bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnocellular Bias in Exogenous Attention to Biologically Salient Stimuli as Revealed by Manipulating Their Luminosity and Color
Authors: Carretié Luis , Kessel Dominique , García-Rubio María J. , Giménez-Fernández Tamara , Hoyos Sandra , Hernández-Lorca María
Published: May 2017

Exogenous attention is a set of mechanisms that allow us to detect and reorient toward salient events—such as appetitive or aversive—that appear out of the current focus of attention. The nature of these mechanisms, particularly the involvement of the parvocellular and magnocellular visual processing systems, was explored. Thirty-four participants performed a demanding digit categorization task while salient (spiders or S) and neutral (wheels or W) stimuli were presented as distractors under two figure–ground formats: heterochromatic/isoluminant (exclusively processed by the parvocellular system, Par trials) and isochromatic/heteroluminant (preferentially processed by the magnocellular system, Mag trials). This resulted in four conditions: SPar, SMag, WPar, and WMag. Behavioral (RTs and error rates in the task) and electrophysiological (ERPs) indices of exogenous attention were analyzed. Behavior showed greater attentional capture by SMag than by SPar distractors and enhanced modulation of SMag capture as fear of spiders reported by participants increased. ERPs reflected a sequence from magnocellular dominant (P1p, ≃120 msec) to both magnocellular and parvocellular processing (N2p and P2a, ≃200 msec). Importantly, amplitudes in one N2p subcomponent were greater to SMag than to SPar and WMag distractors, indicating greater magnocellular sensitivity to saliency. Taking together, results support a magnocellular bias in exogenous attention toward distractors of any nature during initial processing, a bias that remains in later stages when biologically salient distractors are present.
Not Being Oneself: A Critical Perspective on ‘Inauthenticity’ in Schizophrenia
Authors: Stephensen Helene , Henriksen Mads Gram
Published: May 2017

The task of being oneself lies at the heart of human existence and entails the possibility of not being oneself. In the case of schizophrenia, this possibility may come to the fore in a disturbing way. Patients often report that they feel alienated from themselves. Therefore, it is perhaps unsurprising that schizophrenia sometimes has been described with the heideggerian notion of inauthenticity. The aim of this paper is to explore if this description is adequate. We discuss two phenomenological accounts of schizophrenia: Binswanger’s account of schizophrenia as a form of inauthenticity and Blankenburg’s account of schizophrenia as a loss of common sense, which seems construable as a loss of inauthenticity. We argue that the accounts are highlighting aspects of the same underlying phenomenon, viz. schizophrenic autism. Moreover, we argue that Binswanger’s description of schizophrenia as a form of inauthenticity is inadequate and we discuss experiences of self-alienation in schizophrenia.
A Comparative Study of International Maritime Conventions: Italian and Greek Perspectives
Authors: Zournatzi Christina
Published: May 2017

This paper brings together a comparative study alongside expert analysis of the most important International Maritime Conventions of interest to two European Member States with extensive and significant maritime traditions, Italy and Greece. Initially the general legal framework of these two States with civil law systems is pointed out, followed by an analysis of the most influential and eminent maritime Conventions that have been implemented in the States’ legal systems. The Conventions on salvage, arrest of ships, maritime liens and mortgages and limitation of liability are considered and scrutinised. The methods and the legislative actions that the States adopted for the International rules to become part of their national legislative systems are examined thoroughly.
The Otherness in Comparative Constitutional Law
Authors: Barbisan Benedetta
Published: May 2017

Comparative Constitutional Law (ccl) has known a renaissance in the last decades. Nonetheless, it is still haunted by the apprehension of amounting to an abundant collection of valuable materials illustrating constitutional enterprises without an established and uncontroversial methodology. Should political science come to rescue the legal doctrine when it cannot grasp the variables influencing constitutional dynamics? What intellectual understanding should ccl serve? Does ccl shift from the treatment of specific topics to general themes? In my experience, both methodologies and main stream interests in ccl are critically tested in an English as a Medium of Instruction (emi)-teaching environment: that is the reason why emi-taught ccl courses may turn into useful opportunities to scrutinize the canon we have been developing. In this Article, I will try to offer a few examples of how the emi-teaching of ccl may contribute to identify a methodological guidance and a latitude of investigation.
Three new species of Ventilago (Rhamnaceae) from South-East Asia
Authors: CAHEN DANIEL , UTTERIDGE TIMOTHY M.A.
Published: May 2017

Three new species of Ventilago from Malesia are described and illustrated here: V. crenata from New Guinea, V. ferruginea from Borneo, Singapore and Sumatra and V. flavovirens from Borneo. The morphology of V. dichotoma, V. ferruginea and V. flavovirens is compared, and a key to the Ventilago species of Borneo is presented. An IUCN conservation status assessment is given for each new species.
Bulbophyllum jingdongense (Orchidaceae), a new species in the Cirrhopetalum alliance from South China and Laos
Authors: HU AI-QUN , YE DE-PING , GALE STEPHAN W. , SAUNDERS RICHARD M. K. , FISCHER GUNTER A. , LI JIAN-WU
Published: May 2017

