bluuebunny/crossref_metadata_2025 huggingface dataset:
Unifying ‘the’ Precautionary Principle? Justification and Reflective Equilibrium
Authors: Rechnitzer Tanja
Published: September 2022

The precautionary principle (PP) is an influential principle for making decisions when facing uncertain, but potentially severe, harm. However, there is a persistent disagreement about what the principle entails, exactly. It exists in a multitude of formulations and has potentially conflicting ideas associated with it. Is there even such a thing as ‘the precautionary principle’? This paper analyses the debate between unificationists and pluralists about ‘the PP’, arguing that the debate is hindered by neglecting the question of justification. It introduces reflective equilibrium as a method of justification, and sketches how it could be applied to justify a PP.
FAIRifizierung von Real World Data für die Gesundheitsforschung
Authors: Pigeot Iris , Intemann Timm , Kollhorst Bianca , Sax Ulrich , Ahrens Wolfgang
Published: September 2022

Hintergrund

Die Bereitstellung von Real-World-Daten im Sinne der FAIR-Prinzipien ist die Voraussetzung einer effizienten Ausschöpfung des Potenzials von Gesundheitsdaten für Prävention und Versorgung.

Ziel der Arbeit

Möglichkeiten und Limitationen der Nachnutzung und Verknüpfung von Gesundheitsdaten in Deutschland werden dargestellt.

Material und Methoden

Es werden Initiativen zur Schaffung einer verbesserten Forschungsdateninfrastruktur vorgestellt und an einem Beispiel die Einschränkungen illustriert, die das Record Linkage personenbezogener Gesundheitsdaten behindern.

Ergebnisse

In der Regel erfüllen Gesundheitsdaten in Deutschland nicht die Anforderungen der FAIR-Prinzipien. Ihre Auffindbarkeit scheitert bereits daran, dass entweder keine Metadaten zur Verfügung stehen oder diese nicht standardisiert in suchbare Repositorien eingestellt werden. Die Verknüpfung von personenbezogenen Gesundheitsdaten ist durch restriktive Datenschutzbestimmungen und das Fehlen eines sog. Unique Identifiers extrem eingeschränkt. Datenschutzkonforme Lösungen für die Verknüpfung von Gesundheitsdaten, die in europäischen Nachbarländern erfolgreich praktiziert werden, könnten hier als Vorbild dienen.

Schlussfolgerung

Die Schaffung einer Nationalen Forschungsdateninfrastruktur (NFDI), insbesondere für personenbezogene Gesundheitsdaten (NFDI4Health), ist nur mit erheblichen Anstrengungen und Gesetzesänderungen realisierbar. Bereits vorliegende Strukturen und Standards, wie sie z. B. durch die Medizininformatik-Initiative und das Netzwerk Universitätsmedizin geschaffen wurden, sowie internationale Initiativen wie z. B. die European Open Science Cloud müssen dabei berücksichtigt werden.
Identification of sesquiterpene synthase genes in the genome of Aquilaria sinensis and characterization of an α-humulene synthase
Authors: Ran Jiadong , Li Yuan , Wen Xin , Geng Xin , Si Xupeng , Zhang Liping , Ma Yimian , Zhang Zheng
Published: September 2022

Sesquiterpenes are the major pharmacodynamic components of agarwood, a precious traditional Chinese medicine obtained from the resinous portions of Aquilaria sinensis trees that form in response to environmental stressors. To characterize the sesquiterpene synthases responsible for sesquiterpene production in A. sinensis, a bioinformatics analysis of the genome of A. sinensis identified six new terpene synthase genes, and 16 sesquiterpene synthase genes were identified as type TPS-a in a phylogenetic analysis. The expression patterns for eight of the sesquiterpene synthase genes after treatment with various hormones or hydrogen peroxide were analyzed by real-time quantitative PCR. The results suggest that 100 μM methyl jasmonate, ethephon, ( ±)-abscisic acid or hydrogen peroxide could be effective short-term effectors to increase the expression of sesquiterpene synthase genes, while 1 mM methyl salicylate may have long-term effects on increasing the expression of specific sesquiterpene synthase genes (e.g., As-SesTPS, AsVS, AsTPS12 and AsTPS29). The expression changes in these genes under various conditions reflected their specific roles during abiotic or biotic stresses. Heterologous expression of a novel A. sinensis sesquiterpene synthase gene, AsTPS2, in Escherichia coli produced a major humulene product, so AsTPS2 is renamed AsHS1. AsHS1 is different from ASS1, AsSesTPS, and AsVS, for mainly producing α-humulene. Based on the predicted space conformation of the AsHS1 model, the small ligand molecule may bind to the free amino acid by hydrogen bonding for the catalytic function of the enzyme, while the substrate farnesyl diphosphate (FPP) probably binds to the free amino acid on one side of the RxR motif. Arg450, Asp453, Asp454, Thr457, and Glu461 from the NSE/DTE motif and D307 and D311 from the DDxxD motif were found to form a polar interaction with two Mg2+ clusters by docking. The Mg2+-bound DDxxD and NSE/DTE motifs and the free RXR motif are jointly directed into the catalytic pocket of AsHS1. Comparison of the tertiary structural models of AsHS1 with ASS1 showed that they differed in structures in several positions, such as surrounding the secondary catalytic pocket, which may lead to differences in catalytic products. Based on the results, biosynthetic pathways for specific sesquiterpenes such as α-humulene in A. sinensis are proposed. This study provides novel insights into the functions of the sesquiterpene synthases of A. sinensis and enriches knowledge on agarwood formation.
Beyond images: the external archaeological context of Palaeolithic rock art (EAC). A case study from the Nalón river basin (northern Iberia)
Authors: Fano Miguel Ángel , García-Moreno Alejandro , Portillo Fabiola , Garate Diego , Palacio-Pérez Eduardo , Corchón-Rodríguez Mª Soledad
Published: September 2022

