bluuebunny/crossref_metadata_2025 huggingface dataset:
Orthotopic Liver Transplantation: A Pathological Study of 63 Serial Liver Biopsies from 17 Patients with Special Reference to the Diagnostic Features and Natural History of Rejection†
Authors: Snover Dale C. , Sibley Richard K. , Freese Deborah K. , Sharp Harvey L. , Bloomer Joseph R. , Najarian John S. , Ascher Nancy L.
Published: August 2008

The histopathological features of orthotopic liver transplants were evaluated in 63 serial biopsy specimens from 17 patients. Biopsies were taken at the time of insertion of the liver (six biopsies), at the time of development of liver function abnormalities (11 biopsies) and as follow-up to previously abnormal biopsies (46 biopsies). The biopsies taken at the time of insertion all showed diffuse hepatocellular ballooning with confluent areas of necrosis in one case. Biopsies taken at the time of onset of rejection (nine cases) all showed a mixed portal inflammatory infiltrate, bile duct damage and central or portal vein endothelialitis (i.e., attachment of lymphocytes to the vein endothelium). Follow-up biopsies showed several patterns including: (i) resolution of changes of acute rejection with subsequent development of recurrent acute or chronic rejection (four cases); (ii) prolonged acute rejection simulating extrahepatic biliary obstruction (four cases); (iii) prolonged acute rejection with predominance of eosinophils simulating a drug reaction (one case); and (iv) rapidly progressive acute rejection leading to death (one case). Biopsy of the transplanted liver at the time of transplantation is useful to provide a baseline for comparison with later biopsies. Biopsy at the time of onset of changes in liver function is essential to confirm the presence of rejection prior to alteration of immunosuppression.
Effect of model selection on computed water balance components
Authors: Jhorar Raj Kumar , Smit A. A. M. F. R. , Roest C. W. J.
Published: August 2008

Soil water flow modelling approaches as used in four selected on‐farm water management models, namely CROPWAT, FAIDS, CERES and SWAP, are compared through numerical experiments. The soil water simulation approaches used in the first three models are reformulated to incorporate an evapotranspiration process similar to that used in SWAP. Computations are carried out for three soil types, representing sandy loam, loam and sandy clay loam. The reformulated models are calibrated against simulation results obtained with SWAP. All the modelling approaches predict nearly equal estimates of cumulative actual evapotranspiration for a wheat crop. When compared with SWAP simulation results, the CERES type approach outperformed the other two approaches in respect of estimated cumulative deep percolation losses. A new criterion is proposed to interpret simulation results under deep water table conditions to suggest appropriate depth of water application. The resulting recommendations for irrigation planning suggest that any of the modelling approaches may be used to suggest practical irrigation considered in the present study. Copyright © 2008 John Wiley & Sons, Ltd.
Role of musculature during defecation in a particle‐feeding arachnid, Archegozetes longisetosus (Acari, Oribatida)
Authors: Heethoff Michael , Norton Roy A.
Published: August 2008

Most extant Chelicerata are characterized by external digestion and the ingestion of fluid food. Exceptions include the marine taxa, most Opiliones, and the mite groups Opilioacarida (Parasitiformes) and Sarcoptiformes (Acariformes), which ingest particulate food. This leads to different physiological and morphological adaptations for food processing, including the production and extrusion of solid fecal pellets, which are rather large in sarcoptiform mites. Few studies have investigated the defecation of such large fecal pellets, and available information is contradictory. We use a combination of non invasive microscopical techniques and in vivo examination to investigate the complex functional morphology of the anal region of the oribatid mite Archegozetes longisetosus Aoki. The opening of the anus is at least initiated by indirect muscular action via an increase of hemolymph pressure, through the action of dorsoventral muscles (dvm). Extrusion of the fecal pellet is accomplished by the prerectal muscle collar, with full opening of the anus and rotation and bowing of the plates probably resulting from pressure of the pellet. The sequential nature of these actions was demonstrated by many observations in which the anus opened only partially; these were concomitant with dmv contraction but pellets were not being extruded. All muscles directly connected to the anal and adanal regions assist in keeping the anus closed; they are antagonists to hydrostatic forces that are necessary for normal activity. Based on the literature, no obvious similarities were noted with defecation musculature in other particle‐feeding chelicerates, but most muscles can be homologized with those of more specialized oribatid mites. The function of the outer anal muscles has been modified in both Euphthiracaridae and Brachypylina to assist in providing general hemolymph pressure. J. Morphol., 2009. © 2008 Wiley‐Liss, Inc.
Postoperative residual disease evaluation in the locoregional treatment of peritoneal surface malignancy
Authors: González‐Moreno Santiago , Kusamura Shigeki , Baratti Dario , Deraco Marcello
Published: August 2008

Background

The maximum size of the residual lesions left behind after cytoreductive surgery for peritoneal surface malignancy has consistently been shown to be the main prognostic factor in this setting. However, a uniform assessment method and categorization for this paramount prognostic indicator is lacking.

Methods

In order to achieve a consensus among experts, the Delphi methodology was employed. Conflicting points were identified and related multiple choice questions were circulated among a panel of experts on peritoneal surface oncology. Two rounds of web‐based voting were carried out.

Results

The completeness of cytoreduction (CC) Score described by Sugarbaker was considered the current best classification for residual disease size. The experienced surgeon's naked‐eye estimation was considered the ideal method to assess residual disease size. There was agreement that the definition of CC‐0 or R0 cytoreduction needs further specification. A redefinition of “completeness of cytoreduction” according to disease process was favored by the experts but not favored for the type of intraperitoneal chemotherapy employed.

