLN) is the major sensory nerve for the upper larynx. Damage to this nerve impacts successful swallowing. The first aim of the study was to assess the effect of unilateral SLN lesion on the threshold volume sufficient to elicit swallowing in an intact pig model; this volume was defined radiographically as the maximum bolus area visible in lateral view. The second aim was to determine if a difference existed between ipsilateral and contralateral function as a result of unilateral sensory loss, measured as the radiologic density of fluid seen in the valleculae. Finally, we determined whether there was a relationship between the threshold volume and the occurrence of aspiration after a unilateral SLN lesion.

Study Design

Repeated measures animal study.

Methods

Four female infant pigs underwent unilateral SLN lesion surgery. The maximum vallecular bolus area in lateral view and the relative vallecular density on each side in the dorsoventral view were obtained from videofluoroscopic recordings in both the prelesion control and postlesion experimental states.

Results

In lateral view, the lesioned group had a larger maximum bolus area than the control group (P < .001). Although occasional left–right asymmetry in the dorsoventral view was observed, the vallecular densities were, on average, equal on both the left (intact) and right (lesioned) sides (P > .05). A bigger maximum bolus area did not predict aspiration in the lesioned group (P > .05).

Conclusions

Unilateral SLN lesions increased the swallowing threshold volume symmetrically in right and left valleculae, but the increased threshold may not be the main mechanism for the occurrence of aspiration. Laryngoscope, 123:1942–1947, 2013
Hypoglossal‐facial‐jump‐anastomosis without an interposition nerve graft
Authors: Beutner Dirk , Luers Jan C. , Grosheva Maria
Published: May 2013

Objectives/Hypothesis

The hypoglossal‐facial‐anastomosis is the most often applied procedure for the reanimation of a long lasting peripheral facial nerve paralysis. The use of an interposition graft and its end‐to‐side anastomosis to the hypoglossal nerve allows the preservation of the tongue function and also requires two anastomosis sites and a free second donor nerve. We describe the modified technique of the hypoglossal‐facial‐jump‐anastomosis without an interposition and present the first results.

Study Design

Retrospective case study.

Methods

We performed the facial nerve reconstruction in five patients. The indication for the surgery was a long‐standing facial paralysis with preserved portion distal to geniculate ganglion, absent voluntary activity in the needle facial electromyography, and an intact bilateral hypoglossal nerve. Following mastoidectomy, the facial nerve was mobilized in the fallopian canal down to its bifurcation in the parotid gland and cut in its tympanic portion distal to the lesion. Then, a tensionless end‐to‐side suture to the hypoglossal nerve was performed. The facial function was monitored up to 16 months postoperatively.

Results

The reconstruction technique succeeded in all patients: The facial function improved within the average time period of 10 months to the House‐Brackmann score 3.

Conclusion

This modified technique of the hypoglossal‐facial reanimation is a valid method with good clinical results, especially in cases of a preserved intramastoidal facial nerve.

Level of Evidence

Level 4.Laryngoscope, 123:2392–2396, 2013
Survival of diced and block cartilage grafts in combination with injectable calcium hydroxylapatite
Authors: Erdogmuş Nagehan , Cingi Cemal , Canaz Funda , Acikalin Mustafa , Gurbuz Melek Kezban , Kaya Ercan , Çakli Hamdi , Incesulu Armagan , Ozudogru Erkan
Published: May 2013

Objectives/Hypothesis

Dorsal nasal irregularities after trauma, and various procedures such as excessive nasal hump resection, are major problems for patients who have undergone rhinoplasty. Many grafts have been described for the correction of dorsal nasal irregularities. In this study, we used an injectable implant, in combination with diced or block cartilage grafts, to test the efficacy of injectable calcium hydroxylapatite on the survival of diced or block cartilage grafts.

Study Design

Prospective, controlled, parallel group animal study.

Methods

Fourteen New Zealand white rabbits were used. Block cartilage and diced cartilage grafts, alone and in combination with injectable calcium hydroxylapatite, were placed subcutaneously in the rabbits' dorsal thoracolumbar region. On the 90th day following surgery, the graft areas were extracted immediately after the rabbits were sacrificed. Pathological examination was conducted on all specimens.