Bulbophyllum jingdongense, a new species from South China and Laos belonging to the Cirrhopetalum alliance (Orchidaceae), is described and illustrated. It is morphologically distinct from all other known species in the alliance on account of the following diagnostic characters: pseudobulbs compressed subglobose; sepals and petals with dense, reddish-purple papillae on abaxial surfaces; lateral sepals basally connivent along their lower edges, the upper edges strongly incurved and connivent at the middle and then becoming separate again towards their incurved, horn-shaped, obtuse apex; column with a single orange-yellow gland below the stigma; and stelidia well-developed, 2.5–3 mm long, truncate at base, acuminate, merging with the column wings on each side of the column. The conservation status of B. jingdongense is assessed and taxonomic notes are provided.
A new species of Chrysopogon (Poaceae: Andropogoneae) from India
Authors: SUNIL C.N. , RATHEESH NARAYANAN M.K. , SIVADASAN M. , SHAJU T. , NAVEEN KUMAR V.V. , ALFARHAN A.H.
Published: May 2017

A new species of Chrysopogon from the lateritic hillocks of Kannur District, Kerala, India, is described and illustrated. It closely resembles C. tadulingamii, but differs mainly in having sessile spikelets with a ciliate, short-awned upper glume and a short-awned upper lemma, pedicelled spikelets with 7-nerved, awned lower glume, a short 3-nerved awnless, retrorsely ciliate upper glume and a retuse or bifid upper lemma. The new species also resembles C. asper in some characters, but differs in having acicular or linear leaf blades, rounded leaf sheaths, and sessile spikelets with short-awned upper glume and upper lemma. A key for identification of species in Chrysopogon from Kerala is also provided.
A survey for potential biological control agents of Pereskia aculeata Miller (Cactaceae) in Brazil reveals two new species of Horismenus Walker (Hymenoptera: Eulophidae)
Authors: PIKART TIAGO G. , COSTA VALMIR A. , HANSSON CHRISTER , CRISTO SANDRA C. DE , VITORINO MARCELO D.
Published: May 2017

This paper deals with the description of two new species of Horismenus Walker (Hymenoptera: Eulophidae) from Brazil, parasitoids of larvae of Adetus analis (Haldeman) (Coleoptera: Cerambycidae). Both species are similar to Horismenus steirastomae (Girault), a species that also parasitizes cerambycids. Adetus analis is a pest of Sechium edule (Jacq.) Swartz (Cucurbitaceae), a minor crop in Brazil, Argentina and U.S.A., but also feeds in stems of Pereskia aculeata Miller (Cactaceae), an ornamental plant that has become a problematic weed species in Africa, where it was introduced. The two new Horismenus species are described, diagnosed, and compared to H. steirastomae.
Drivers and Environmental Responses to the Changing Annual Snow Cycle of Northern Alaska
Authors: Cox Christopher J. , Stone Robert S. , Douglas David C. , Stanitski Diane M. , Divoky George J. , Dutton Geoff S. , Sweeney Colm , George J. Craig , Longenecker David U.
Published: May 2017

Linkages between atmospheric, ecological, and biogeochemical variables in the changing Arctic are analyzed using long-term measurements near Utqiaġvik (formerly Barrow), Alaska. Two key variables are the date when snow disappears in spring, as determined primarily by atmospheric dynamics, precipitation, air temperature, winter snow accumulation, and cloud cover, and the date of onset of snowpack in autumn that is additionally influenced by ocean temperature and sea ice extent. In 2015 and 2016 the snow melted early at Utqiaġvik owing mainly to anomalous warmth during May of both years attributed to atmospheric circulation patterns, with 2016 having the record earliest snowmelt. These years are discussed in the context of a 115-yr snowmelt record at Utqiaġvik with a trend toward earlier melting since the mid-1970s (–2.86 days decade–1, 1975–2016). At nearby Cooper Island, where a colony of seabirds, black guillemots, have been monitored since 1975, timing of egg laying is correlated with Utqiaġvik snowmelt with 2015 and 2016 being the earliest years in the 42-yr record. Ice out at a nearby freshwater lagoon is also correlated with Utqiaġvik snowmelt. The date when snow begins to accumulate in autumn at Utqiaġvik shows a trend toward later dates (+4.6 days decade–1, 1975–2016), with 2016 being the latest on record. The relationships between the lengthening snow-free season and regional phenology, soil temperatures, fluxes of gases from the tundra, and to regional sea ice conditions are discussed. Better understanding of these interactions is needed to predict the annual snow cycles in the region at seasonal to decadal scales and to anticipate coupled environmental responses.
Wintertime Simulations of a Boreal Lake with the Canadian Small Lake Model
Authors: MacKay Murray D. , Verseghy Diana L. , Fortin Vincent , Rennie Michael D.
Published: May 2017

A one-dimensional mixed layer dynamic lake model is enhanced with snow and ice physics for an examination of processes governing ice cover and phenology in a small boreal lake. The complete snowpack physics module of the Canadian Land Surface Scheme along with a new snow-ice parameterization have been added to the Canadian Small Lake Model, and detailed meteorological and temperature profile data have been acquired for the forcing and evaluation of two wintertime simulations. During the first winter, simulated ice-on and ice-off biases were −3 and −5 days, respectively. In the second winter simulation, ice-on bias was larger, likely due to the absence of a frazil ice scheme in the model, and simulated ice-off was 6 days late, evidently due to insufficient convective mixing beneath the ice in the weeks leading up to ice-off. Ice cover was simulated about 25% too thin between January and March for this year, though late January simulated snow and snow-ice amounts were close to observed. The impact of snow-ice production on simulated ice cover and phenology was found to be dramatic for this lake. In the absence of this process, January snow was more than twice as deep as observed and March ice thickness was less than one-third of that observed. Without snow-ice production, a reasonable simulation of ice cover could only be restored if 62% of snowfall was removed ad hoc (e.g., through blowing snow redistribution)—an excessive amount for a small, sheltered boreal lake.
Pilot Study of Universal Newborn Hearing Screening in Japan: District-Based Screening Program in Okayama
Authors: Fukushima Kunihiro , Mimaki Nobuyoshi , Fukuda Shoichiro , Nishizaki Kazunori
Published: May 2017

Objectives: Newborn hearing screening was started in Okayama Prefecture in 2001 as part of a nationwide pilot study in Japan. Nearly 50,000 infants have been screened to date, and an observational study and more than 2 years of follow-up of this population are described in this report.