Conclusions

Following the experts' consensus, it is recommended that the CC score be used to categorize residual disease after cytoreductive surgery for peritoneal surface malignancy. Pending issues for further consensus development in this area have been identified. J. Surg. Oncol. 2008;98:237–241. © 2008 Wiley‐Liss, Inc.
Hyperthermic intraperitoneal chemotherapy with and without cytoreductive surgery for epithelial ovarian cancer
Authors: Helm C. William , Bristow Robert E. , Kusamura Shigeki , Baratti Dario , Deraco Marcello
Published: August 2008

Women with epithelial ovarian cancer (EOC) usually present with advanced disease and overall only just over half survive 5 years. Even following a complete response to front‐line treatment two‐thirds will recur, with a resultant dismal prognosis. We review and discuss the role of surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in EOC and present the results of the ovary consensus panel (OCP) convened for the 5th International Workshop on Peritoneal Surface Malignancy. J. Surg. Oncol. 2008;98:283–290. © 2008 Wiley‐Liss, Inc.
A prospective study of trait anger and PTSD symptoms in police
Authors: Meffert Susan M. , Metzler Thomas J. , Henn‐Haase Clare , McCaslin Shannon , Inslicht Sabra , Chemtob Claude , Neylan Thomas , Marmar Charles R.
Published: August 2008

It is unknown whether anger is a risk factor for the development of posttraumatic stress disorder ( PTSD) symptoms, arises as a consequence of PTSD, or both. Two hypotheses were tested in 180 police recruits: Greater trait anger during training will predict greater PTSD symptoms at one year; greater PTSD symptoms at one year will predict greater state anger at one year. Both hypotheses were confirmed, suggesting that trait anger is a risk factor for PTSD symptoms, but that PTSD symptoms are also associated with an increase of state anger. Increased anger is important not only because of the impact it has on individual distress and physical health, but also because of its potential public health impact.
Does prior psychological health influence recall of military experiences? a prospective study
Authors: Wilson Jennifer , Jones Margaret , Hull Lisa , Hotopf Matthew , Wessely Simon , Rona Roberto J.
Published: August 2008

In a prospective study, we evaluated pre‐ and postdeployment psychological health on recall of risk factors to assess recall bias. Measures of the General Health Questionnaire (GHQ), PTSD Checklist (PCL), and symptom clusters from the PCL were obtained from 681 UK military personnel along with information on traumatic and protective risk factors. Postdeployment psychological health was more important in explaining recall of traumatic experiences than predeployment psychological health. Predeployment intrusive cluster scores were highly associated with traumatic exposures. Postdeployment, but not predeployment GHQ showed small effects for most risk factors. With the exception of intrusive thoughts, there is insufficient evidence to suggest predeployment psychological status would be useful in correcting for recall bias in subsequent cross‐sectional studies.
Patient reported and anatomical outcomes after surgery for pelvic organ prolapse
Authors: El‐Azab Ahmed S. , Abd‐Elsayed Alaa A. , Imam Hala M.K.
Published: August 2008

Aim

Primary aim was to modify Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) to assess pelvic organ prolapse (POP) in Arabic Muslim women. Secondary aim was to compare functional and anatomical outcomes of POP repair.

Methods

Questionnaire. A characteristic (prayer) was added to PFIQ. Linguistic validation of questionnaires was then done. Twenty cases were enrolled in a pilot study to test internal consistency and reliability. Subsequent study. Prospective study included women with symptomatic POP ≥ stage II. History, examination by POP‐Q, and administration of PFDI and PFIQ, were done before and 6 months after surgery.

Results

Questionnaire. Internal consistency of added question was good (Cronbach α = 0.78). Test–retest reliability of individual PFIQ items was variable. Subsequent Study. Between September 2004 and February 2007, 78 consecutive women were included. Cystocele, rectocele, and no site predominated in 74.4%, 17.9% and 7.7% of cases, respectively. Preoperatively 19.2%, 15.4% and 47.4% reported stress, urge, and mixed incontinence, respectively. Overall and individual urinary symptoms scores improved significantly after surgery. There were significant improvements in individual symptoms of constipation, splint to defecate and losing not well formed stools. Low self‐esteem was most negative impact of prolapse on quality of life (QoL) followed by prayer. After surgery 90% of subjects had anatomical cure. After surgery, QoL issues are significantly related to anatomic location of prolapse as determined by POP‐Q.

Conclusions

Modified PFIQ and PFDI are suitable to assess POP among Muslim women. Postoperatively, many prolapse‐related symptoms and QoL significantly improve after surgery on the short term with an anatomic cure rate of 90%. Neurourol. Urodynam. 28:219–224, 2009. © 2008 Wiley‐Liss, Inc.
Impact of irradiation‐induced point defects on electronically and ionically induced magnetic relaxation mechanisms in titano‐magnetites
Authors: Walz F. , Brabers V. A. M. , Kronmüller H.
Published: August 2008