Results

The pathologic and histochemical findings were compared between groups. There was chronic inflammation observed in all of the groups. However, none of the groups had metaplastic bone formation or calcification. The group that received diced cartilage in combination with the injectable implant received the highest scores for peripheral chondrocyte proliferation, matrix collagen, elastic fiber, and proteoglycan content (P <0.05). A comparison of the block and diced cartilage grafts revealed that peripheral chondrocyte proliferation was more pronounced in the diced cartilage grafts (P <0.05).

Conclusion

The use of calcium hydroxylapatite in combination with diced cartilage grafts does not have any long‐term negative effects on chondrocyte viability.

Level of Evidence

N/A. Laryngoscope, 123:E17–E22, 2013
Long‐term utility outcomes in patients undergoing endoscopic sinus surgery
Authors: Rudmik Luke , Mace Jess , Soler Zachary M. , Smith Timothy L.
Published: May 2013

Objectives/Hypothesis

To define long‐term health‐state utility outcomes in patients undergoing endoscopic sinus surgery (ESS) for refractory chronic rhinosinusitis (CRS).

Study Design

Prospective, longitudinal, cohort study.

Methods

The short‐form (SF)−12 survey was issued to the 168 patients who were enrolled in an initial study evaluating short‐term utility outcomes following ESS. SF‐12 responses were converted into SF‐6D utility scores using the University of Sheffield algorithm. The primary outcome was mean overall long‐term utility level following ESS. Secondary outcomes evaluated annual utility level following ESS and utility outcomes for different subgroups of patients with CRS.

Results

A total of 83 patients provided long‐term health‐state utility outcomes. The mean overall long‐term utility level was 0.80 at a mean follow‐up of 5.2 years after ESS. Compared to the baseline (0.67) and short‐term follow‐up (0.75) utility levels in this group, there was a significant improvement at the long‐term period (P = .002). A total of 54% (45/83) of patients achieved long‐term postoperative utility scores higher than the United States norm of 0.81. There was a significant improvement in utility scores for all subsequent years after ESS compared to preoperative responses (all P < .028). All subgroups of CRS received significant long‐term utility improvements (all P < .001), and those undergoing revision ESS demonstrated continued improvement past the short‐term postoperative period.

Conclusions

This study has demonstrated that patients with refractory CRS achieve stable mean long‐term utility levels following ESS and often return to a health state comparable to US population norms.

Level of Evidence

2b. Laryngoscope, 124:19–23, 2014
Influence of baclofen on laryngeal and spinal motor drive during cough in the anesthetized cat
Authors: Castillo Daniel , Pitts Teresa
Published: May 2013

Objectives/Hypothesis

The antitussive properties of (±) baclofen on laryngeal muscle activities have not been determined. The hypothesis of this study was that administration of (±) baclofen would suppress upper airway muscle motor activity in a dose‐dependent manner during cough.

Study Design

This is a prospective, preclinical, hypothesis‐driven, paired design.

Methods

Electromyograms of the parasternal, rectus abdominis, thyroarytenoid, posterior cricoarytenoid, and thyrohyoid were measured, along with esophageal pressure. Cough was elicited by mechanical stimulation of the lumen of the intrathoracic trachea in spontaneously breathing cats.

Results

Baclofen (±) (3–10 μg kg−1 i.a.) induced decreases in the electromyogram amplitude of the rectus abdominis motor drive during coughing, the inspiratory and active expiratory (E1) phases of cough, and cough number per epoch. There was no effect of (±) baclofen on the EMG amplitudes of any of the laryngeal muscles, the parasternal, or the duration of the passive expiratory (E2) phase.

Conclusions

Results from the present study indicate differential control mechanisms for laryngeal and inspiratory motor drive during cough, providing evidence of a control system regulating laryngeal activity and inspiratory spinal drive that is divergent from the control of expiratory spinal motoneurons.

Level of Evidence

N/A. Laryngoscope, 123:3088–3092, 2013
Comparison between endoscopic and microscopic stapes surgery
Authors: Kojima Hiromi , Komori Manabu , Chikazawa Satoshi , Yaguchi Yuichiro , Yamamoto Kazuhisa , Chujo Kyoko , Moriyama Hiroshi
Published: May 2013

Objectives/Hypothesis

To investigate whether endoscopic stapes surgery is safer and less invasive than conventional stapes surgery using an operating microscope.