Methods: Between June 2001 and March 2005 (45 months), 47,346 neonates were screened with automated auditory brain stem response systems and followed up for at least 2 years. This total corresponds to 95% of the infants born in the 44 gynecologic institutions in this district.

Results: After undergoing the screening process twice, 248 infants (0.52%) received referrals; 108 of them had apparent bilaterally affected hearing, and 140 had apparent unilaterally affected hearing. Among the bilateral cases, hearing impairment was diagnosed in 40 infants, for a total prevalence of hearing impairment of 0.08%. In 3 additional infants who received a bilateral pass result and 1 infant who received a unilateral pass result, hearing impairment that was progressive or of late onset was subsequently diagnosed. The positive and negative predictive values were calculated as 40% and 99.993%, respectively.

Conclusions: The screening program was carefully designed to work in the Japanese society and to be well managed in Okayama Prefecture.
Clinical and Pathologic Predictors of Survival in Patients with Squamous Cell Carcinoma of the Hypopharynx after Surgical Treatment
Authors: Chu Pen-Yuan , Li Wing-Yin , Chang Shyue-Yih
Published: May 2017

Objectives: Hypopharyngeal squamous cell carcinoma (HPSCC) usually presents at an advanced stage. Although chemo-radiotherapy has become more popular in treating HPSCC in recent years, surgery with postoperative adjuvant therapy still plays an important role. The purpose of this study was to identify the clinicopathologic factors that predict survival in patients with HPSCC who underwent surgical treatment.

Methods: Between 1986 and 1995, 94 previously untreated HPSCC patients who underwent surgery with or without postoperative radiotherapy were enrolled. The surgical specimens were reexamined by a single pathologist. The clinicopathologic parameters and prognostic data were analyzed.

Results: With a median follow-up of 50 months, the 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) were 47%, 60%, and 58%, respectively. Thirty-seven patients (39%) had tumor recurrence. The level of lymph node metastasis was an independent factor in OS, DSS, and RFS. Neck biopsy before surgery, tumor involvement of more than 1 subsite, and extracapsular spread were independent factors in DSS, as was lymphovascular permeation in RFS.

Conclusions: The level of cervical lymph node metastasis is the only independent prognostic factor in OS, DSS, and RFS. The addition of postoperative chemoradiotherapy may benefit high-risk cases.
Changes in Cytokine Signaling and Extracellular Matrix Production Induced by Inflammatory Factors in Cultured Vocal Fold Fibroblasts
Authors: Lim Xinhong , Bless Diane M. , Muñoz-Del-Río Alejandro , Welham Nathan V.
Published: May 2017

Objectives: Modulating cytokine signaling in vocal fold fibroblasts after injury may influence extracellular matrix (ECM) production and eventual fibrotic outcome. To evaluate previously established in vivo cytokine and ECM gene expression hypotheses, we examined in vitro vocal fold fibroblast responses to exogenous inflammatory factor stimulation.

Methods: Rat vocal fold fibroblast lines derived from expiants were separately treated with interleukin-1β (IL-1β), interferon gamma (IFN-γ), tumor necrosis factor a (TNF-α), transforming growth factor β subtype 1 (TGF-β1), or prostaglandin E2 (PGE2). We examined the in vitro messenger RNA expression profiles of IL-1β, IFN-γ, TNF-α, TGF-β1, and cyclooxygenase 2 (COX-2), as well as those of hyaluronic acid synthase (HAS) 1, HAS-2, procollagen subtype 1, and procollagen subtype 3, at 1, 4, 8, 16, 24, and 72 hours after treatment, and compared them to those of untreated fibroblasts and in vivo data, using real-time reverse transcription-polymerase chain reaction.

Results: IL-Iβ and TNF-α induced each other and synergistically increased HAS-1 and HAS-2 expression. PGE2also up-regulated HAS-1 and HAS-2 expression. IFN-γ, IL-1β, TNF-α, and TGF-β1 up-regulated HAS expression alongside either transient up-regulation of, or no change in, procollagen 1 and 3 expression. Most treatments appeared to suppress procollagen expression, possibly through HAS up-regulation. All inflammatory factors attenuated TGF-β1 expression.