In this study of the location and physical characteristics of the surroundings of a series of decorated caves in the Nalón river basin in Asturias (northern Iberia), the spatial analysis, which included fieldwork and the use of GIS, has defined the external archaeological context (EAC) of pre-Magdalenian art in that area. The spatial information has been integrated with the study of the rock art in order to observe tendencies that are statistically quantifiable by means of multidimensional scaling (MDS), hierarchical cluster analysis (HCA) and property fitting. The study of the potential association between the location of the caves and the rock art constitutes a new approach within Palaeolithic cave art research. First, the sample of decorated caves was analysed to discriminate different situations as regards the total number of representations, relative importance of figurative and non-figurative motifs, and the type of figurative representations. Second, the relationship between the EAC and graphic activity was tested. The location of the decorated caves does not fit a homogeneously distributed pattern owing to marked contrasts in the spatial variables. The greater or lesser ease of access to the location of the cave art sites does not condition the type of graphic expression. Instead, visibility is clearly associated with the total number of representations, and particularly with the number of non-figurative representations. However, this particular association between high visibility and non-figurative motifs should be nuanced because the issues of the conservation and interpretation of the exterior engravings mostly affect the identification of the figurative representations.
The Impact of a Mindfulness App on Postnatal Distress
Authors: Bear Katie A. , Barber Carol C. , Medvedev Oleg N.
Published: September 2022

Objectives

The present study investigated the effectiveness of an 8-week mindfulness mobile phone app on women’s depression, anxiety, stress and mindful attention/awareness in the postnatal period.

Methods

The study enrolled 99 mothers of a child under 1 year old, and randomly assigned them to intervention (n = 49, mean age = 31.11, SD = 4.30, years) and control (n = 50, mean age = 31.35, SD = 5.29, years) groups. Multiple regression examined intervention effects on depression, anxiety, stress and mindful attention/awareness measured post-intervention and at 4-week follow-up, controlling for the baseline and post-intervention measurement of the specific outcome, respectively.

Results

The intervention group showed significant decreases in depression, anxiety and stress levels and an increase of mindful attention/awareness post-intervention compared to the control group, with medium to large effect sizes after controlling for effects of corresponding variables at baseline. The intervention group showed further decrease in depression and stress levels and an increase in mindful attention/awareness at 4 weeks post-intervention compared to the control group, with small to medium effect sizes, after controlling for effects of corresponding variables at post-intervention.

Conclusions

The outcomes of the study suggest that delivery of mindfulness via smartphones could be a viable and affordable resource for reducing postnatal depression, anxiety and stress.
Exploring the role of Nrf2 signaling in glioblastoma multiforme
Authors: Awuah Wireko Andrew , Toufik Abdul-Rahman , Yarlagadda Rohan , Mikhailova Tatiana , Mehta Aashna , Huang Helen , Kundu Mrinmoy , Lopes Leilani , Benson Sylvester , Mykola Lyndin , Vladyslav Sikora , Alexiou Athanasios , Alghamdi Badrah S. , Hashem Anwar M. , Md Ashraf Ghulam
Published: September 2022

Glioblastoma multiforme (GBM) is one of the most aggressive glial cell tumors in adults. Although current treatment options for GBM offer some therapeutic benefit, median survival remains poor and does not generally exceed 14 months. Several genes, such as isocitrate dehydrogenase (IDH) enzyme and O6-methylguanine-DNA methyltransferase (MGMT), have been implicated in pathogenesis of the disease. Treatment is often adapted based on the presence of IDH mutations and MGMT promoter methylation status. Recent GBM cell line studies have associated Nuclear Factor Erythroid 2-Related Factor 2 (Nrf2) expression with high-grade tumors. Increased Nrf2 expression is often found in tumors with IDH-1 mutations. Nrf2 is an important transcription factor with anti-apoptotic, antioxidative, anti-inflammatory, and proliferative properties due to its complex interactions with multiple regulatory pathways. In addition, evidence suggests that Nrf2 promotes  GBM cell survival in hypoxic environment,by up-regulating hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF). Downregulation of Nrf2 has been shown to improve GBM sensitivity to chemotherapy drugs such as Temozolomide. Thus, Nrf2 could be a key regulator of GBM pathways and potential therapeutic target.  Further research efforts exploring an interplay between Nrf2 and major molecular signaling mechanisms could offer novel GBM drug candidates with a potential to significantly improve patients prognosis.
Knowledge and awareness of sickle cell disease: a cross sectional study amongst unmarried adults in Nigeria’s capital city
Authors: Adigwe Obi Peter
Published: September 2022