Study Design

Retrospective study.

Methods

The subjects were 15 patients (15 ears) who underwent endoscopic stapes surgery for otosclerosis or congenital stapedial fixation. Another 35 patients (41 ears) in whom microscopic stapes surgery was performed by the same surgeon were assigned to the control group. The procedures for endoscopic surgery were fundamentally the same as those for microscopic surgery, unless there was no anterior or posterior auricular skin incision. The two surgical techniques were compared with respect to the operating time, postoperative hearing, complications, postoperative pain, and the extent of drilling at the posterosuperior part of the external auditory canal.

Results

There were no differences of operating time or postoperative hearing between the endoscopic and microscopic groups. There was very little postoperative pain in the endoscopic group. Postoperative dizziness was mild in all patients who received endoscopic surgery. Drilling at the posterosuperior part of the external auditory canal was less extensive in the endoscopic group than in the microscopic group.

Conclusion

Endoscopic surgery is particularly suitable for stapedial disease. Endoscopic stapes surgery can even be done in patients with a curved and narrow external auditory canal. Endoscopic surgery is also suitable for education: The surgical anatomy can be understood easily and both the surgeon and assistants can observe the procedure on the same monitor. However, it should only be performed by experienced surgeons because one‐handed manipulation is required and stereoscopic vision is not available.

Level of Evidence

3b. Laryngoscope, 124:266–271, 2014
Subclassification of chronic rhinosinusitis with nasal polyp based on eosinophil and neutrophil
Authors: Ikeda Katsuhisa , Shiozawa Akihito , Ono Noritsugu , Kusunoki Takeshi , Hirotsu Mikio , Homma Hirotomo , Saitoh Tatsuya , Murata Junko
Published: May 2013

Objectives/Hypothesis

Japanese patients with chronic rhinosinusitis with nasal polyps (CRSwNP), differing from European and U.S. patients, are suggested to show two distinct phenotypes: Th2‐polarized and Th1‐shifted immunity. The purpose of this study was to conduct clinical subgrouping of CRSwNP based on inflammatory cell infiltration, which was evaluated and supported by clinical backgrounds and immunological characteristics.

Study Design

A cross‐sectional study.

Methods

One hundred thirty Japanese patients with CRSwNP were classified by the infiltration of eosinophils and neutrophils in nasal polyps. Immunohistochemical analysis was performed in 42 patients.

Results

The patients were classified into three groups: 1) 42 patients with eosinophilic type, 2) 27 patients with neutrophilic type, and 3) 61 patients with noneosinophilic nonneutrophilic type. Both the number of serum eosinophils and the recurrence rates were significantly higher in the eosinophilic group compared to the other two groups. The IgE value was significantly higher in the eosinophilic group, followed by the noneosinophilic nonneutrophilic and neutrophilic groups. Both the symptomatic and CT scores were significantly greater in the eosinophilic group than in the neutrophilic group. The expressions of eotaxin, IL‐17A, MUC5AC, and CD68 were greater in the eosinophilic group than in the other two groups.

Conclusion

The eosinophilic CRSwNP phenotype is clinically characterized by serum eosinophilia, atopy, extensive disease, and poor prognosis compared to the neutrophilic and the noneosinophilic nonneutrophilic groups. We clearly demonstrated that all three subgroups of CRSwNP had characteristic differences in those inflammatory markers, which allows for pathophysiologically meaningful differentiations with likely therapeutic consequences.

Level of Evidence

3b. Laryngoscope, 123:E1–E9, 2013
Pharmacoeconomics of Cyclamen europaeum in the management of acute rhinosinusitis
Authors: Mullol Joaquim , Crespo Carlos , Carré Carme , Brosa Max
Published: May 2013

Objectives/Hypothesis

To carry out a pharmacoeconomic analysis of Cyclamen europaeum (CE) in the management of acute rhinosinusitis (ARS) in Spain using data from the PROSINUS (PROspective epidemiological study of the diagnosis and treatment of acute rhinoSINUSitis) study.

Study Design

This was a prospective observational study to compare the effectiveness and cost‐effectiveness between therapies including CE versus other therapies in the management of ARS.