This report deals with the analysis of point‐defect‐induced magnetic after‐effect (MAE) processes occurring in as‐grown, single‐crystalline titano‐magnetite (Fe2.8–D Ti0.2O4), containing B‐site vacancies (D < 0.005). In a foregoing experiment, these processes, situated near 450 K, 200 K and 65 K, have been completely recovered in the course of systematic annealing up to Ta ≤ 1200 K. Analysis of respective annealing kinetics suggested to associate them with vacancy‐ (450 K) and interstitial‐based (200 K) defect reorientations, including modified electron hopping (65 K). The present study was performed in order to check the previously developed relaxation model by low‐temperature (80 K) electron (e–) irradiation of the prerecovered crystal and investigating if thereby the point‐defect relaxations of the initial, as‐grown, state could be reconstituted. MAE analyses, based on systematic sample annealing in the temperature range 80 K ≤ Ta ≤ 1200 K prove, indeed, radiation‐induced reproduction of related processes. Partial modifications of respective process genealogies may be conveniently assigned to the alternative techniques of defect induction, i.e. high‐temperature crystal growth in thermal equilibrium or out‐of‐equilibrium, low‐temperature e–‐irradiation. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Photoconductivity and thermally stimulated current in CaGa2S4 single crystals doped with Eu2+ and Ce3+
Authors: Hidaka Chiharu , Hiraguri Kazuma , Takizawa Takeo
Published: August 2008

Photoconductivity (PC) measurements are carried out on single crystals of CaGa2S4 doped with Ce3+ and Eu2+ at room temperature and at about 30 K. Low temperature PC spectra can only be measured for Ce doped samples but not for Eu ones owing to too high resistivity. Based on the data obtained, the energy level scheme of Ce3+ ions is discussed in reference to the optical band edge.

Single crystals of CaGa2S4 are grown by codoping Ce3+ with Na+ ions to observe the charge compensation effect expected to occur under the substitution of Ca2+ ions by Ce3+ ions. Their electrical resistivity is reduced about two orders in magnitude from ca. 1013 Ω cm to ca. 1011 Ω cm without much change in PC spectra, suggesting a mere decrease in scattering centers for carriers. From the variation in DC resistivity with time, it is expected that many carrier traps may exist in the compounds. To clarify those trap levels the thermally stimulated current (TSC) is measured using samples with different Ce3+ concentrations. From the analysis of TSC spectra, 6 traps with different depths have been retrieved. We have also found traps which may have repelling potential barriers. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Surface characterisation of silicon substrates seeded with diamond nanoparticles under UHV annealing
Authors: Arnault J. C. , Saada S. , Williams O. A. , Haenen K. , Bergonzo P. , Nesladek M. , Polini R. , Osawa E.
Published: August 2008

The thermal stability of Ultra Dispersed Diamond on silicon surfaces has been investigated. Samples have been annealed under Ultra‐High Vacuum conditions. The evolution of the carbon binding states at the surface has been monitored sequentially by XPS and XEELS. After annealing at 1173 K, sp3 seeds present initially have been significantly modified. Contrary to lower temperature, no diamond has been detected either by XPS or by FEG‐SEM after a short growth step. XPS spectra indicate the formation of silicon carbide. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Incremental modified pushover analysis
Authors: Azimi Hossein , Galal Khaled , Pekau Oskar A.
Published: August 2008

The recently developed Incremental Dynamic Analysis (IDA) requires nonlinear time history analyses at different levels of intensity of an ensemble of ground motions, which is time‐consuming due to the high computational efforts involved. In the current study, a simplified method named as Incremental Modified Pushover (IMP) is developed and evaluated. In this method, the response of the structure is obtained using one pushover analysis at any specified level of ground motion intensity. The associated higher mode effects are explicitly considered when determining target roof displacement and lateral load pattern. In the bilinear idealization of the pushover curves, a new approach has been used. Moment resisting steel frames with 4, 8, 12 and 16 stories, as well as their corresponding soft‐story models are used for verifying the proposed method. The studied frames were subjected to seventeen different scaled earthquake ground motions. The results of the presented method, IMP, are verified in terms of maximum roof displacement, maximum inter‐story drift and maximum plastic hinge rotation at different ground motion intensities. The results show that the IMP method gives higher response values compared with IDA, which can be viewed as being more conservative. Copyright © 2008 John Wiley & Sons, Ltd.
Leisure time physical activity during pregnancy and preterm birth in Brazil
Authors: Domingues Marlos R. , Barros Aluísio J. , Matijasevich Alicia
Published: August 2008

Objective

To investigate the relationship between leisure time physical activity (LTPA) during pregnancy and preterm birth.

Methods

A cross‐sectional, population‐based study evaluated LTPA during pregnancy in 4147 mothers using data from the 2004 Pelotas Birth Cohort Study. Gestational age was determined by last menstrual period, or when not available, by ultrasound or the Dubowitz method. Type of LTPA, length of usual session, and frequency were determined for each trimester.

Results

A total of 14.6% of all births were considered preterm. Only 13.3% of women reported engaging in LTPA during pregnancy. After adjusting for confounders, LTPA in all 3 trimesters (prevalence ratio [PR] 0.55; 95% confidence interval [CI] 0.32–0.96), LTPA in the third trimester (PR 0.50; 95% CI 0.31–0.80), and minimum LTPA (≥ 90 min/week) in the third trimester (PR 0.58; 95% CI 0.34–0.98) showed a protective association with preterm birth in the adjusted analysis.

Conclusion

LTPA, especially throughout pregnancy and in the third trimester, was associated with a lower chance of preterm birth.
Collagen type 3 alpha 1 polymorphism and risk of pelvic organ prolapse
Authors: Chen Huey‐Yi , Chung Ya‐Wen , Lin Wei‐Yong , Wang Jiunn‐Chin , Tsai Fuu‐Jen , Tsai Chang‐Hai
Published: August 2008

Objective

To investigate whether pelvic organ prolapse (POP) is associated with collagen 3 alpha 1 (COL3A1) polymorphisms and other factors.