Sickle cell disease is a genetic disorder characterised by the tendency of haemoglobin to polymerise and deform red blood cells to a sickle or crescent shape; this consequently results in vaso-occlusive condition. A better knowledge and awareness about sickle cell disease amongst the population can help reduce its prevalence. This study aimed at assessing awareness and knowledge of unmarried adults in Nigeria’s capital. A cross sectional survey was undertaken amongst unmarried individuals residing in the Federal Capital Territory. Questionnaires were administered to participants using convenience sampling strategy. Data were analysed using Statistical Package for Social Sciences version 25. Descriptive and inferential statistical analyses were carried out. A total of 1423 questionnaires were completed and returned, response rate was 83.71%, male participants were in the majority as indicated by 52% of the sample, and the dominant age group was 21 to 30 years (47.90%). Almost all the study participants (92.50%), have heard about sickle cell disease. Knowledge about sickle cell disease was average, as mean score for all the participants was 9.01 ± 3.18, with a range of 0 to 17. Some misconceptions were observed, for instance some participants believed that bacterial or viral infections could cause sickle cell disease. Male participants had a higher knowledge score compared to females (p < 0.001), and older participants were more knowledgeable about sickle cell disease (p < 0.001). This study identified that knowledge gaps exist about sickle cell disease. Emergent findings can underpin government, policymakers’ and stakeholders’ contextual strategies to prevent sickle cell through public health enlightenment and other relevant means.
Democracy and Banking Stability: Is the Relationship U-Shaped?
Authors: Ben Ali Mohamed Sami , Ben Mim Sami
Published: September 2022

This study addresses the impact of democracy on the stability of the banking system for a sample of 114 countries over the period 2000–2017. Our findings offer strong evidence for a U-shaped relationship between democracy and banking stability. Results also show that the way democratic institutions impact banking stability is highly dependent on their ability to implement effective anti-corruption policies. Controlling for countries’ income levels reveals that not all high-income countries are necessarily enjoying the positive effects of democracy on banking stability.
Proteomic characterisation of prostate cancer intercellular communication reveals cell type-selective signalling and TMSB4X-dependent fibroblast reprogramming
Authors: Wu Yunjian , Clark Kimberley C. , Nguyen Elizabeth V. , Niranjan Birunthi , Horvath Lisa G. , Taylor Renea A. , Daly Roger J.
Published: September 2022

Background

In prostate cancer, the tumour microenvironment (TME) represents an important regulator of disease progression and response to treatment. In the TME, cancer-associated fibroblasts (CAFs) play a key role in tumour progression, however the mechanisms underpinning fibroblast-cancer cell interactions are incompletely resolved. Here, we address this by applying cell type-specific labelling with amino acid precursors (CTAP) and mass spectrometry (MS)-based (phospho)proteomics to prostate cancer for the first time.

Methods

Reciprocal interactions between PC3 prostate cancer cells co-cultured with WPMY-1 prostatic fibroblasts were characterised using CTAP-MS. Signalling network changes were determined using Metascape and Enrichr and visualised using Cytoscape. Thymosin β4 (TMSB4X) overexpression was achieved via retroviral transduction and assayed by ELISA. Cell motility was determined using Transwell and random cell migration assays and expression of CAF markers by indirect immunofluorescence.

Results

WPMY-1 cells co-cultured with PC3s demonstrated a CAF-like phenotype, characterised by enhanced PDGFRB expression and alterations in signalling pathways regulating epithelial-mesenchymal transition, cytoskeletal organisation and cell polarisation. In contrast, co-cultured PC3 cells exhibited more modest network changes, with alterations in mTORC1 signalling and regulation of the actin cytoskeleton. The expression of the actin binding protein TMSB4X was significantly decreased in co-cultured WPMY-1 fibroblasts, and overexpression of TMSB4X in fibroblasts decreased migration of co-cultured PC3 cells, reduced fibroblast motility, and protected the fibroblasts from being educated to a CAF-like phenotype by prostate cancer cells.

Conclusions

This study highlights the potential of CTAP-MS to characterise intercellular communication within the prostate TME and identify regulators of cellular crosstalk such as TMSB4X.
Submarine hydrodynamics for off-design conditions
Authors: Toxopeus Serge , Kerkvliet Maarten , Vogels Roderik , Quadvlieg Frans , Nienhuis Bart
Published: September 2022

Traditionally, submarine hydrodynamic design has focussed mainly on requirements regarding operational range, powering performance and manoeuvring ability for deeply submerged conditions. To improve the effectiveness of the boat, attention is also paid to operating near or at the surface and fortunately, computational tools and experimental methods are available to analyse the performance of submarines at these conditions. To advance submarine hydrodynamics knowledge and tools, DMO and MARIN have conducted a wide variety of bi-lateral or collaborative studies using potential and viscous flow methods and experiments on several submarine hull forms. In this article, several examples are presented of the development and use of hydrodynamic tools available during the design and assessment process of future submarines. These examples range from experimental and numerical studies into at-surface and periscope-depth resistance and powering, periscope-depth manoeuvring, high-fidelity flow around the boat during straight flight and manoeuvring motions, wakes of surface-piercing masts, to depth keeping under waves. It is demonstrated how state-of-the-art studies help in advancing the knowledge on submarine hydrodynamics and improving the overall design of modern submarines.
Pleomorphic Adenoma of Palatal Minor Salivary Glands with Bone Infiltration: Case Report with Long-term Follow-up
Authors: Tsekos Antonios , Tatsis Dimitris , Fotiadou Anastasia , Kechagias Nikolaos , Vahtsevanos Konstantinos
Published: September 2022