Methods

The study was carried out as a secondary analysis of the PROSINUS study, combining healthcare resource use, productivity loses, and health outcomes from the observational study, with costs representative of the Spanish Health System.

Results

CE given as monotherapy appears to be more effective (cure rate) than other monotherapies (15.3% higher, P < .05) and combination (10.3% higher, P < .05) therapies. The addition of CE to other single‐drug or combination therapies showed a statistically significant improvement in terms of cure rates when adding CE to two‐drug combinations (93.9% vs. 76.5%; P < .05) and no significant effect when added to combinations of three or more drugs (81.1% vs. 79.8; nonsignificant). CE‐based therapies generally showed lower indirect costs, although only the comparison of CE alone versus other monotherapies, with a net cost savings of €101 per patient, reached statistical significance (€331 vs. €432, P < .05). In addition, CE‐based therapies show lower cost per cured patient in all comparisons, except when CE was used in combination with three or more other drugs.

Conclusions

The use of CE (Nasodren®) may be associated to better clinical outcomes at no additional cost for the healthcare system with respect to treatments commonly used for ARS in clinical practice.

Level of Evidence

2c. Laryngoscope, 123:2620–2625, 2013
Differential Gene Expression in Cholesteatoma by DNA Chip Analysis
Authors: Macias John D. , Gerkin Richard D. , Locke Darren , Macias MiMi P.
Published: May 2013

Objectives/Hypothesis

In contrast to normal epithelium, the desquamating stratified squamous epithelium of temporal bone cholesteatoma characteristically exhibits sustained hyperproliferative growth and a capacity for bone erosion. We conducted genome‐wide microarray analyses to determine the molecular nature of cholesteatoma's biological processes and identify disease‐associated, altered gene activity. We tested the hypothesis that genes contributing to the pathophysiology of cholesteatoma are differentially expressed compared to control tissue.

Study Design

Prospective experimental analysis.

Methods

Using new, enhanced microarray platforms and well‐annotated human transcriptome probes, we measured global gene expression levels in surgical specimens of cholesteatoma and in the corresponding normal postauricular skin in four patients. Genes of interest were verified by quantitative real time reverse transcriptase polymerase chain reaction analyses using cholesteatoma and postauricular sample pairs (n = 13). External auditory canal skin from six additional patients was also evaluated as a normal control. Immunohistochemistry detected protein expression in tissue sections and the cells involved.

Results

DNA chip analyses identified 282 differentially expressed genes in cholesteatoma compared to control samples. Of these, 104 genes were upregulated and 178 were downregulated. Ontological classifications indicate relationships to cellular processes including receptor binding, cell communication and motion, vitamin metabolism, and cytokine‐mediated inflammation. Based on potential involvement in disease pathology, 10 genes were selected and independently verified by quantitative polymerase chain reaction. Immunohistochemical detection of transcobalamin‐1 and CCL27 implicates cholesteatoma keratinocytes and dermal endothelial cells as contributors in disease processes.

Conclusions

We present a comprehensive, human genome‐wide survey of disease‐associated gene expression that extends the public database and provides new evidence for molecular mechanisms involved in cholesteatoma pathology. Laryngoscope, 123:S1–S21, 2013
Antibodies directed against integration host factor mediate biofilm clearance from nasopore
Authors: Brandstetter Kathleyn A. , Jurcisek Joseph A. , Goodman Steven D. , Bakaletz Lauren O. , Das Subinoy
Published: May 2013

Objectives/Hypothesis

Intranasal resorbable packing, such as Nasopore, is commonly used during sinus surgery despite a paucity of evidence that demonstrates clinical benefit. We theorized that Nasopore supports bacterial growth and biofilm formation. The DNABII family of bacterial nucleic acid binding proteins stabilizes the extracellular polymeric substance of the biofilm, thus protecting bacteria from host defenses and traditional antibiotics. We tested the hypothesis that use of anti‐IHF antibodies in conjunction with antibiotics would enhance biofilm eradication from Nasopore.

Study Design

In vitro experiments.