Conclusions: These results confirm several in vivo trends, identify potential cytokine pathways and therapeutic candidates, and suggest the utility of this in vitro setup for future studies.
Endoscopie Laser Resection of Laryngeal Cancer: Is it Oncologically Safe?
Authors: Burns James A. , Har-El Gady , Shapshay Stanley , Maune Steffen , Zeitels Steven M.
Published: May 2017

The purpose of this report is to summarize the salient points made during a panel discussion at the 88th Annual Meeting of the American Broncho-Esophagological Association about the efficacy and oncological safety of endoscopic laser treatment of laryngeal cancer. Guidelines for endoscopic laser management of early glottic and supraglottic cancer, including contraindications for this treatment modality, are presented. On the basis of all currently available data, the panel, which critically considered the question of oncological safety, is of the opinion that endoscopic laser resections are oncologically safe when applied judiciously and by a skilled oncological surgeon. Relative contraindications for endoscopic laser resection of laryngeal cancer include instances in which the whole tumor cannot be visualized; large tumors that require removing too much of the functional laryngeal unit, severely decreasing airway protection and leading to aspiration; and cartilage invasion. Specific contraindications for supraglottic cancer include bilateral arytenoid involvement and direct extension into the neck.
Comparative Study of Vocal Outcomes with Silicone versus Gore-Tex Thyroplasty
Authors: Suehiro Atsushi , Hirano Shigeru , Kishimoto Yo , Tanaka Shinzo , Ford Charles N.
Published: May 2017

Objectives

We examined vocal outcomes of patients who underwent type I thyroplasty for unilateral vocal fold paralysis. Specifically, the vocal outcomes were compared between 15 patients whose thyroplasties were performed with silicone and 15 patients whose thyroplasties were performed with Gore-Tex.

Methods

The examined clinical characteristics did not differ significantly between the groups. The vocal outcomes were evaluated by aerodynamic and acoustic measurements.

Results

Aerodynamic examination indicated significant postoperative improvements in the maximum phonation time and mean flow rate in both groups. Shimmer was significantly improved only in the Gore-Tex group. A direct comparison between groups showed no significant difference in the degree of improvement of the vocal parameters, except for a significant improvement in the noise-to-harmonics ratio in the Gore-Tex group. The duration of surgery was significantly less in the Gore-Tex group than in the silicone group.

Conclusions

Gore-Tex thyroplasty is considered to be comparable to silicone thyroplasty in terms of postoperative vocal outcomes. Gore-Tex thyroplasty enables a less invasive procedure with a shorter surgical duration and easier adjustment of medialization due to its flexibility.
Extended Lateral Pharyngotomy for Selected Squamous Cell Carcinomas of the Lateral Tongue Base
Authors: Laccourreye Ollivier , Seccia Veronica , Ménard Madeleine , Garcia Dominique , Vacher Christian , Holsinger F. Christopher
Published: May 2017

Objectives

In a retrospective review of an inception cohort of 26 patients with an isolated, previously untreated, moderately to well-differentiated invasive squamous cell carcinoma of the lateral tongue base, consecutively managed with an extended lateral pharyngotomy approach at a single tertiary referral care center, the authors review the key surgical points, highlight the potential technical pitfalls, and document the complications and long-term functional and oncological outcomes in terms of survival and local control.

Methods

The adjunctive measures included induction chemotherapy, ipsilateral neck dissection, and postoperative radiotherapy, used in 96.1%, 96.1%, and 38.5% of patients, respectively. All patients but 2 were followed for at least 5 years or until death (maximum, 158 months).

Results

The significant postoperative complications included pharyngocutaneous fistula in 3 patients (11.5%) and hemorrhage requiring reoperation, partial flap necrosis, and pneumonia from aspiration in 1 patient (3.8%) each. In univariate analysis, no significant statistical relationship was noted between the significant postoperative complications noted and the variables under analysis. Overall, successful oral alimentation was achieved in 100% of patients by the first postoperative month without gastrostomy, tracheotomy, or completion total laryngectomy. There were no intraoperative or perioperative deaths. The main causes of death were metachronous second primary tumor, intercurrent disease, and distant metastasis, resulting in 84.6%, 64%, and 46.9% 1-, 3-, and 5-year Kaplan-Meier actuarial survival estimates, respectively. Two patients (7.6%) had local recurrence, resulting in 100%, 86.7%, and 86.7% 1-, 3-, and 5-year Kaplan-Meier actuarial local control estimates, respectively. As a function of T stage, the 3- and 5-year actuarial local control estimates were 100%, 87.5%, and 90.9% in patients with tumors classified as T1, T2, and T3–T4a, respectively.

Conclusions

Such results suggest that extended lateral pharyngotomy should be integrated among the various conservative treatment options available to patients with selected carcinomas of the lateral tongue base.
Techniques of Celloidin Removal from Temporal Bone Sections
Authors: O'malley Jennifer T. , Burgess Barbara J. , Jones Diane D. , Adams Joe C. , Merchant Saumil N.
Published: May 2017

Objectives

We sought to determine whether the technique of celloidin removal influences the results of immunostaining in celloidin-embedded cochleae.

Methods

We compared four protocols of celloidin removal, including those using clove oil, acetone, ether-alcohol, and methanol saturated with sodium hydroxide. By optimally fixing our tissue (perfused mice), and keeping constant the fixative type (formalin plus acetic acid), fixation time (25 hours), and decalcification time (ethylenediaminetetraacetic acid for 7 days), we determined whether the technique of celloidin removal influenced the immunostaining results. Six antibodies were used with each removal method: prostaglandin D synthase, sodium, potassium adenosine triphosphatase (Na+JC+-ATPase), aquaporin 1, connective tissue growth factor, tubulin, and 200 kd neurofilament.