Intraoral pleomorphic adenoma is a rare entity, with the most common site of appearance being the palate. As a benign lesion, it rarely involves underlying structures. The aim is to present a case of a palatal pleomorphic adenoma (cellular) with bone involvement, with reference to clinical and histological features of the tumour, emphasis on diagnostic and therapeutic management and comparison with the findings of similar studies in the literature. Pleomorphic adenomas of the palatal minor salivary glands remain a rather rare clinical condition, and it is unusual to infiltrate the adjacent palatal bone. A thorough clinical imaging and histological/cytological examination should always be performed to define the benign or malignant nature of the lesion, preoperatively.
Modeling the upshots of induced temperature and water stress on germination and seedlings length of radish (Raphanus sativus L.) via hydrothermal time model
Authors: Khan Jalal , Ullah Sami , Shah Sikandar , Sadaf  , Khan Sheharyar , Sulaiman
Published: September 2022

Radish (Raphanus sativus L.), a representative of the Brassicaceae family, is an extensively cultivated root vegetable across the world. Thermal time (TT), hydro time (HT), and hydrothermal time (HTT) models can be used to characterize the response of seed germination rate to temperature (T) and water potential (ψ). The germination behavior of radish was investigated throughout a range of constant temperatures and water potentials to evaluate the effectiveness of hydro-thermal time model and offer a data set of germination thresholds and parameters. The study was intended to simultaneously inspect the radish seed germination (SG) pattern, base water potentials (ψb(50)) and cardinal temperatures across varying temperatures (Ts) and PEG-6000 water potentials (Ψs) via the hydrothermal time (HTT) model. In a laboratory experiment Raphanus sativus L. seeds were germinated at four constant Ts of 15, 20, 30 and 40 °C under four different water potentials (ψs) of 0, − 0.2, − 0.4 and − 0.6 MPa. Germination decreased significantly at (p ≤ 0.01) from 40% at 15 °C in − 0.2 MPa to 13% in − 0.8 MPa at 40 °C. The results also revealed that radish was more sensitive to ψ than T (p ≤ 0.01). As per the significance level of the model attributes (R2: 0.527), the average cardinal temperatures were 15, 20 and 40 °C for the base (Tb), optimal (To) and ceiling (Tc) temperatures respectively. Germination energy (GE), germination rate index (GRI), germination percentage (G%), germination index (GI), mean moisture content (MMC), seed vigor index 1 and 2 (SVI-1 and SVI-2), were recorded maximum in control condition at 15 and 20 °C and minimum at − 0.8 MPa at 40 °C. The model applied here, and its attributes, may be used as a prediction tool in different SG simulation studies, each with its own set of strengths and drawbacks. The hydrothermal constant investigates the interaction influence of T and ψ on germination under diverse ecological settings using germination data, cardinal temperatures, and statistical analysis.
Morita equivalence of w*-rigged modules
Authors: Papapetros E.
Published: September 2022

The w*-rigged modules over dual operator algebras were introduced by Blecher and Kashyap as a generalization of W*-modules. In this paper, we introduce two new types of Morita equivalence between right w*-rigged modules over unital dual operator algebras and we examine whether these notions imply stable isomorphism between the corresponding modules. Furthermore, we investigate them in detail for the class of right w*-rigged modules over nest algebras, a class which was characterized by G.K. Eleftherakis.
Global Attractors for a Class of Weakly Damped Wave Equations with Gradient Type Nonlinearity
Authors: Pan Zhigang , Wang Yanhua , Shuai Kun
Published: September 2022

In this paper, the main purpose is to study existence of the global attractor for the weakly damped wave equation with gradient type nonlinearity. To this end, we first verify the existence and uniqueness of global weak solution by the Galerkin method and compulsively variational method. Furthermore, we obtained the global strong solution under some mild assumptions on f. Secondly, we utilize the $$\omega$$
ω
-limit compactness to show the semigroup generated by the equation has a compact, connected and invariant attractor.
Multinodular Goiter: The Surgical Procedure of Choice
Authors: Cohen‐Kerem Raanan , Schachter Pinhas , Sheinfeld Maxim , Baron Elzbieta , Cohen Oded
Published: September 2022

Surgical management of multinodular goiter (MNG) poses an ongoing dilemma between radical resection with its associated complications and partial resection, which carries the risk of recurrence and increased morbidity and difficulty for rethyroidectomy. This study was designed to evaluate the recurrence rate and need for reoperation in a carefully selected population of MNG patients, after nontotal thyroidectomy. The study addressed a highly selected population of patients who were treated and thoroughly evaluated at one surgical department for several years. We analyzed the recurrence rate of MNG in 124 patients. The follow‐up duration extended from 6 to 516 months (mean 93 months). The general recurrence rate for all nontotal bilateral thyroidectomies was 21% (21/100 patients), increasing from 13.4% to 60% according to the extent of resection. The average time for recurrence was 105 months (8.75 years). Among the patients with recurrent MNG, only 4 (4% of the patients with nontotal bilateral thyroidectomy) required secondary surgical interventions with no resultant morbidity. In our series of very highly selected patients, the recurrence rate for nontotal thyroidectomy was high (21%); however, the need for secondary surgical intervention was low (4%). Thus nontotal thyroidectomy for MNG is legitimate. However, we suggest that the surgical procedure of choice be tailored according to the severity of the disease and the patient's general condition.
A Prospective Study on the Efficacy of Mometasone Furoate Monohydrate Aqueous Nasal Spray on Chinese Patients with Allergic Rhinitis
Authors: Tsang Raymond K. Y. , Tong Michael C. F. , Woo John K. S. , Van Hasselt C. Andrew
Published: September 2022

OBJECTIVE

We undertook a prospective study of the efficacy of a new intranasal steroid, mometasone furoate nasal spray (Nasonex; Schering‐Plough Corp, Kenilworth, NJ).