Methods

Nontypeable Haemophilus influenzae (NTHI) biofilms were grown on Nasopore. Following 24‐hour incubation, biofilms were incubated for an additional 16 hours with either medium alone, naïve rabbit serum, rabbit anti‐IHF serum, amoxicillin/clavulanate, or anti‐IHF serum + amoxicillin/clavulanate. Computer statistics (COMSTAT) analysis was performed on images of biofilms obtained via confocal microscopy.

Results

NTHI readily formed a biofilm on Nasopore. Treatment with amoxicillin/clavulanate alone mediated an increase in biomass by 92% to 6.63 μ2/μ3 compared to incubation in sterile medium alone (3.46 μ2/μ3). Treatment with anti‐IHF alone reduced the biomass by 77% to 1.29 μ2/μ3 compared to incubation with naïve rabbit serum (5.53 μ2/μ3). Anti‐IHF + amoxicillin/clavulanate reduced biomass by 88% to 0.66 μ2/μ3 (P <0.02) compared to incubation with naïve rabbit serum.

Conclusion

Antibiotics alone were ineffective in eradicating NTHI biofilms that had formed on Nasopore in vitro. Anti‐IHF antibodies plus amoxicillin/clavulanate therapy synergistically reduced biofilm biomass by 88%. These data support clinical studies for the use of anti‐IHF combined with antibiotics to reduce biofilm formation on intranasal packing.

Level of Evidence

N/A. Laryngoscope, 123:2626–2632, 2013
Depressive symptoms are associated with visceral adiposity in a community‐based sample of middle‐aged women and men
Authors: Murabito Joanne M. , Massaro Joseph M. , Clifford Brian , Hoffmann Udo , Fox Caroline S.
Published: May 2013

Objective

To examine the relation between measures of adiposity and depressive symptoms in a large well characterized community‐based sample, we examined the relations of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) to depressive symptoms in 1,581 women (mean age 52.2 years) and 1,718 men (mean age 49.8 years) in the Framingham Heart Study.

Design and Methods

Depressive symptoms were measured using the Center for Epidemiologic Studies Depression (CES‐D) scale. Regression models were created to examine the association between each fat depot (exposure) and depressive symptoms (outcome). Sex‐specific models were adjusted for age, body mass index, smoking, alcohol consumption, diabetes, hypertension, total and HDL cholesterol, lipid lowering treatment, CVD, menopause, C‐reactive protein, and physical activity.

Results

Mean CES‐D scores were 6.8 and 5.6 in women and men. High levels of depressive symptoms were present in 22.5% of women and 12.3% of men. In women, one standard deviation increase in VAT was associated with a 1.3 point higher CES‐D score after adjusting for age and BMI (P < 0.01) and remained significant in the fully adjusted model (P = 0.03). The odds ratio of depressive symptoms per 1 standard deviation increase in VAT in women was 1.33 (P = 0.015); results were attenuated in fully adjusted models (OR 1.29, P = 0.055). In men, the association between VAT and CES‐D score and depressive symptoms was not significant. SAT was not associated with CES‐D score or depressive symptoms.

Conclusions

This study supports an association between VAT and depressive symptoms in women. Further work is needed to uncover the complex biologic mechanisms mediating the association.
Serum leptin and adiponectin levels and risk of renal cell carcinoma
Authors: Liao Linda M. , Schwartz Kendra , Pollak Michael , Graubard Barry I. , Li Zhen , Ruterbusch Julie , Rothman Nathaniel , Davis Faith , Wacholder Sholom , Colt Joanne , Chow Wong‐Ho , Purdue Mark P.
Published: May 2013

Objective

The incidence of renal cell carcinoma (RCC) has increased rapidly in the U.S., particularly among African Americans. Despite a well‐established link between obesity and RCC, the mechanism through which obesity increases cancer risk has yet to be established. Adipokines, such as leptin and adiponectin, may link obesity and cancer, with different quantitative effects by race.

Design and Methods

We evaluated the association between leptin and adiponectin concentrations and RCC risk among Caucasians (581 cases, 558 controls) and African Americans (187 cases, 359 controls) in a case‐control study conducted in Detroit and Chicago. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated using unconditional logistic regression.