Results

Clove oil, acetone, and ether-alcohol resulted in incomplete removal of the celloidin, thereby negatively affecting the results of immunostaining. The methanol-sodium hydroxide method was effective in completely removing the celloidin; it produced the cleanest and most reproducible immunostaining for all six antibodies.

Conclusions

Freshly prepared methanol saturated with sodium hydroxide and diluted 1:2 with methanol was the best solvent for removing celloidin from mouse temporal bone sections, resulting in consistent and reproducible immunostaining with the six antibodies tested.
New Mouse Model for Studying Laryngeal Transplantation
Authors: Shipchandler Taha Z. , Lott David G. , Lorenz Robert R. , Friedman Aaron D. , Dan Olivia , Strome Marshall
Published: May 2017

Objectives

Laryngeal transplantation research has been studied in various animal models. For in-depth, immunology-based transplantation research, however, a thoroughly studied animal model must exist. The purpose of this study was to develop a reliable surgical technique in mice to serve as a model for further study of laryngeal transplantation.

Methods

Heterotopic laryngeal transplantation was attempted in 15 immunocompetent mice by use of modifications of previously described techniques established in rats.

Results

Various microvascular techniques were used that led to 8 successful transplants (of 15) with patent vascularity at the time of sacrifice. The first 7 attempts at transplantation were unsuccessful because of technical difficulties related to vessel size, soft tissue traumatic injury, and venous congestion. Subsequently, 8 transplantation procedures were successfully performed after modifications of the surgical technique.

Conclusions

This pilot study describes the reproducible surgical techniques performed in using mice for studying laryngeal transplantation. Mice are cost-effective and immunologically well studied, and are thus ideal for further laryngeal transplantation research.
Effectiveness of Calcium Hydroxylapatite Paste in Vocal Rehabilitation
Authors: Gillespie M. Boyd , Dozier Thomas S. , Day Terry A. , Martin-Harris Bonnie , Nguyen Shaun A.
Published: May 2017

Objectives

We determined the effectiveness of calcium hydroxylapatite (CaHA) paste in vocal rehabilitation.

Methods

We examined a retrospective case series of 39 adult patients who underwent CaHA paste injection for vocal fold rehabilitation over a 5-year period. The outcomes included the change in the Voice Handicap Index (VHI) score; procedure-related complications; and the need for follow-up voice procedures.

Results

The VHI scores demonstrated overall improvement, with a decrease from the preoperative mean of 61.2 ± 24.0 to a postoperative mean of 35.9 ± 26.3 (p = 0.0001) after a mean follow-up time of 17.8 ± 13.6 months. The procedure was more likely to succeed in patients with paralysis and/or paresis than in patients with glottic soft tissue defects. After injection, the VHI scores worsened in 3 of 7 patients (43%) in the soft tissue defect group, compared to only 2 of 28 (7%) in the paralysis and/or paresis group (p = 0.04). Four of 7 patients with soft tissue defects (57%) required secondary vocal procedures to improve the voice, compared to only 2 of 32 (6%) in the paralysis and/or paresis group (p = 0.006).

Conclusions

Injection of CaHA paste results in significantly improved vocal scores in the majority of patients. Use of the paste was less satisfactory in patients with soft tissue defects because of poor retention of the paste in the scarred vocal fold remnant.
Acute Mastoiditis in Children: Is Computed Tomography Always Necessary?
Authors: Tamir Sharon , Schwartz Yehuda , Peleg Uri , Perez Ronen , Sichel Jean-Yves
Published: May 2017

Objectives

Acute mastoiditis (AM) is the most common intratemporal complication of acute otitis media in children. In the past decade, reports have indicated a rise in the incidence of AM in the pediatric population. A parallel rise in the use of computed tomography (CT) imaging has occurred. The rise in the use of CT scanning in the pediatric population, entraining with it a rise in pediatric brain irradiation, has led us to question the necessity of using CT for pediatric patients with AM.

Methods

We reviewed the medical files of pediatric patients who had AM in the years 2005 through 2007.

Results

Fifty patients were identified. The gender distribution was equal, and the ages ranged from 4 months to 12 years. Of the 46 patients who were admitted to our institution “de novo,” only 2 underwent CT scanning on admission, and 4 other patients had CT performed during hospitalization. The majority of patients (92%) with AM did not have a CT scan performed and were treated conservatively with no complications.

Conclusions

In most pediatric patients, CT does not seem to be indispensable in the diagnosis of AM. Conservative therapy and close follow-up seem to suffice for most.
Typing Vocal Fold Vibratory Patterns in Excised Larynx Experiments Via Digital Kymography
Authors: Zhang Yu , Krausert Christopher R. , Kelly Michael P. , Jiang Jack J.
Published: May 2017

Objectives

Signal typing is central to the understanding of vocal fold vibratory patterns. Digital kymography (DKG) allows the direct observation of vocal fold vibratory patterns, and therefore, using DKG for vibratory signal typing may provide a useful complement to traditional signal typing techniques.

Methods

Video data collected from 20 larynges excised from mongrel dogs were observed with DKG in order to find examples of type 1 (nearly periodic), type 2 (subharmonic), and type 3 (aperiodic) vibratory patterns. The time series, frequency spectra, and correlation dimensions were calculated for each signal type.