STUDY DESIGN

Chinese patients with allergic rhinitis were recruited. The patients were assessed by a questionnaire that included demographic data and a Rhinitis Symptoms Score. Objective assessments of the nasal passages were performed with a 2.7‐mm 30‐degree rigid nasoendoscope and scored according to the modified Lund and Kennedy sinusitis staging and scoring for endoscopic appearances of the nasal cavity in rhinosinusitis. Patients were assessed before treatment, and then 200 μg/d MFNS was prescribed. Patients were reevaluated after 8 and 16 weeks of commencement of MFNS. A total of 51 patients completed the 16‐week study.

RESULTS

There were significant reductions in mean Rhinitis Symptoms Score from 6.19 to 3.8 (P < 0.001) and mean Endoscopic Appearance Score from 4.6 to 3.58 (P = 0.046). Analysis showed that there were reductions in the severity of all 3 aspects of rhinitis symptoms: rhinorrhea, sneezing, and nasal obstruction.

CONCLUSION

Mometasone furoate nasal spray was effective in controlling allergic rhinitis and was well tolerated by patients.
Biofeedback Rehabilitation for Prevention of Synkinesis after Facial Palsy
Authors: Nakamura Katsuhiko , Toda Naoki , Sakamaki Koichiro , Kashima Kenji , Takeda Noriaki
Published: September 2022

OBJECTIVE

We developed a new training method of biofeedback rehabilitation for the prevention of synkinesis after facial palsy and evaluated the efficacy of the training.

METHODS

Twenty‐seven patients with complete facial palsy were divided randomly into 2 groups. Twelve of the patients were treated with the training method, and the other 15 patients served as controls. Patients were instructed to keep their eyes open symmetrically during mouth movements using a mirror. Thirty minutes of daily training was continued for a period of 10 months. The degree of synkinesis was evaluated by computing the percent asymmetry of eye opening width.

RESULTS

The percent asymmetry of eye opening width was significantly greater in the training group than in the control group (P < 0.05). The results indicate that the degree of synkinesis is much less in the training group than in the control group.

CONCLUSION

Our new training method is very effective for preventing the development of synkinesis after facial palsy.
The Use of the Facial Translocation Technique in the Management of Tumors of the Paranasal Sinuses and Skull Base
Authors: Hao Sheng‐Po , Pan Whei‐Lin , Chang Chen‐Nen , Hsu Yung‐Shin
Published: September 2022

OBJECTIVE

We sought to assess the efficacy of facial translocation in the management of tumors of the skull base and paranasal sinuses.

STUDY DESIGN AND SETTING

From July 1993 to December 1999, 75 patients, aged 3 to 102 years old, underwent facial translocation. Thirty‐three (44%) patients also underwent a combined neurosurgical procedure. Nineteen (25%) had previous surgery. These patients were followed up to 6 years.

RESULTS

There were 21 benign and 54 malignant tumors. There were no perioperative deaths. The morbidity rate was 31%. Of the 54 patients with malignant tumors, the actuarial 3‐year survival rate was 59%, whereas the local control rate was 54%.

CONCLUSION

The facial translocation technique offers favorable exposure of the critical zones of the anterior and middle cranial base, thus facilitating extensive resection and reconstruction.

SIGNIFICANCE

This study demonstrates that facial translocation is one of the best surgical approaches to the skull base.
Oncologic and Functional Results of Near‐Total Laryngectomy
Authors: Bernáldez Ricardo , García‐Pallares Marta , Morera Eduardo , Lassaletta Luis , del Palacio Antonio , Gavilán Javier
Published: September 2022

OBJECTIVE

To report the oncologic and functional outcome of patients undergoing near‐total laryngectomy.

STUDY DESIGN AND SETTING

A retrospective analysis was carried out from 1991 through 1998.

RESULTS

Eighty‐seven patients underwent near‐total laryngectomy. The Kaplan‐Meier overall survival, cause‐specific survival, and relapse‐free survival estimates at 5 years were 48.2%, 75.8%, and 72.4%, respectively. Univariate analysis revealed prognosis significance for location, stage, and pathologic cervical lymph node status. Five percent of the patients developed local recurrence, 16% recurrence in cervical lymph nodes, and 10% distant metastasis. Pharyngocutaneous fistula was the most frequent complication (48%). Seventy‐seven percent of cases achieved voice preservation. Symptomatic aspiration was noted in 12.3% of cases.

CONCLUSION

Near‐total laryngectomy can be a successful surgical procedure for selected patients; it does not replace total laryngectomy but reduces its indications. Voice preservation can be achieved in most cases.

SIGNIFICANCE

Near‐total laryngectomy enhances the speech rehabilitation options for the laryngectomy patient by adding a physiologic, nonprosthetic tissue technique.
Tuberculosis of the Lymph Glands of the Neck: A Limited Role for Surgery
Authors: Ammari Fuad F. , Hani Ashraf H. Bani , Ghariebeh Kamal I.
Published: September 2022

BACKGROUND AND OBJECTIVE

The clinical problem of a neck mass in general and tuberculous lymph nodes in the neck in particular may present a diagnostic dilemma. This retrospective study was conducted to highlight clinical presentation, management, and outcome.

PATIENTS AND METHODS

All patients (n = 59) diagnosed with tuberculosis of the cervical lymph node in Irbid governorate during the period 1996 through 2000 were reviewed for standard criteria, in addition to diagnostic and therapeutic modalities.