Methods

A case‐control association study was conducted with 84 women affected with POP and 147 controls. The genotypes of nucleotides COL3A1 rs1800255 and COL3A1 rs1801184 polymorphisms were ascertained by polymerase chain reaction and restriction fragment length polymorphism analysis.

Results

The distribution of the COL3A1 rs1800255 genotypes was significantly different among affected women and controls. Older age and incidence of COL3A1 rs1800255 genotype AA were significantly associated with risk of POP.

Conclusion

There may be an association between COL3A1 genotype and risk of POP.
Progesterone receptor gene polymorphisms are not associated with preterm birth in a Hispanic population
Authors: Diaz‐Cueto Laura , Dominguez‐Lopez Pablo , Cantillo‐Cabarcas Julio , Perez‐Figueroa Gloria , Arechavaleta‐Velasco Miguel , Arechavaleta‐Velasco Fabian
Published: August 2008

Objective

To determine whether increased frequency of mutant alleles of the progesterone receptor gene (PGR) was associated with preterm birth in a population of Hispanic women.

Methods

Placental DNA from 64 patients who had preterm births and 54 control patients was genotyped for 4 progesterone receptor gene polymorphisms by polymerase chain reaction (PCR) restriction fragment length polymorphism. The test and t test were used to calculate statistical significance. Linkage disequilibrium was calculated using the Linkage Disequilibrium Analyzer program.

Results

The genotypic frequencies of the 4 polymorphisms were not significantly different between the study and control groups. In addition, there was complete linkage disequilibrium between V660L, H770H, and PROGINS polymorphisms, but not with + 331G/A polymorphism.

Conclusions

The present study suggests that polymorphisms in the progesterone receptor gene are unlikely to be associated with an increased risk of preterm birth in a Hispanic population.
Clinical significance of micrometastases detection in lymph nodes from head and neck squamous cell carcinoma
Authors: Xu Yanan , Lefèvre Marine , Périé Sophie , Tao Lei , Callard Patrice , Bernaudin Jean‐François , Guily Jean Lacau St
Published: August 2008

OBJECTIVE

Study the clinical relevance of micrometastases in head and neck squamous cell carcinoma (HNSCC).

METHODS

We reviewed the outcome of 31 patients who underwent neck dissection for HNSCC with lymph node analysis by cytokeratin 19 real‐time Taqman polymerase chain reaction (CK19RT‐PCR) for detection of micrometastasis. Fifteen patients were N+ on histopathology (group 1) and 16 were N‐; nine of these 16 patients were CK19RT‐PCR positive (group 2), whereas seven were negative (group 3). Local and neck recurrences, metastases, and other tumour sites were recorded during follow‐up.

RESULTS

Five patients in group 1, eight patients in group 2, and one patient in group 3 experienced a tumor‐related event. N‐patients in groups 2 and 3 had a different outcome (P < 0.01).

CONCLUSION

It is suggested that CK19RTPCR detection of micrometastasis in lymph nodes could be of significant prognostic value in HNSCC, because more aggressive treatment could be indicated in these patients.
The administration of IL‐12/GM‐CSF and Ig‐4‐1BB ligand markedly decreases murine floor of mouth squamous cell cancer
Authors: Adappa Nithin D. , Sung Chi‐Kwang , Choi Bryan , Huang Tian‐Gui , Genden Eric M. , Shin Edward J.
Published: August 2008

OBJECTIVE

To assess immune‐based gene therapy in a murine floor of mouth (FOM) squamous cell carcinoma (SCC) model.

STUDY DESIGN

In vitro and in vivo testing of immune therapy for SCC.

METHODS

Multiple SCC lines were infected by using advRSV‐interleukin‐12 (IL‐12) and advCMV‐interleukin‐12/granulocyte macrophage colony‐stimulating factor (IL‐12/GM‐CSF) and monitored for production of IL‐12 and GM‐CSF. Intratumoral injections of viral vectors were administered with systemic Ig‐4‐1BB ligand in an orthotopic murine FOM SCC model and followed for tumor size and survival.

RESULTS

In vitro, all cell lines produced substantial levels of IL‐12 and GM‐CSF. In vivo, tumors treated with advCMV‐IL‐12/GM‐CSF and Ig‐4‐1BBL showed a striking reduction in tumor volume (vs control P < 0.0001) and improved median survival (38 days vs 19 days for control, P < 0.0001).

CONCLUSION

Combination immune‐based therapies effectively improve survival in mice bearing FOM SCC over single‐modality therapy.
Prognostic factors of unknown primary head and neck squamous cell carcinoma
Authors: Huang Chun‐Chi , Tseng Fen‐Yu , Yeh Te‐Huei , Wen Yu‐Hsuan , Hsu Chuang‐Jen , Ko Jeng‐Yuh , Lou Pei‐Jen , Chen Yuh‐Shyang
Published: August 2008

OBJECTIVE

To evaluate the prognostic factors of unknown primary head and neck squamous cell carcinoma (HNSCC).

STUDY DESIGN

Retrospective study.

SUBJECTS

Patients with unknown primary HNSCC from 1980 to 2000 were included.