Results

The type 1 pattern showed a periodic time series of glottal edges and a discrete frequency spectrum. The type 2 vibratory pattern displayed a time series of alternating high- and low-amplitude waves and a frequency spectrum that included a subharmonic (F0/2) frequency component. Regular and symmetric vibratory patterns were observed in the type 1 and type 2 patterns. The type 3 vibratory pattern was characterized by an aperiodic time series of glottal edges, a broadband frequency spectrum, and irregular and asymmetric vibratory patterns. The correlation dimension estimates increased from type 1 to type 2 to type 3.

Conclusions

Imaging with DKG demonstrated an ability to assign a signal type to various laryngeal vibrations. Signal typing techniques utilizing direct observation of the vocal folds could be useful in determining valid methods for the analysis of vocal fold vibrations.
Anatomy-Based Algorithms for Detecting Oral Cancer Using Reflectance and Fluorescence Spectroscopy
Authors: McGee Sasha , Mardirossian Vartan , Elackattu Alphi , Mirkovic Jelena , Pistey Robert , Gallagher George , Kabani Sadru , Yu Chung-Chieh , Wang Zimmern , Badizadegan Kamran , Grillone Gregory , Feld Michael S.
Published: May 2017

Objective

We used reflectance and fluorescence spectroscopy to noninvasively and quantitatively distinguish benign from dysplastic/malignant oral lesions. We designed diagnostic algorithms to account for differences in the spectral properties among anatomic sites (gingiva, buccal mucosa, etc).

Methods

In vivo reflectance and fluorescence spectra were collected from 71 patients with oral lesions. The tissue was then biopsied and the specimen evaluated by histopathology. Quantitative parameters related to tissue morphology and biochemistry were extracted from the spectra. Diagnostic algorithms specific for combinations of sites with similar spectral properties were developed.

Results

Discrimination of benign from dysplastic/malignant lesions was most successful when algorithms were designed for individual sites (area under the receiver operator characteristic curve [ROC-AUC], 0.75 for the lateral surface of the tongue) and was least accurate when all sites were combined (ROC-AUC, 0.60). The combination of sites with similar spectral properties (floor of mouth and lateral surface of the tongue) yielded an ROC-AUC of 0.71.

Conclusions

Accurate spectroscopic detection of oral disease must account for spectral variations among anatomic sites. Anatomy-based algorithms for single sites or combinations of sites demonstrated good diagnostic performance in distinguishing benign lesions from dysplastic/malignant lesions and consistently performed better than algorithms developed for all sites combined.
Surgical Rehabilitation of Voice and Swallowing after Jugular Foramen Surgery
Authors: Oestreicher-Kedem Yael , Agrawal Sumit , Jackler Robert K. , Damrose Edward J.
Published: May 2017

Objectives

We sought to determine the patient population that will benefit from surgical rehabilitation of voice and swallowing after jugular foramen tumor (JFT) resection.

Methods

We performed a retrospective case study of patients with a history of JFT resection. The patients' files were reviewed for data on preoperative and postoperative function of cranial nerves VII and IX through XII, voice and swallowing function, and surgical procedures for voice and swallowing rehabilitation and their timing.

Results

Twenty-one patients underwent JFT resection. Thirty-eight percent presented with deficits of cranial nerves VII and IX through XII, and 61% developed new postoperative deficits. Three patients recovered glossopharyngeal nerve function, 2 recovered vagus nerve function, and 1 recovered facial nerve function. Surgical rehabilitation procedures were undertaken in 8 patients. Patients who eventually underwent surgical rehabilitation procedures for voice and swallowing tended to have larger tumors, tumors within the nerve bundle in the jugular foramen, and multiple nerve deficits.

Conclusions

Most patients with multiple deficits of cranial nerves VII and IX through XII after JFT resection are unlikely to regain spontaneous nerve function, will experience long-term dysphonia and dysphagia, and will elect to undergo corrective surgery to improve voice and swallowing. Preoperative evaluation and close postoperative follow-up can identify patients who would benefit from early surgical rehabilitation.
Trends in Scientific Interest of the American Broncho-Esophagological Association
Authors: Jacobson Joel P. , Har-El Gady
Published: May 2017

Objectives

The specialty of otolaryngology in the United States has changed dramatically over the past century, and this is particularly true in the field of bronchoesophagology, which has evolved from a new specialty at the beginning of the 20th century to one that is now multidisciplinary and further subspecialized. The purpose of this report was to trace the evolution of bronchoesophagology over the past 60 years by examining and quantitating the scientific subject matter of the annual meetings of the American Broncho-Esophagological Association (ABEA).

Methods

The Transactions of the ABEA annual meetings from the 1940s to the present day were examined in depth for subject matter, and articles were categorized by topic. Each decade was represented by 3 years. Data were sorted into 3 domains: 1) anatomic area, 2) adult versus pediatric, and 3) subject matter, including neoplasms, infectious diseases, foreign bodies, technologies, function, and trauma. The overall changes were quantified to outline the direction and interests of the ABEA.

Results

We reviewed 483 scientific articles from the 1940s into the present decade, with a mean of 69.7 papers (SD, 32.4) representing each decade. Bronchology and pulmonology decreased in percentage of papers, from 43% and 17.9% in 1940 to 1.7% and 2.6%, respectively, in the 2000s. Laryngology evolved from 12.5% to 58.1%. Esophagology peaked in the 1950s at 35.7%, dropped to 4% in the 1980s, and then rose to its present-day level of 15.4%. Trends were also discernible in gastric and tracheal areas. Pediatric topics rose to 26.7% in the 1980s, then declined to their present level of 12.8%. Topics related to aerodigestive tract function increased from 3.6% to 34.2%, and presentation of technology declined from 23.2% in the 1940s to nil in the 2000s. Trends in neoplasms, infectious diseases, foreign bodies, and trauma were less significant.