RESULTS

Medical records were reviewed and relevant data were included; all age groups were equally involved with a female/male ratio of 2:1. Most of the patients presented with a neck mass to the outpatient surgical clinic. The diagnosis was made mainly based on the clinical picture and results of the Mantoux test, Ziehl‐Neelsen staining, and culture of bacilli. Fine needle aspiration cytology and histologic examination of incisional or excisional specimens are the main objective diagnostic tools. All patients were treated with antituberculous drugs under directly observed therapy short‐course regimen with 83% cure rate.

CONCLUSION

Tuberculosis of the cervical lymph nodes responds well to antituberculous drugs and the surgical role is limited to guidance in fine needle aspiration, incision and drainage, and incisional and limited excisional biopsy. Major excisional procedures are not without complications and should be avoided.
Injection Snoreplasty: Extended Follow‐Up and New Objective Data
Authors: Brietzke Scott E. , Mair Eric A.
Published: September 2022

OBJECTIVE

Injection snoreplasty was recently introduced as a safe, effective, and minimally invasive treatment for primary snoring. Extended follow‐up data (19 months) are presented from the initial pilot study cohort, and pretreatment/posttreatment objective data are presented on a new prospective patient cohort.

STUDY DESIGN AND SETTING

The successfully treated patients from the initial pilot study (n = 25) were surveyed regarding their current snoring level, overall discomfort, and overall satisfaction. A new patient cohort with primary snoring (Respiratory Disturbance Index <10) was prospectively treated with injection snoreplasty. Snoring was objectively measured pretreatment and posttreatment using a take‐home acoustical analysis device.

RESULTS

Subjective success dropped from 92% to 75% at a mean of 19‐month follow‐up with a snoring relapse rate of 18%. Objective analysis of a new patient cohort (n = 17) confirmed statistically significant decreases in palatal flutter snoring and palatal loudness after injection. Preprocedure measurements were highly correlated to eventual treatment success.

CONCLUSIONS AND SIGNIFICANCE

Success and snoring relapse rates of injection snoreplasty are similar to those of other current treatments. Objective analysis confirms the procedure is effective in reducing palatal flutter snoring. Preprocedure snoring analysis may predict patient response to palatal stiffening treatments.
Systematic Approach to Benign Paroxysmal Positional Vertigo in the Elderly
Authors: Angeli Simon I. , Hawley Rose , Gomez Orlando
Published: September 2022

OBJECTIVE

We evaluated the effectiveness of a management approach that combines the canalith repositioning maneuver (CRM) and vestibular rehabilitation (VR) in the treatment of benign positional paroxysmal vertigo (BPPV) in elderly persons.

STUDY DESIGN AND SETTING

Forty‐seven patients (>70 years old) with the diagnosis of unilateral posterior semicircular canal BPPV formed the study population. This study has 2 parts. In the first part, patients were randomly assigned to 1 of 2 groups: the CRM and avoidance (no treatment). Patients were evaluated 1 month after the first visit. Those patients not responding to treatment were enrolled in the second part of the study, treated with an individualized combination of CRM and VR, and then reevaluated 3 months later.

RESULTS

Statistically significant improvement of vertigo and provoked nystagmus in 64% of patients in the CRM group compared with the no‐treatment group. After the addition of VR, 77% of all patients improved.

CONCLUSION

A combination of CRM and VR improves BPPV in the elderly.

SIGNIFICANCE

These findings suggest that although CRM is more effective than no treatment, VR can be added to improve the results in the treatment of BPPV.
Prognostic value of otoacoustic emissions in children with middle ear effusion
Authors: Yeo Sang W. , Park Shi‐Nae , Park Yong Soo , Suh Byung Do
Published: September 2022

The amplitude and frequency spectra of otoacoustic emissions are influenced by the condition of the middle ear. These are noninvasive measurements of cochlear function that are accurate, rapid, and simple to perform. In this study, prognostic value of otoacoustic emissions in children with middle ear effusion (MEE) was investigated. A total of 49 children aged 3.5 to 11.2 years with MEE were included. Spontaneous otoacoustic emission, transient evoked otoacoustic emission (TEOAE), and distortion product (DP) otoacoustic emission measurements were performed on each ear before medical treatment and were compared according to the responsiveness of medical treatment (medicine responder vs medicine nonresponder groups). Responses of spontaneous otoacoustic emissions and DP audiogram showed no significant difference between the 2 groups but TEOAE response was significantly decreased in medicine nonresponders (P > 0.05). Positive responses of the DP Input‐Output function curve in geometric mean frequencies at 5 and 6 kHz using a primary tone of 55 dB SPL were significantly detected in medicine responders (P > 0.01). The sensitivity, specificity, and predictive values of TEOAE and the DP I‐O function curve in geometric mean frequency at 6 kHz using a primary tone of 55 dB SPL showed the high prognostic value of these tests in terms of predicting response to medical treatment in the patients with MEE. This suggests that otologists may have to be more aggressive in their treatment of children with MEE who showed no response.
Color duplex sonography for the monitoring of vascularized free bone flaps
Authors: SchöN Ralf , Schramm Alexander , Gellrich Nils‐Claudius , Maier Wolfgang , Jürgen Düker , Schmelzeisen Rainer
Published: September 2022

OBJECTIVE

When vascular complications are suspected after the microsurgical transfer of free buried fibular bone flaps without a skin island, revision surgery often proves to be unnecessary. We sought to determine the efficacy of color duplex sonography in the close observation of bone graft patency postoperatively.

STUDY DESIGN

Twelve free fibular bone flaps without a skin island were postoperatively monitored through color duplex sonography with a 7.5‐MHz scanner.