RESULTS

Forty‐eight patients, predominantly male and with a mean age of 63.3 ± 11.6 years, were recruited. The median survival time (MST) was 44 months. The overall survival rate was 60.4 percent at three years and 39.6 percent at five years. Forty‐two patients receiving intervention regimens had a MST of 45 months, while six patients receiving palliative therapy had a MST of 8.5 months (log rank test, P = 0.016). With multivariate Cox regression analysis, age (per year), higher nodal stage (N3 vs N1 or N2), and treatment (operation vs nonoperation) had a hazard ratio of 1.081 (P < 0.0001), 5.852 (P = 0.010), and 0.4 (P = 0.042), respectively.

CONCLUSION

Older age, higher nodal stage, and palliative treatment indicated poor prognosis. Survival time might be prolonged if surgical treatment is tolerable.
A systematic review of the use of intranasal steroids in the treatment of chronic rhinosinusitis
Authors: Joe Stephanie A. , Thambi Rakhi , Huang Jie
Published: August 2008

OBJECTIVE

To determine if intranasal steroids (INS) are useful in the management of chronic rhinosinusitis without polyps and chronic rhinosinusitis (CRS) with polyps.

DATA SOURCES

Studies for inclusion were searched using Medline, EMBASE, Cochrane databases, and references of included studies.

REVIEW METHODS

Initial screening of article titles and abstracts obtained from the literature search was performed independently by two reviewers (SAJ and RT) based on the research protocol criteria. These articles then underwent a second‐stage review. Each article was read in detail and discussed by the two reviewers before inclusion in the study.

RESULTS

The review yielded 13 studies regarding the treatment of sinonasal polyps with intranasal steroids. Six of these could be included in the meta‐analysis. The outcome measure used for meta‐analysis was change in polyp size from baseline compared between the treatment and control groups. Results from both conservative and optimistic selection of treatment effect are positive, providing significant improvement in polyp size in the treatment group as compared to controls. In the conservative estimate, the mean improvement in polyp size score between the treatment and placebo group is 0.43 with a 95% CI of [0.25, 0.61]. Of those treatment groups with the largest improvement, the mean improvement in polyp size score can go as high as 0.63 with a 95% CI of [0.43, 0.82].

CONCLUSION

Intranasal steroids are beneficial in the treatment of chronic rhinosinusitis with sinonasal polyps. Further studies looking at the use of INS in the treatment of CRS without polyps are warranted.
Actinomycosis of the paranasal sinus
Authors: Woo Hyun‐Jae , Chang Hoon Bae , Song Si‐Youn , Choi Yun Seok , Kim Yong‐Dae
Published: August 2008

OBJECTIVE

To report clinical characteristics and treatment outcomes of actinomycosis of the paranasal sinus.

STUDY DESIGN

Retrospective review.

SUBJECTS AND METHODS

The medical records of six patients with actinomycosis of the paranasal sinus between 1998 and 2006 were analyzed.

RESULTS

There were no immunocompromised patients and all lesions were unilateral. Only one patient had a history of an oroantral fistula due to facial trauma. On CT scan, all patients had unilateral opacification of the maxillary sinus with focal calcified densities. All cases underwent endoscopic sinus surgery followed by relatively short‐term antibiotic administration, and there was no recurrence.

CONCLUSIONS

Chronic unilateral maxillary sinusitis, a calcified density in the involved sinus on radiological studies, and unresponsiveness to antibiotics are characteristics of actinomycotic sinusitis. Surgical removal of the involved tissues and the restoration of sinus ventilation seem to be important factors for treating the disease.
Residual hearing preservation after cochlear implantation: Comparison between straight and perimodiolar implants
Authors: Soda‐Merhy Antonio , Gonzalez‐Valenzuela Leonardo , Tirado‐Gutierrez Carmen
Published: August 2008

Objective

Investigate whether perimodiolar cochlear implants provide a better preservation of residual hearing than straight implants.

Study Design and Setting

Longitudinal, observational, and comparative study in tertiary center in Mexico City. Forty‐eight patients who underwent cochlear implant surgery were included and were divided into two groups depending on whether they received a straight or a perimodiolar implant. The residual hearing of the operated ear was measured audiometrically before and after surgery. Variables analyzed were pure‐tone average threshold at 125, 250, and 500 Hz and residual hearing at frequencies from 125 to 8000 Hz. Residual hearing was considered as preserved when audiometric changes were less than 10 dB HL in each variable.

Results

No statistically significant difference was found in the preservation of residual hearing between the two groups or between individual devices (P > 0.05 in all variables).

Conclusion

Straight and perimodiolar cochlear implants seem to preserve residual hearing at similar rates across frequencies.
Randomized controlled studies and the treatment of middle‐ear effusions and tonsillar pharyngitis: How random are the studies and what are their limitations?
Authors: Ruben Robert J.
Published: August 2008

Objective

To determine the applicability and external validity of randomized control studies (RCTs) in the light of patient susceptibilities and vulnerabilities to the sequelae of otitis media with effusion (OME) and tonsillar pharyngitis (T&A) and the composition of their cohorts.

Study Design

RCTs for OME and T&A were analyzed to determine which intrinsic and extrinsic susceptibilities to the otolaryngic disease and its sequelae were included or excluded and the composition of the cohort.

Methods

A Medline and a Science Direct search were performed for all RCTs concerning OME and T&A through 2007. The articles selected to be included in this study are the OME RCTs that reported language and/or hearing outcomes and the T&A RCT studies in which the outcome measure was infection, alleviation of airway obstruction, and/or quality of life. These were analyzed for their inclusion or exclusion of intrinsic and extrinsic susceptibilities to the otolaryngic disease and their sequelae and the composition of the cohort. The pertinent otolaryngologic literature was assessed to determine applicable risk factors.