Conclusions

Analysis of the data reveals changing trends in the focus of the ABEA. The changing focus of the ABEA has paralleled scientific advances in our field, as well as the rise of other subspecialties such as interventional pulmonology and gastroenterology.
Pepsin as a Marker of Extraesophageal Reflux
Authors: Samuels Tina L. , Johnston Nikki
Published: May 2017

Diagnosis of extraesophageal reflux (EER) currently relies on tools designed for diagnosis of gastroesophageal reflux. Such tools lack the sensitivity and reproducibility to detect the less frequent and mildly acidic reflux associated with upper airway disease. Pepsin has been posited to be a reliable biological marker of EER. Our aim was to present a comprehensive literature review of the use of pepsin as a diagnostic marker of EER. Two methods are typically used for detection of pepsin in the airways: enzymatic and immunologic. The limitations, advantages, and examples of use of each are discussed. Pepsin assay has been used to identify refluxate in trachea, lung, sinus, middle ear, combined sputum and saliva, and breath condensate. An immunologic pepsin assay of combined sputum and saliva was determined to be 100% sensitive and 89% specific for detection of EER (based on pH-metry), and an enzymatic test of nasal lavage fluid (100% sensitivity and 92.5% specificity) demonstrated an increased incidence of EER in patients with chronic rhinosinusitis. Pepsin assay identified tracheal pepsin to be an indicator of bronchopulmonary dysplasia and related mortality risk in ventilated preterm infants. Pepsin assay is a useful tool for correlation of reflux with airway disease and is a reliable diagnostic marker of EER.
Extraluminal Perforation Complicating Foreign Bodies in the Upper Aerodigestive Tract
Authors: Al-Sebeih Khalid , Abu-Shara Khairy-Alhag , Sobeih Amro
Published: May 2017

Objectives

Ingestion of a foreign body is a common problem in nearly all otolaryngology practices. One of the uncommon complications of ingested foreign bodies is penetration and migration of the object, which may lead to serious morbidity and/or death. This study will evaluate the presentation, complications, and management of different sites of penetration.

Methods

We present a retrospective study of a series of 11 patients who presented with a penetrating foreign body of the upper aerodigestive tract in the past 10 years.

Results

All of the patients had radiologic evidence of a foreign body, but negative findings on rigid endoscopy. A computed tomographic scan was done to confirm the presence of a penetrating foreign body. The foreign body was lodged in the extrapharyngeal tissue in 6 patients, was lodged in the upper thyroid pole in 2 patients, had penetrated a Zenker's diverticulum in 2 patients, and had migrated to the thoracic retroesophageal tissue in 1 patient. All patients underwent extraction of the foreign body by an external approach.

Conclusions

Although the occurrence is rare, impacted foreign bodies in the upper digestive tract can perforate and migrate into the soft tissue of the neck. In the presence of negative findings on endoscopy, a computed tomographic scan of the neck is essential for the prompt diagnosis and management of perforating foreign bodies.
Endoscopic Laser Anterior Commissurotomy for Anterior Glottic Web: One-Stage Procedure
Authors: Su Chih-Ying , Alswiahb Jamil N. , Hwang Chung-Feng , Hsu Cheng-Ming , Wu Pei-Yin , Huang Hsun-Hsien
Published: May 2017

Objectives

The conventional method for preventing web formation after anterior glottic web surgery is keel insertion. However, this presents risks of airway compromise and granulation tissue formation, which could necessitate tracheotomy in addition to a secondary procedure for keel removal. We introduce a novel, 1-stage endoscopic laser anterior commissurotomy for preventing anterior glottic web re-formation.

Methods

Twenty patients with glottic webs involving the anterior commissure were studied. The lesions were removed by transoral carbon dioxide laser microsurgery. In all patients, the anterior glottic web was vaporized along with the inner perichondrium of the thyroid cartilage over the anterior commissure area, creating a raw vertical break “alley” between the anterior vocal folds that measured between 0.3 and 0.5 cm in width and between 0.8 and 2 cm in length. The preoperative and postoperative vocal folds and voice quality were evaluated by videostrobolaryngoscopy and voice recordings.

Results

All 20 patients had anterior glottic webs ranging from 11 % to 64% of the length from the anterior commissure to the vocal process. None of the patients developed restenosis at the anterior commissure of a severity similar to that of the initial lesion during follow-up (mean, 13 months; range, 3 to 44 months). All patients except 1 reported satisfaction with their voice improvement. Outcome analysis revealed that partial re-formation of the web was noted in 4 patients.