RESULTS

With color duplex sonography, the rate of perfusion in the vascular pedicle could be visualized in all 12 fibular flaps. In 3 patients, vascular complications and flap failure were suspected. However, because adequate perfusion of the vascular pedicle was observed immediately after surgery and in the daily follow‐up examinations, revision surgery was not necessary.

CONCLUSIONS

Color duplex sonography is not time‐consuming; in fact, it is a reliable, noninvasive, and inexpensive method for the postoperative monitoring of free bone flaps.
Histologic changes to olfactory epithelium in hypothyroid rats
Authors: Dhong Hun‐Jong , Kim Hyo Yeol , Ha Byung Suk
Published: September 2022

OBJECTIVE

The purpose of this study was to immunohistochemically evaluate the effects of thyroid hormones on the olfactory epithelium (OE) in adult rats.

STUDY DESIGN AND SETTING

Hypothyroidism was induced in rats by propylthiouracil (PTU) administration. Animals were grouped into 5 consisting of a control group, and 4 groups that had been treated with PTU for 3, 6, 9, or 12 weeks, respectively. The thickness and cell densities of the OE were examined according to the duration of PTU treatment. Changes to OE cell properties were investigated with immunohistochemical stains.

RESULTS

No statistically significant differences were found in the thickness and cell densities of the OE among the 5 groups. The number of olfactory receptor neurons positive for neuron‐specific enolase or protein gene product 9.5, however, decreased with increasing duration of PTU treatment.

CONCLUSION

Thyroid hormones play an important role in the maturation of olfactory receptor neurons.
Uvulopalatal Flap for Snoring on an Outpatient Basis
Authors: Neruntarat Chairat
Published: September 2022

OBJECTIVE

Snoring is now seen as one end of a spectrum of sleep‐related breathing disorders, and in its extreme form, snoring can cause obstructive sleep apnea syndrome. Since the introduction of uvulopalatopharyngoplasty, many other procedures have been introduced to alleviate palatal abnormalities seen in patients with obstructive sleep apnea syndrome. A reversible uvulopalatal flap (UPF) achieves the same results as the uvulopalatopharyngoplasty but with less postoperative discomfort. The purpose of this study was to assess the safety and efficacy of UPF for the treatment of simple snoring on an outpatient basis.

METHODS

UFP was performed on an outpatient basis under local anesthesia. The mucosa on the lingual surface of the uvula and soft palate was removed with cold knife dissection. The uvular tip was amputated. The uvula was reflected back toward the soft palate and sutured. Most of the patients were male with simple snoring by history and confirmed by polysomnographic study. Data on patients were compared from preoperative to postoperative assessment points. Statistic analysis was performed.

RESULTS

Fifty‐six patients tolerated the procedure well, and it was performed in an average of 20 minutes. Patients had a mean age of 48 years and a mean body mass index of 26.5 kg/m2. The mean follow‐up was 14 months (range, 12 to 20 months). Significant improvement was observed in snoring scale (8.2 ± 3.4 versus 2.6 ± 1.4, P < 0.05). Mean snoring index decreased from 245.8 ± 40.8 to 42.5 ± 20.7 events/hr (P < 0.001). The correlations between the changes in the subjective and objective snoring assessments were statistically significant. Postoperative complications included transient nasal regurgitation (4%) and foreign body sensation (2%). Bleeding, dysphagia, infection, and nasopharyngeal stenosis were not observed. Most patients had mild to moderate pain (visual analog scale, ≤7) for 5 to 7 days after the procedures. The overall success rate was 88%.

CONCLUSION

Snoring, as reported by subjective and objective results, decreased after UPF. It appears to be a safe and effective procedure, which can be easily performed under local anesthesia on an outpatient basis, in carefully selected patients. (Otolaryngol Head Neck Surg 2003;129:353–9.)
Hot Versus Cold Tonsillectomy: A Systematic Review of the Literature
Authors: Leinbach Robert F. , Markwell Stephen J. , Colliver Jerry A. , Lin Sandra Y.
Published: September 2022

OBJECTIVE

We systematically reviewed the literature comparing monopolar electrocautery versus cold knife dissection tonsillectomy.

METHODS

The MEDLINE database was searched using the key words “tonsillectomy,” “hot,” “cold,” “sharp,” “bleeding,” and “cautery.” Selection criteria included prospective trials comparing electro‐dissection versus cold knife dissection on posttonsillectomy pain and hemorrhage. Six of the 815 articles met the selection criteria.

RESULTS

Pooled data for the paired studies showed significantly more patients with pain worse on the electrodissection side (148 of 293 = 51%) than the cold knife side (33 of 293 (11%); P = 0.001) on postoperative days 4 to 10. There were significantly more analgesic doses after surgery with electrodissection (means 26.7 versus 19.2; P = 0.028) and higher pain scores for adults undergoing electrodissection (means, 2.6 versus 0.8; significance could not be determined). There were no differences in hemorrhage rates.

CONCLUSIONS

Electrodissection increases pain in comparison to sharp dissection for tonsillectomy. Postoperative hemorrhage rates are not significantly different when comparing the 2 methods. (Otolaryngol Head Neck Surg 2003;129:360–4.)
Coronal Computed Tomography Prevalence of Superior Semicircular Canal Dehiscence
Authors: Williamson Robert A. , Vrabec Jeffrey T. , Coker Newton J. , Sandlin Marlin
Published: September 2022

OBJECTIVES

The relatively new clinical entity superior canal dehiscence syndrome (SCDS) is diagnosed by clinical symptoms and signs. Coronal computed tomography (CT) has been used to confirm the diagnosis. A consecutive series of temporal bone CT scans was reviewed to define the prevalence of a dehiscent‐appearing superior semicircular canal.