Results

The analysis of the inclusion or exclusion of risk factors showed that for OME 0 percent were included and 16 percent were excluded, and there were no data for 84 percent. The T&A findings were similar in that 1 percent of risk factors were included, 8 percent excluded, and there were no data for 92 percent. Both the OME and the T&A cohorts data were similar in that approximately half of the suitable candidates completed the study; 25 percent of the OME and 13 percent of the T&A enrolled subjects were either withdrawn or placed into a different experimental group. On the average, with data available, it took 4.6 years to recruit the OME sample and 5.5 years to recruit the T&A sample.

Conclusion

The results of RCTs for these conditions are only applicable to narrowly defined and highly circumscribed populations. They cannot be generalized to the entire patient population because of their limited external validity. Future RCT protocols should be designed to control for the intrinsic and extrinsic susceptibilities that result in a propensity to acquire the disease and/or an exacerbation of the disease's sequelae. These studies would determine the most effective strategies for preventing disorders and/or their deleterious sequelae.
Postoperative bleeding in transoral laser microsurgery for upper aerodigestive tract tumors
Authors: Salassa John R. , Hinni Michael L. , Grant David G. , Hayden Richard E.
Published: August 2008

Objectives

To report the incidence, cause, and outcome of bleeding after transoral laser microsurgery.

Study Design

A two‐center prospective case series analysis.

Subjects and Methods

Seven hundred one patients underwent transoral laser microsurgery for tumors of the oral cavity, pharynx, and larynx from June 1996 through September 2006.

Results

Ten patients (1.4%) experienced postoperative bleeding between 0 and 17 days after surgery. Five patients had previously untreated tumors, and five patients had salvage surgery. Two patients (0.3%) had minor bleeding and required observation only. Five patients (0.7%) experienced major bleeding requiring exploration under general anesthesia. Three patients (0.4%) had catastrophic life‐threatening bleeds, two of whom died. The bleeding vessel was identified as the lingual artery in four patients, the superior laryngeal artery in two, the facial artery in two, and unknown in two.

Conclusions

Bleeding after transoral laser microsurgery is rare but potentially life‐threatening.
Evaluation of submucosal minimally invasive lingual excision technique for treatment of obstructive sleep apnea/hypopnea syndrome
Authors: Friedman Michael , Soans Rohit , Gurpinar Berk , Lin Hsin‐Ching , Joseph Ninos
Published: August 2008

Objective

Submucosal minimally invasive lingual excision (SMILE) is a novel approach to address hypopharyngeal obstruction. This study compares the efficacy, morbidity, and complications of this technique to radiofrequency reduction of the tongue base (RFBOT), the current standard in minimally invasive tongue base reduction.

Study Design

Retrospective analysis of data extracted from a prospective database.

Methods

Ninety‐six patients who underwent SMILE (n = 48) or RFBOT (n = 48) were studied. Efficacy and safety of the procedures were compared on the basis of polysomnography results, morbidity measures, and complications.

Results

Patients in both groups demonstrated a significant reduction in the apnea/hypopnea index. Success rates for SMILE and RFBOT were 64.6 percent and 41.7 percent, respectively (P = 0.024). SMILE, however, was associated with increased morbidity and complications.

Conclusion

In a comparable surgical protocol for obstructive sleep apnea‐hypopnea syndrome, SMILE technique for tongue base reduction demonstrated increased efficacy over RFBOT but resulted in more complications. Additional experience with the procedure may reduce complications and increase overall efficacy.
Six Sigma tympanostomy tube insertion: Achieving the highest safety levels during residency training
Authors: Isaacson Glenn
Published: August 2008

Objective

To evaluate a protocol designed to avoid complications during tympanostomy tube insertion by residents.

Design

Ten‐year consecutive cases series by a single surgeon supervising residents.

Setting

Tertiary children's hospital.

Patients

Children 6 weeks to 21 years.

Intervention

Residents followed a defined protocol for tube insertion. A resident operated until the tube was placed or he/she committed one major or two minor errors.

Main Outcome Measures

Incidence of 1) major complications: profound sensorineural hearing loss (SNHL), injury to major vascular structures, or disruption of the ossicular chain; and 2) minor complications: tube loss into the middle ear, tympanic membrane tears, or tube occlusion by blood clot.

Results

There were no major complications in 10,000 tube insertions. Two children had unilateral profound SNHL; both were found to have Mondini malformations. Five tubes were recovered from the middle ear. Eight tympanic membrane tears healed with gelatin patches. Three tubes were occluded by blood clots.

Conclusion

By following a defined protocol, major complications of a common operation can be reduced to the five‐sigma level and minor complications minimized.
Vocal outcome measures after bilateral posterior cricoarytenoid muscle botulinum toxin injections for abductor spasmodic dysphonia
Authors: Klein Adam M. , Stong Benjamin C. , Wise Justin , DelGaudio John M. , Hapner Edie R. , Johns Michael M.
Published: August 2008

Objective

To review vocal outcome measures, using the Voice Related Quality of Life (VRQOL) index, after simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections.

Study Design

Case series.

Setting

Tertiary care academic clinic.

Subjects and Methods

Fourteen subjects with abductor spasmodic dysphonia received 37 simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections for isolated abductor spasmodic dysphonia (ABSD) over a 16‐month period.

Main Outcome Measures

VRQOL index.

Results

Of the 37 injections, 33 of 37 (89%) resulted in improvement. Three injections resulted in no improvement, and one injection resulted in a worse VRQOL. The overall VRQOL mean improvement was 19.8 (range 5–53), with an average pre/postinjection VRQOL interval of 36 days (range 21–45 days).