Conclusions

One-stage, endoscopic laser anterior commissurotomy was effective and relatively safe for removing glottic webs, for preventing anterior glottic web re-formation, and for improving vocal fold performance among our patients.
Congenital Familial Fixation of the Malleus
Authors: Miller Mia E. , Kirsch Claudia , Canalis Rinaldo F.
Published: May 2017

We present a familial association of radiographically and surgically demonstrated mallear fixation with concurrent stapedial abnormality and dehiscence of the facial nerve in a father and son, including history, physical findings, surgical findings, radiologic analyses, and a literature review. A 12-year-old boy presented with long-term left-sided conductive hearing loss, and was found to have mallear fixation and a dehiscent facial nerve on a computed tomographic (CT) scan of the temporal bone. Release of the malleus was performed at surgery, revealing hypermobility of the remaining ossicular chain. A repeat CT scan of the temporal bone showed successful release of the mallear head. The patient's father later presented with bilateral hearing loss, and a CT scan of the temporal bones showed bilateral osseous fixation of the mallear head to the tegmen and bilateral facial nerve dehiscences. He underwent right middle ear exploration, but release of the malleus was not performed because of the risk to the dehiscent facial nerve. The stapes crurae were found to be filiform at surgery. This is the first reported familial association of mallear fixation. Mallear fixation with facial nerve dehiscence and an abnormal stapes occurring in a parent and his child is interesting embryologically, and suggests that these anomalies may be genetically linked.
Inhaled Triamcinolone with Proton Pump Inhibitor for Treatment of Vocal Process Granulomas: A Series of 67 Granulomas
Authors: Hillel Alexander T. , Lin Li-Mei , Samlan Robin , Starmer Heather , Leahy Kevin , Flint Paul W.
Published: May 2017

Objectives

We sought to analyze the outcomes of vocal process granulomas treated with proton pump inhibitors and inhaled triamcinolone acetonide.

Methods

We reviewed the medical records of patients with a diagnosis of contact granuloma or vocal process granuloma between 1995 and 2008. Data included age, gender, intubation history, reflux history, lesion location, previous treatment methods, treatment course, and recurrence. All patients were treated with daily or twice-daily protein pump inhibitors and inhaled triamcinolone acetonide (300 μg 3 times a day).

Results

Sixty-seven granulomas were diagnosed in 54 patients: 13 bilateral and 41 unilateral. Twenty patients, including all 11 women, had a recent history of intubation. Sixty-two granulomas in 50 patients were treated with triamcinolone and a proton pump inhibitor. Of the 57 granulomas that completed treatment, 5 (9%) did not respond (mean follow-up, 50 weeks; range, 30.3 to 78.3 weeks), 13 (22%) partially responded (mean follow-up, 11 weeks; range, 3 to 30 weeks), and 40 (69%) completely responded (mean follow-up, 21 weeks; range, 5.9 to 84.6 weeks). Three cases had recurrence: 2 nonresponders and 1 complete responder. One patient developed oral thrush.

Conclusions

In this study, vocal process granulomas occurred more frequently in men, whereas women developed granulomas only after intubation. The anti-inflammatory action of inhaled triamcinolone combined with antireflux proton pump inhibitors successfully treats most vocal process granulomas with low rates of side effects and recurrence.
Modified Extracorporeal Septoplasty Technique in Rhinoplasty for Severely Deviated Noses
Authors: Jang Yong Ju , Kwon Minsu
Published: May 2017

Objectives

Secure fixation of the reimplanted septum is critical for successful long-term aesthetic and functional outcomes following extracorporeal septoplasty (ECS). We describe the results of our modified ECS technique.

Methods

This retrospective study involved 27 patients with a deviated nose who underwent our modified ECS method in rhinoplasty between June 2006 and January 2009. Anthropometric changes were assessed from preoperative and postoperative facial photographs. Patient satisfaction was evaluated, and nasal obstruction improvement was assessed on a visual analog scale.

Results

Postoperative correction of the external nose deviation angle was statistically significant. Twenty-four patients (89%) were satisfied with the cosmetic outcome, and all 23 patients with moderate to severe preoperative nasal obstruction were satisfied with the postoperative improved nasal breathing.

Conclusions

Our modified ECS fixation technique was easy to perform and effective in septorhinoplasty for severe septal deviation.
Furosemide Administered before Noise Exposure can Protect the Ear
Authors: Adelman Cahtia , Perez Ronen , Nazarian Yoram , Freeman Sharon , Weinberger Jeffrey , Sohmer Haim
Published: May 2017

Objectives

We assessed the effect of furosemide administration on noise-induced hearing loss. This drug reversibly elevates the auditory threshold by inducing a temporary reduction of the endocochlear potential and thereby suppresses the cochlear amplifier and active cochlear mechanics.

Methods

Mice were given a single injection of furosemide 30 minutes before exposure to 113 dB sound pressure level broadband noise. Control animals received saline solution. Furosemide was administered in other mice after the noise exposure. Auditory threshold shifts were assessed by recording auditory nerve brain stem evoked response (ABR) thresholds to broadband clicks.

Results

The mean ABR threshold in the group injected with furosemide and exposed to temporary threshold shift (TTS)-producing noise was elevated by 20.4 ± 12.3 dB, and that in the saline control group was elevated by 35.4 ± 18.3 dB (p < 0.02). The mean threshold elevations in the group injected with furosemide and exposed to permanent threshold shift (PTS)-producing noise and in the PTS saline control group were 15.0 ± 10.3 dB and 27.0 ± 12.7 dB, respectively (p < 0.01). Similar results were obtained when the PTS was assessed with an 8-kHz tone burst ABR. There was no significant difference in the PTS between mice given a single injection of furosemide and those given saline solution after the noise; this finding shows that furosemide is not acting as an antioxidant.

Conclusions

It appears that reversible hearing threshold elevation as a result of furosemide administration before noise exposure can reduce the TTS and PTS. This finding provides insight into the mechanism of noise-induced hearing loss.