Results

Among controls, Caucasians had higher median adiponectin than African Americans (males: 8.2 vs. 7.0 μg/ml, P = 0.001; females: 13.4 vs. 8.4 μg/ml, P < 0.0001), and lower median leptin than African Americans (males: 11.8 vs. 14.1 ng/ml, P = 0.04; females: 28.3 vs. 45.9 ng/ml, P < 0.0001). Among Caucasians, the ORs for RCC comparing the highest (Q4) to the lowest (Q1) sex‐specific quartile of leptin were 3.2 (95% CI: 1.9–5.2) for males and 4.7 (95% CI: 2.6–8.6) for females. Serum leptin was not significantly associated with RCC among African American males (OR 1.5, 95% CI: 0.7–3.1) or females (OR 2.1, 95% CI: 0.8–5.5). Higher adiponectin was associated with RCC risk among African American males (Q4 vs. Q1: OR 2.3, 95% CI: 1.1–4.6) and females (OR 2.1, 95% CI: 1.2–6.7), but not significantly among Caucasian males (OR 1.6, 95% CI: 0.99–2.7) and females (OR 1.6, 95% CI: 0.9–3.1).

Conclusion

We observed an association between both leptin and adiponectin concentrations and risk of RCC, which may differ by race. Confirmation in further investigations is needed.
High protein intake stimulates postprandial GLP1 and PYY release
Authors: van der Klaauw Agatha A. , Keogh Julia M. , Henning Elana , Trowse Victoria M. , Dhillo Waljit S. , Ghatei Mohammad A. , Farooqi I. Sadaf
Published: May 2013

Objective

Meals high in protein induce greater intermeal satiety than meals high in fat and carbohydrates. We studied the gut hormone response and subsequent food intake after breakfasts high in protein, carbohydrate or high in fat controlled for volume, calories and appearance.

Design and Methods

Eight healthy volunteers participated in this randomized three‐way crossover study. Study breakfasts were calculated to provide 20% of daily energy requirements and provided either 60% of energy from protein, fat or carbohydrate. Blood was drawn half‐hourly for 4 h; energy intake at a subsequent ad libitum meal was measured.

Results

Total ghrelin decreased after food intake equally with the three breakfasts. PYY levels were highest after the high protein breakfast (P = 0.005). Indeed, PYY at 240 min was highest after the high protein breakfast compared to the high fat breakfast and to the high carbohydrate breakfast (P = 0.011 and P = 0.012, respectively). GLP‐1 levels were highest after the high protein breakfast (P = 0.041) at 120 min and remained higher throughout the study. These differences in gut hormones did not translate into differences in food intake (1023 ± 390 kcal after high protein, 1016 ± 388 kcal after high fat and 1158 ± 433 kcal after high carbohydrate).

Conclusion

We conclude that a high protein meal increases circulating concentrations of the gut hormones PYY and GLP‐1, but when meals are matched for volume, appearance and caloric value, these gut hormone changes do not translate into a reduction in ad libitum food intake.
College expectations in high school mitigate weight gain over early adulthood: Findings from a national study of American youth
Authors: Clarke Philippa J. , O'Malley Patrick M. , Schulenberg John E. , Lee Hedwig , Colabianchi Natalie , Johnston Lloyd D.
Published: May 2013

Objective

Research conducted on school‐based interventions suggests that school connectedness protects against a variety of risk behaviors, including substance abuse, delinquency and sedentary behavior. The line of research is extended by examining the link between college expectations and early adult weight gain using nationally representative panel data from thirty cohorts of American high school seniors followed prospectively to age 30 in the Monitoring the Future Study (1986‐2009).

Design and Methods

Growth mixture models identified two latent classes of trajectories of body mass index (BMI) from age 19 to 30: a persistently overweight class (BMI ≥ 25) and a second class exhibiting more moderate growth in BMI to age 30.

Results

Compared to those who did not expect to graduate from college, students fully expecting to graduate from college had 34% lower odds of being in the persistently overweight class (adjusted odds ratio = 0.66, 95% confidence interval = 0.54, 0.81), controlling for academic performance and socioeconomic status.

Conclusions

Successful prevention of obesity early in the life course is based on a multifactorial approach incorporating strategies that address the contexts in which adolescents are embedded. The school setting may be one avenue where successful educational attachment could have positive consequences for subsequent weight gain in early adulthood.