CONCLUSIONS

Simultaneous bilateral posterior cricoarytenoid muscle botulinum injections result in a statistically significant improvement in VRQOL index scores for a high percentage of ABSD patients, thus improving patient quality of life.
Interexaminer agreement of Friedman tongue positions for staging of obstructive sleep apnea/hypopnea syndrome
Authors: Friedman Michael , Soans Rohit , Gurpinar Berk , Lin Hsin‐Ching , Joseph Ninos J.
Published: August 2008

Objective

To determine if strong interexaminer agreement exists in identifying Friedman tongue positions (FTPs) for staging of obstructive sleep apnea/hypopnea syndrome (OSAHS).

Study Design and Methods

Twenty‐six digital video clips of oropharyngeal examinations were prepared to demonstrate FTPs I through IV. Specific parameters for each FTP were provided to 126 examiners (otolaryngology residents, attendings, and fellows). The video clips were then presented to the examiners to determine the FTP. Kappa statistical analysis was used to evaluate the degree of intergrader agreement or disagreement.

Results

A generalized kappa statistic of 0.8 is considered the upper limits of substantial agreement. Thus, the overall kappa value (0.82) as well as all the subgroup kappa values for attendings (0.84), fellows (0.87), and residents (0.84) represented “Very good” agreement.

Conclusion

The strong interexaminer correlation of FTP demonstrated by this study indicates that FTP may be a useful adjunct in describing hypopharyngeal anatomy in patients with OSAHS.

© 2008 American Academy of Otolaryngology‐Head and Neck Surgery Foundation. All rights reserved.
Clinical experience with symptomatic superior canal dehiscence in a single neurotologic practice
Authors: Teixido Michael T. , Artz Gregory J. , Kung Brian C.
Published: August 2008

Objective

To discuss the range of signs and symptoms of patients with superior canal dehiscence syndrome identified in a single neurotologic practice.

Study Design

Retrospective chart review of 35 patients diagnosed with superior canal dehiscence from April 2000 to June 2007.

Results

All patients had evidence of superior canal dehiscence on computed tomography. These 35 patients represented 0.56% of new patients seen over a five‐year period. The incidence of clinical symptoms and signs is compared to other published series. The mean vestibular evoked myogenic potential thresholds of affected ears are significantly lower than the mean vestibular evoked myogenic potential thresholds of unaffected ears. To date, 5 of 35 patients have undergone transmastoid occlusion of the superior semicircular canal with significant improvement in clinical symptoms in 4 of 5 cases.

Conclusion

Not all patients with a diagnosis of superior canal dehiscence syndrome will have classic symptoms and signs. A high index of suspicion with careful clinical examination and properly performed ancillary testing is required to confirm this diagnosis.

© 2008 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.
Use of computerized manometry for the detection of pharyngoesophageal spasm in tracheoesophageal speech
Authors: Chone Carlos Takahiro , Seixas Vinicius O. , Paes Lucia A. , Gripp Flavio M. , Teixeira Cristiane , Andreollo Nelson A. , Spina Ana L. , Quagliato Elizabeth , Barcelos Irene K.H. , Crespo Agricio N.
Published: August 2008

Objective

To evaluate the utility of computerized manometry (CM) to identify pharyngoesophageal segment (PES) spasm during tracheoesophageal speech.

Study Design

Prospective clinical, controlled study.

Subjects and Methods

Intraluminal pressures of the PES were collected in 12 tracheoesophageal speakers without spasm and 8 tracheoesophageal speakers with PES spasm before and after localized injection of botulinum toxin to the PES. All subjects underwent voice analysis and videofluoroscopy in addition to CM before and after treatment.

Results

All tracheoesphageal speakers with PES spasm presented with mean intraluminal pressures greater than 16 mmHg (mean, 25.36 mmHg). In contrast, mean intraluminal pressures of subjects without spasm was 11.76 mmHg (P < 0.05). The negative predictive value associated with the use of 16 mmHg as a threshold value for spasm was 100%.

Conclusion

CM is a clinically useful tool to aid in speech rehabilitation for tracheoesophageal speakers. Intraluminal pressures of greater than 16 mmHg was highly predictive for PES spasm.

© 2008 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.
The changes of MRSA infections in chronic suppurative otitis media
Authors: Park Moo Kyun , Jung Myung Ho , Kang Hee Joon , Woo Jeong‐Soo , Lee Heung‐Man , Jung Hak Hyun , Hwang Soon Jae , Chae Sung Won
Published: August 2008

Objectives

To investigate the epidemiologic and microbiological characteristics of community‐acquired methicillin‐resistant Staphylococcus aureus (CA‐MRSA) and hospital‐acquired methicillin‐resistant Staphylococcus aureus (HA‐MRSA) infections in the otorrhea of chronic suppurative otitis media (COM) patients.

Design

Retrospective study of patients with newly identified MRSA infections from January 1998 through December 2006. A total of 2773 patients with a diagnosis of COM were included in this study. An antibiotic sensitivity test was performed for each isolate.

Results

The prevalence of MRSA in COM was 4.9 percent (137 of 2773 patients). The proportion of CA‐MRSA rose from 0.7 percent in 1998 to 11.4 percent in 2006. However, the proportion of HA‐MRSA did not change significantly, from 0.7 percent in 1999 to 1.3 percent in 2006. All of the CA‐MRSA strains identified in our study were susceptible to trimethoprim/sulfamethoxazole (TMP/SMX). Rifampin susceptibility was also noted in 90 percent of the cases.