STUDY DESIGN AND SETTING

Temporal bone CT scans performed over a 2‐year period at a university‐based tertiary referral center were reviewed independently by 3 individuals. Scans were excluded if coronal images were not obtained or reconstructed from axial images. Prevalence figures for dehiscent‐appearing superior semicircular canal were determined by consensus. Medical records of selected individuals with a dehiscent‐appearing canal were reviewed for study indications and otologic symptoms.

RESULTS

A dehiscent‐appearing superior semicircular canal was seen in 9% of studies. Correlation among examiners was greater than 94%. Medical records indicated symptoms suggestive of or compatible with the diagnosis of SCDS in rare cases.

CONCLUSION

The prevalence of a dehiscent‐appearing superior semicircular canal on coronal CT of the temporal bones performed with 1.0‐mm collimation is substantially greater than that predicted by temporal bone histologic study. Clinical symptoms compatible with the diagnosis were seldom recorded, suggesting low specificity. The high sensitivity and low specificity of CT scan create a risk for overdiagnosis of SCDS if the coronal CT scans are not correlated with clinical symptoms.
The Agger Nasi Cell: The Key to Understanding the Anatomy of the Frontal Recess
Authors: Peter John Wormald
Published: September 2022

The key to successful surgery in the frontal recess is a complete understanding of the anatomy. The frontal recess is behind the beak of the frontal bone between the lamina papyracea and superior portion of the middle turbinate. It is a hazardous and complex area with a range of anatomical configurations. This article describes the anatomy of the frontal recess as it relates to the agger nasi cell using this cell as the key around which the anatomy is built. The simplest anatomical configuration is explained first and this knowledge is built upon so that the more complex configurations can be better understood. The classification of frontal ethmoidal cells by Kuhn is incorporated into the anatomical description of the various configurations. The implication of each anatomical variation on the surgical approach to the frontal recess is discussed.
Randomized Trial of the Canalith Repositioning Procedure
Authors: Lynn Susan , Pool Angela , Rose Darrell , Brey Robert , Suman Vera
Published: September 2022

Thirty‐six subjects with confirmed, unilateral benign paroxysmal positioning vertigo of at least 2 months' duration were randomly assigned to one of two treatment groups. After complete informational counseling and explanation of the posttreatment instructions, subjects were randomly assigned to receive either Epley's canalith repositioning procedure or a placebo maneuver. All subjects completed a daily diary for 1 month to document any dizzy spells and their adherence to the posttreatment instructions. Follow‐up Dix‐Hallpike testing was performed after 1 month by an audiologist who was blinded to the patient's treatment group status. Analysis of Dix‐Hallpike results confirmed that those who received the canalith repositioning procedure had significantly more negative responses (88.9%) than did those in the placebo group (26.7%).
Transcutaneous cervical miniesophagostomy
Authors: Har‐El Gady , Balwally Atul N.
Published: September 2022

Nasogastric tubes have been shown to cause damage to the pharyngolaryngeal complex, producing laryngeal inflammation, granulation, muscle damage, and even vocal cord immobility. The coexistence of nasogastric and tracheotomy tubes after conservation laryngeal surgery is especially harmful. The friction between these two semirigid structures may result in damage to the remaining part of the larynx. This may result in a significant delay in healing, oral feeding, and decannulation. Percutaneous endoscopic gastrostomy is a possible solution. This procedure requires time, special expertise, and cooperation between services. We present our experience with 17 transcutaneous cervical miniesophagostomies using a small‐caliber feeding tube, which were performed during conservation laryngeal and/or pharyngeal surgery. The rate of minor complications was 11.7%, or 0.40 complications per 100 tube days, and no major complications were related to the procedure. Transcutaneous cervical miniesophagostomy is a simple and quick procedure that may be performed during the primary cancer surgery. It is done by the head and neck surgeon and does not require special expertise. It takes about 5 minutes to perform and, if done correctly with tunneling under skin flaps, is associated with minimal or no postoperative morbidity.
Juvenile nasopharyngeal angiofibroma and familial adenomatous polyposis: An association?
Authors: Ferouz Aliya S. , Mohr Rose M. , Paul Philip
Published: September 2022

Juvenile nasopharyngeal angiofibroma is a benign neoplasm affecting the nasopharynx of male adolescents. Two patients treated at Temple University Hospital for this condition were also diagnosed with familial adenomatous polyposis. Familial adenomatous polyposis results from the inheritance of a mutated adenomatous polyposis coli gene in an autosomal dominant pattern. The development of colorectal carcinoma in middle age is seen almost invariably in familial adenomatous polyposis, if a prophylactic colectomy is not performed. To identify a possible association between juvenile nasopharyngeal angiofibroma and familial adenomatous polyposis, chart reviews and patient interviews were carried out for all patients treated for juvenile nasopharyngeal angiofibroma at Temple University Hospital between 1985 and 1993. Single‐strand conformational polymorphism was performed to detect the presence of certain adenomatous polyposis coli gene mutations within the germline DNA of those juvenile nasopharyngeal angiofibroma patients not previously found to have familial adenomatous polyposis. Although no more patients with both juvenile nasopharyngeal angiofibroma and familial adenomatous polyposis were found by these methods, the two patients with both disorders previously identified constitute 22% of our juvenile nasopharyngeal angiofibroma series. The implications of these findings are discussed.