Conclusions

CA‐MRSA infections have risen dramatically in the past decade. CA‐MRSA and HA‐MRSA in COM differed in both clinical and microbiological aspects. © 2008 American Academy of Otolaryngology‐Head and Neck Surgery Foundation. All rights reserved.
Cat‐scratch disease of the head and neck in a pediatric population: Surgical indications and outcomes
Authors: Munson Patrick D. , Boyce Thomas G. , Salomao Diva R. , Orvidas Laura J.
Published: August 2008

Objective

To identify the presentation of pediatric patients with head and neck manifestations of cat‐scratch disease, one of the most common causes of subacute or chronic lymphadenitis in children, and to determine surgical indications and outcomes.

Study Design

Case series.

Subjects and Methods

All pediatric patients from infancy to age 19 years who presented with clinical symptoms of cat‐scratch disease and had an IgG serological test result of more than 1:128 for Bartonella henselae.

Results

Nine patients had cat‐scratch disease of the head and neck. Median age at presentation was 4 years; median time from symptom onset to presentation was 20 days. Six (67%) children underwent surgical procedures, and median time from presentation to surgical procedure was 43 days.

Conclusion

Despite conservative treatment, a minority of pediatric patients with cat‐scratch disease may require surgical drainage of abscess and removal of lymph nodes. Surgical treatment provides tissue for diagnosis, is generally well tolerated, affords improved recovery, and has minimal complications. © 2008 American Academy of Otolaryngology‐Head and Neck Surgery Foundation. All rights reserved.
A comparison of the effects of botulinum toxin A and steroid injection on nasal allergy
Authors: Yang Tae Yong , Jung Yoon Gun , Kim Young Hyo , Jang Tae Young
Published: August 2008

Objectives

To compare the effects of botulinum toxin A (BTX‐A) with intranasal steroid injections on nasal symptoms in patients with allergic rhinitis (AR).

Study Design

A randomized, placebo‐controlled, single‐blinded clinical trial (patients were blinded).

Material and Methods

Thirty‐nine patients were included in the study. AR was diagnosed by means of history, clinical examination, and skin prick test. Patients were randomly divided into three subgroups as follows: in group A, 25 units of BTX‐A were injected into each inferior turbinate (total 50 units); in group B, 1 cc (20 mg/mL) of triamcinolone was injected into each inferior turbinate; and in group C, 1 cc of isotonic saline was injected as placebo. The symptoms of AR were scored by the patient on a six‐point scale.

Results

At all time points, group A was significantly better than group C. In the nasal obstruction and rhinorrhea scores, group A was significantly better than group B after 8 weeks.

Conclusion

BTX‐A may provide better AR symptom relief in terms of duration and degree than a steroid injection.

© 2008 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.
The Discovery of Common-Sense Psychology
Authors: Reisenzein Rainer , Rudolph Udo
Published: August 2008

This special issue of Social Psychology commemorates the 50th anniversary of Fritz Heider’s 1958 book The Psychology of Interpersonal Relations. The contributions to the special issue address the history and current state of attribution research, or illustrate contemporary research in the field. The historical articles document that Heider’s analysis of causal attribution and of common-sense psychology was significantly influenced by his academic teachers Alexius Meinong and Ernst Cassirer. We distinguish between the mainstream reception of Heider’s book, which has given rise to an extensive empirical research program, and a minority reception by authors who emphasized aspects of Heider’s thinking not well represented in mainstream psychology. Currently, there are indications of a “back to Heider” movement in social psychology. This new phase of attribution research is inspired by a fresh reading of Heider’s book, and is marked by an interdisciplinary orientation. The articles illustrating current attribution research address both classic and novel topics: the causality implicit in language, the role of causal attribution in hindsight bias, the justification of actions, and the attribution of mistakes in organizational contexts.
Fritz Heider – My Academic Teacher and His Academic Teachers
Authors: Schönpflug Wolfgang
Published: August 2008

In the summer of 1958 at the University of Kansas, Heider offered a seminar based on the galley proofs of his forthcoming book The Psychology of Interpersonal Relations. Personal memories of the seminar are reported, and an attempt is made to reconstruct the European background of Heider’s work. It is argued that the warm reception of Heider’s book was partly the result of his revival of philosophical ideas that had served as starting points for psychology, but had since been abandoned. Especially with respect to the analysis of naive concepts, complex structures, and causal attributions, Heider owes an intellectual debt to his mentor Alexius Meinong at the University of Graz, and to Ernst Cassirer at the University of Hamburg. Commemorating the publication of Heider’s book can, therefore, also be regarded as an implicit tribute to the European philosophy of the late 19th and early 20th century.
From Heider to Psycho-Logic
Authors: Smedslund Jan
Published: August 2008

Fritz Heider pointed out that common-sense psychology contains many analytic propositions. This discovery opened up the possibility that many scientific psychological hypotheses are also analytic and that the ensuing studies are pseudoempirical, that is, they only test the truth of auxiliary hypotheses. This appears to frequently be the case. The reason may be that hypotheses involving semantically related variables are plausible but nonempirical, whereas empirical hypotheses involving logically independent variables do not make sense. The discovery of numerous analytic propositions in common-sense psychology led to construction of an axiomatic system called psycho-logic. The undefined concepts of this system are semantic primitives assumed to be common to all human languages. Hence, Heider’s discovery of analytic propositions of common-sense psychology led to a new view of psychology.